How to read a Kaiser Permanente small group renewal

This page covers what is specific to Kaiser Permanente. The checks that apply to any carrier are in how to read a carrier rate sheet. Kaiser Permanente runs separate regions with separate documents. Most of the detail below comes from California's January 2026 small business guidelines, and each point says which region it applies to. Sources are listed under Sources.

What you'll see on a Kaiser Permanente renewal

• A renewal notice on a fixed schedule (California). The renewal date is always the first of the month, 12 months after the contract effective date. The notice goes to groups at least 60 days before the renewal date and to brokers about 75 days before. Renewal contracts are issued within 60 days after the renewal date [1].
• The renewal online. Kaiser Permanente's employer site says renewals can be managed online when available, 75 days before the renewal effective date. Employers can see the rates they will pay if they change nothing, compare other plans and submit changes [4]. The California renewal page lists the year's Small Business Guidelines and Plan Highlights as the renewal support documents [3].
• Alternate renewals (Mid-Atlantic and Georgia). Kaiser Permanente's broker guide puts renewals in the broker portal from 75 days before the renewal date. Brokers download the renewal packet there, generate alternate renewal quotes and submit them [5].
• A redesigned packet (Northwest). From January 2026 small group renewals, the Northwest renewal packet shows current enrollment only, not last year's renewal census. Plan changes go on a renewal changes form at the back of the packet, due 15 days before the effective date. Member-level age rates for Southwest Washington plans move to business.kp.org [6]. Kaiser Permanente's Oregon renewal page asks for benefit changes by the 15th of the month before renewal [7].

Walking through the document

Plan names (California)

California plan names put the metal level, the actuarial value, the plan type, then the deductible and the primary care copay. "Gold 80 HMO 250/35 PCP + Child Dental" is a $250 deductible with a $35 primary care visit. "Bronze 60 HMO 5800/60 PCP" is a $5,800 deductible with a $60 visit. HSA-qualified plans swap the copay for coinsurance: "Gold 80 HDHP HMO 1900/15% PCP" [2]. Two suffixes matter. "ALT" marks plans Kaiser Permanente developed itself. An asterisk marks plans also sold through Covered California for Small Business and CaliforniaChoice [2].

The Northwest uses a different convention: state, metal, then the deductible. Examples are "KP OR Gold 1000", "KP OR Gold HSA 1800" and "KP OR Gold Added Choice 2 OOA 500". Added Choice is a point-of-service plan with three levels of cost sharing: KP Select providers, PPO providers and non-participating providers [8]. A name tells you where to look. It does not replace the SBC.

Plan families that are not plain HMO

California's KP Plus plans allow up to 10 out-of-network physician visits or outpatient services and 5 prescription fills a year, with specialty drugs excluded out of network. California also has a deductible HMO paired with an HRA [2]. In Colorado, the narrower KP Select network now covers Metro Denver as well as Colorado Springs for fully insured groups of 1 to 50 [9].

Rating basis (California)

Kaiser Permanente says metal-plan rates use two factors, rating area and member age, and that claims and utilization are not used [1]. Other rules from the same guidelines:

• The rating area comes from the business's physical address. A business outside California is rated in rating area 4.
• Age bands are 0–14, then single years to 63, then 64 and over. A family pays for at most the three oldest children under 21.
• Each member's rate is set at the contract effective date and updated at renewal.
• Rates are guaranteed for 12 months, and final rates follow actual enrollment.
• Grandfathered (non-metal) plans add a risk adjustment factor between 0.90 and 1.10. It cannot rise more than 10 points at a renewal.

One more rule changes the arithmetic. Kaiser Permanente contracts in California as two regions, Northern and Southern. An employer with employees enrolled in both gets two contracts, with separate group ID numbers and separate rates [1].

Dental, chiropractic and acupuncture

In California, HMO members' child dental is a separate plan underwritten by Delta Dental of California. HMO rates carry its cost only in the 0–18 age bands, while PPO rates include child dental in the overall rate. A supplemental family dental plan can be added only at initial enrollment or at renewal, and then every Kaiser Permanente medical subscriber and dependent must take part. Chiropractic and acupuncture are included in most metal plans. For HMO plans they are administered by American Specialty Health Plans of California [1].

Kaiser Permanente Level Funded

Kaiser Permanente Level Funded is offered in Colorado, Georgia, Maryland, Virginia and Oregon, to groups of 5 to 100 enrolled employees [10]. The monthly payment covers administrative fees, stop-loss insurance and the maximum claims liability. Kaiser Permanente Insurance Company administers the plan and underwrites the stop-loss. Employers choose a 50% or 67% surplus share, and a surplus credit is paid only if the employer renews. A group can offer up to six plans, and gets monthly claims reports, including a high-cost claims report [11].

The surplus share and the claims liability belong in the comparison next to the monthly figure. Stop-loss terms on a level-funded quote and level-funded vs fully insured cover how.

Pitfalls when comparing it with another carrier's quote

1. Options the employer cannot combine. In California, Kaiser Permanente can be offered alongside another carrier only if that carrier's plan is fully insured, age-rated, ACA-compliant small group coverage. A level-funded or composite-rated plan is allowed only where the other carrier covers out-of-state employees [1]. Before building a side-by-side that offers both, check that the employer could actually buy that combination.
2. Unequal contributions. When Kaiser Permanente is offered alongside another carrier, contributions must be equal across carriers. The employer must pay at least 50% of the employee premium on the lowest-priced Kaiser Permanente plan [1]. A comparison that models a different contribution for each carrier describes something the employer cannot offer.
3. Names read in a different order. Kaiser Permanente California names give the deductible first, then the copay: 250/35 is a $250 deductible and a $35 visit. Anthem's California names give the copay first, then the deductible and coinsurance (see how to read an Anthem renewal). Two names that look alike can mean opposite things.
4. Network, not deductible. Most Kaiser Permanente plans are HMOs on its own integrated network. A lower deductible beside another carrier's PPO is not the same benefit. Put the network on the comparison as its own row.
5. Embedded benefits priced elsewhere. Child dental, chiropractic and acupuncture come inside most California Kaiser Permanente metal plans. Another carrier may price them as riders or separate lines. Compare totals with the same benefits on both sides.
6. Two regions, two rates. A statewide employer has a Northern and a Southern California contract. Compare each region's rates separately rather than averaging them.

Checklist

1. Note when the renewal arrived: in California, groups get it at least 60 days out and brokers about 75 days out.
2. Confirm the rating area: a California rate depends on the business's physical address, and out-of-state businesses are rated in area 4.
3. Check whether the group has members in both Northern and Southern California, which means two contracts and two sets of rates.
4. Read each plan name for its deductible and copay, then confirm them on the SBC.
5. Re-age every member: California metal-plan rates are age-based and updated at renewal.
6. If Kaiser Permanente sits beside another carrier, check that the other plan is allowed alongside it and that contributions are equal.
7. List child dental, family dental and chiropractic or acupuncture separately, with who administers each.
8. For Level Funded, record the surplus share (50% or 67%) and the stop-loss terms, not just the monthly payment.