Kaiser Permanente now offers more solutions for small business groups. Running a small business requires maximum flexibility. With more plan choices, you and your employees can find what you need. Here’s a look at what’s new for your small business clients as of July 1, 2008:
   • A $5 million lifetime maximum for the $40/$1,000 PPO offering — up from
      $2 million.
   • A new HSA-compatible PPO plan — the $40/$2,500 PPO gives employees more
      control over their health. (Must be offered with at least one copayment plan
      as part of a multiple plan offering.)

Posted: July 31st, 2008 under California Group.
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A customer asked, “On the $1500 Deductible Plan, why is the deductible not the same as the out-of-pocket maximum?” The short answer is simply that this is the way the plan is set up. On many deductible plans, the annual deductible and the out-of-pocket maximum are different. Usually, you will reach a deductible first and later after paying additional copayments you will reach the out-of-pocket maximum. Of the Kaiser California Individual Plans, the $0/$1500 and the $0/$2700 Deductible Plans with HSA are the only two deductible plans where you reach your deductible and your out-of-pocket maximum at the same time. At this point, both have been satisfied and you have 100% coverage for the remainder of the calendar year.

The $1500 Deductible Plan is different. This plan has an annual deductible of $1500 and an annual out-of-pocket maximum of $3500. Consequently, this plan has three distinct stages:

1. Before the deductible is met

2. After the deductible is met

3. After the annual out-of-pocket maximum is met

Richness of coverage increases as you go from Stage 1 to Stage 3. In Stage 1, doctor/specialist visits are covered with a $30 copay and prescription drugs are covered with a $10 copay for generic and a $35 copay for brand name, but you pay the full member price for most other benefits. In Stage 2, many benefits are added with varying copays (See Plan Highlights for copay dollar amounts.). In Stage 3, you have 100% coverage because the annual out-of-pocket maximum has been reached.

Posted: July 28th, 2008 under California Individual.
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People often ask, “Is it less expensive to get group health insurance?” Actually, at times you can save money by going with individual/family coverage. For many small groups, husband-wife businesses and self-employed individuals, we recommend getting Individual and Family Quotes as well as Small Business Quotes. Compare and contrast rates and benefits on both types in order to find the best coverage and pricing that is right for you.  

Depending on factors such as rate area, age and number of people enrolling, you may find more affordable coverage on an Individual and Family Plan. Often, parents save money by removing children from their group plan and putting the kids on an individual plan. Also, children over age 18 (or 23 for full time students) may no longer be eligible to be on your group plan. In this case, they may be forced to switch over to an individual plan.

Note: Individual and family applications include a medical questionnaire and enrollment may be denied due to pre-existing health conditions. Group coverage, on the other hand, does not include a medical questionnaire and is issued automatically as long as your business qualifies. 

Posted: July 25th, 2008 under Kaiser Permanente.
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The Deductible is not required to be paid in full at the start of coverage. As you use medical services and pay the full member price for them, that amount will be applied toward the deductible. For example, you would pay around $75 for a regular doctor visit. That payment would go toward your deductible. You do not have to pay $1500 the first time you go to see your doctor. However, if your visit includes more serious care such as surgery, hospitalization or an ambulance ride, your out-of-pocket expenses would likely reach the $1500 deductible. Often, you will not reach the deductible in a calendar year if you are healthy and do not use the medical services very often. Visit KaiserQuotes.com for more information.

Posted: July 24th, 2008 under California Individual.
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We recommend the $1500 deductible plan or the $0/$1500 deductible HSA plan. Both plans have reasonably low monthly premiums. The first plan offers you the benefit of being able to see a physician and obtain prescription drugs for a low copay (before the deductible is met). The benefit of the $0/$1500 HSA Plan is that if you are hospitalized, you only pay a max of $1500 out-of-pocket expenses in that year (not including your monthly premium charges). With this plan, once you reach your deductible you have 100% coverage for the remainder of the calendar year (January to December). If the 19-year-old is female and may be getting pregnant, I’d recommend the $25 Copayment Plan, which offers the richest maternity coverage of the Kaiser Permanente

Posted: July 21st, 2008 under California Individual.
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The copayment is the fixed dollar amount you pay for a service. The “Dr. copay” would be the amount you pay to see a physician. In regards to the term ”after deductible”, this is the fixed dollar amount after your annual deductible is met. Many people then ask, “How much is a doctor’s visit or other services before my deductible is met?” A doctor’s visit would range from around $75-$125. As for other services the amount would be determined based on the variables involved. If you are interested, benefits specialists to have access to sample fee lists that give estimated prices for common procedures. Call 1-877-752-4737 for live support.

Posted: July 14th, 2008 under California.
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The copayment is the fixed dollar amount you pay for a service. The “Dr. copay” would be the amount you pay to see a physician. In regards to the term ”after deductible”, this is the fixed dollar amount after your annual deductible is met. Many people then ask, “How much is a doctor’s visit or other services before my deductible is met?” A doctor’s visit would range from around $75-$125. As for other services the amount would be determined based on the variables involved. If you are interested, benefits specialists to have access to sample fee lists that give estimated prices for common procedures. Call 1-877-752-4737 for live support.

Posted: July 14th, 2008 under California.
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We are very excited to announce that as of July 1, 2008, Piedmont Newnan and Piedmont Mountainside Hospitals were added to the Kaiser Georgia commercial networks. However, be aware that these hospitals do not participate in the Senior Advantage product.

You may visit the Piedmont Newnan Hospital web page by going to NewnanHospital.org. This facility is located at 60 Hospital Road; Newnan, GA 30263. The phone number is 770-253-1912 and the fax number is 770-254-3406.

Click PiedmontMountainsideHospital.org to visit the Piedmont Mountainside Hospital website. This facility is located at 1266 Highway 515 South; Jasper, Georgia 30143. The phone number is 706-692-2441.

Posted: July 11th, 2008 under Georgia.
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A customer asked about the “Annual Deductible”. What does “annual deductible” mean? Do I have to pay the annual deducible every year? And, do I have to pay this in addition to my monthly premium? The deductible is the amount you pay out of your pocket before certain benefits become available. By “annual”, we mean that you can satisfy the deductible in a calendar year, January to December. Also, it is important to be aware that your deductible will refresh each year on January 1st. The deductible can be met in a year, but is not required. Often, if you are healthy you will not reach your deductible.  

The out-of-pocket expenses you pay when working toward your deductible are over and above your monthly premium. Before and after the deductible is met, you still must pay the monthly charge to keep the health insurance policy in force. If your deductible is $1500 and you pay $1500 in out-of-pocket expenses during the year, that deductible has been met and increased coverage benefits kick in. With some plans, once the deductible is met, you pay copayments. Other plans like the $0/$1500 Deductible Plan with HSA offer 100% coverage once the deductible is met, meaning there is no additional charge for doctor visits, prescription drugs, hospitalization, etc.

Posted: July 8th, 2008 under Kaiser Permanente.
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A customer asked about the “Annual Deductible”. What does “annual deductible” mean? Do I have to pay the annual deducible every year? And, do I have to pay this in addition to my monthly premium? The deductible is the amount you pay out of your pocket before certain benefits become available. By “annual”, we mean that you can satisfy the deductible in a calendar year, January to December. Also, it is important to be aware that your deductible will refresh each year on January 1st. The deductible can be met in a year, but is not required. Often, if you are healthy you will not reach your deductible.  

The out-of-pocket expenses you pay when working toward your deductible are over and above your monthly premium. Before and after the deductible is met, you still must pay the monthly charge to keep the health insurance policy in force. If your deductible is $1500 and you pay $1500 in out-of-pocket expenses during the year, that deductible has been met and increased coverage benefits kick in. With some plans, once the deductible is met, you pay copayments. Other plans like the $0/$1500 Deductible Plan with HSA offer 100% coverage once the deductible is met, meaning there is no additional charge for doctor visits, prescription drugs, hospitalization, etc.

Posted: July 8th, 2008 under Kaiser Permanente.
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