Kaiser Permanente Georgia Individual Department and Kaiser Permanente Colorado Individual Department allows applicants to have the option of doing a pre-screen before they actually submit an application. This allows them the convenience of finding out if it’s worth filling out an entire application. In some cases, the pre-existing health condition would be cause for an automatic denial. By doing a pre-screen this individual can find out before filling out the application so as not to waste time filling out a long application when the ultimate result will be a denial of health insurance coverage.

If an applicant has a pre-existing they would like to be pre-screened for, they may send an email or handwritten notice with the following information:

1. Applicants name
2. Condition
3. Date of diagnoses
4. List of prescriptions including dosage and frequency
5. Signature and date

The Medical Review team will evaluate the situation and notify the applicant or the broker if the applicant will qualify for the coverage. They will also disclose whether or not there will be a surcharge on the monthly premium for the health insurance coverage. If the pre-screen says that the applicant is still eligible despite the pre-existing condition, that applicant will need to then complete and submit the individual and family application for health insurance coverage.

Posted: May 28th, 2010 under Georgia Individual, Colorado Individual.
Comments: none

Kaiser Permanente’s online application, KPAOL, is undergoing upgrades this week. Due to these upgrades, the medical questions on any incomplete applications will be erased at 9:00 PM Pacific Standard Time on May 7, 2010. Anyone who has started an individual health insurance online application is encouraged to complete it by May 6th in order to avoid having their medical questions erased. Accounts with incomplete applications will still exist after May 7th and customers may still log back into their accounts to complete the application. However, if they have begun answering the medical questions, the answers to those questions will be erased, and they will have to re-enter the information in order to submit their application.

The official deadline is May 8th to submit applications for a May 15th effective date. However, we recommend submitting your application by May 7th before 9:00 PM Pacific Standard Time to avoid any trouble that may be caused due to the system upgrade on the Kaiser Permanente Apply Online System. We apologize for the inconvenience.

Posted: May 4th, 2010 under California Individual, Colorado Individual.
Comments: none

Existing groups with Kaiser Permanente Colorado Health Insurance will be receiving the following information by mail shortly regarding premium credits:

Last year, Kaiser Permanente reached an agreement with the Colorado Division of Insurance (DOI) to provide $155 million in financial relief to our customers. Half of that amount ($77.5 million) was distributed to subscribers in 2009, and other half will be distributed this year. The financial relief will be in the form of premium credits, enhanced benefits to new and renewing employers and individual customers, as well as financial assistance to support the health care needs of lower income members. Individual Medicare members (not group retirees) will receive all of their relief in benefits. In a few days, Kaiser Permanente Colorado will be sending a letter to all eligible employer groups with information regarding the premium credit process.

How much will business groups receive?
The amount of the premium relief checks will not be known until early May.
• The final phase of the premium relief program will be based on a snapshot of membership taken on April 30, 2010.
• In 2009, employers received $287 per non-Medicare subscriber. Employers who offered group Medicare benefits to employees received $212 per enrolled Medicare subscriber.*
• Because Kaiser Permanente’s membership has grown in the past year, and the pool of eligible subscribers has expanded, the amount per subscriber will be smaller this year.
* For Group Medicare, the relief is a combination of benefits and a premium credit less than the commercial credit.

Why is the check going to the employer?
Employers offering Kaiser Permanente health coverage to employees are eligible for this credit. The agreement with the DOI provides for payment to be made directly to employers as principal contributors to premium payments. However, employers should consult with their advisers to evaluate any legal obligations they may have, including, but not limited to, any tax requirements and any obligations under ERISA, COBRA, state law, or any other applicable law about passing any portion or all of this credit on to current or former employees who contribute(d) to the premium.

When will groups receive the premium credit?
The premium credit payment will be based on their company’s eligibility as of April 30, 2010 and will be paid directly to the group in late May or early June 2010. This is about two to four weeks later than last year’s distribution, so that we can ensure greater accuracy and compliance with accounting rules.

What happens next?
Groups will receive another letter in May, announcing the amount of the refund per suscriber.
If you have questions or need to update their records, please call toll free 1-866-989-0272, 9 a.m. to 4 p.m., weekdays, or e-mail PremiumCredit-Queries@kp.org.

Posted: April 8th, 2010 under Colorado.
Comments: none

Kaiser Permanente Colorado for Individuals and Families switched over to a 21-page application on July 17th. They’ll honor the old application for 1 month, until August 18th.

The old application was nine pages and basically the same as Kaiser Permanente’s old California application. The new application for Colorado is modeled after the new California application that Kaiser Permanente California switched to in October of 2008.

Customers Have a Love/Hate Relationship with the New Application
Many customers are frustrated that the application has become so much longer. The old application had 13 medical history questions; the new application has 29. The size of the application has more than doubled in size. Customers complain that the application is tedious and difficult to get through. On the positive side, customers have the hope that the new application will speed up processing time.

Underwriters Love It
Many underwriters felt like the old application just didn’t give them enough information to approve or deny applications. As a result, they often had to do a lot more research, checking medical records, calling applicants, etc. This increased their work load and slowed down the processing of the applications so customers had to wait longer. This more lengthy application will help underwriters be more successful at approving and denying applications accurately and according to the underwriting guidelines.

Posted: July 27th, 2009 under Colorado Individual.
Comments: none

When looking for Kaiser Permanente medical insurance plans in Colorado, there are some key things to consider in order to find the right plan for you and your family.

1. Do you want a plan without a deductible?
If you don’t want a plan with a deductible, then you would want to go with the $35 Copayment Plan. There are three copayment plans offered for Colorado individuals, but the other two plans offer less coverage and the rates are usually about the same. The $35 Copayment Plan includes prescription drug coverage, doctor visits for a copayment of $35 and a fairly low out-of-pocket maximum ($3,000 for individual/$7,500 for family).

2. Do you want a plan with a low out-of-pocket maximum?
If you’re like me, you really want to know what your worst case scenario would be in one year. I ask certain questions. What if I had to have surgery or I was hospitalized for a long time? I don’t mind covering the small stuff out of my own pocket, but I want to know that if something terrible happens, I’m not going to get wiped out financially. If you’re in this scenario, I highly recommend the $2,000 Deductible Plan with HSA. This plan has the lowest out-of-pocket maximum of all the plans. After you pay out $2,000 in one year, you have 100% coverage for the rest of the year. That means that for the rest of the year you only have to pay your monthly premium, and everything else is covered for free. I like that!

3. Are you looking for a cheap health insurance plan?
If you just want a low monthly premium on your medical insurance plan, there are a couple ways you can go. The cheapest health plan is the $5,000 Deductible Plan without Rx. This plan covers doctor visits right away for $30, which is really nice. You get such a low premium because there is no prescription drug coverage and because the deductible and out-of-pocket maximum are so high. However, if you really want prescription drug coverage, for a little bit more on your monthly premium, you can bump up your plan selection to the $3,000 Deductible Plan. Another option is to get the $5,000 Deductible Plan with HSA. This plan is around the same price as the two I just mentioned, but it has a lower out-of-pocket maximum by far. Once you reach $5,000 in one year, you have 100% coverage for the rest of the year, and you have the option of opening a health savings account which allows you to deduct many of your medical expenses from your federal taxes.

Posted: June 25th, 2009 under Colorado Individual.
Comments: none

When looking for Kaiser Permanente medical insurance plans in Colorado, there are some key things to consider in order to find the right plan for you and your family.

1. Do you want a plan without a deductible?
If you don’t want a plan with a deductible, then you would want to go with the $35 Copayment Plan. There are three copayment plans offered for Colorado individuals, but the other two plans offer less coverage and the rates are usually about the same. The $35 Copayment Plan includes prescription drug coverage, doctor visits for a copayment of $35 and a fairly low out-of-pocket maximum ($3,000 for individual/$7,500 for family).

2. Do you want a plan with a low out-of-pocket maximum?
If you’re like me, you really want to know what your worst case scenario would be in one year. I ask certain questions. What if I had to have surgery or I was hospitalized for a long time? I don’t mind covering the small stuff out of my own pocket, but I want to know that if something terrible happens, I’m not going to get wiped out financially. If you’re in this scenario, I highly recommend the $2,000 Deductible Plan with HSA. This plan has the lowest out-of-pocket maximum of all the plans. After you pay out $2,000 in one year, you have 100% coverage for the rest of the year. That means that for the rest of the year you only have to pay your monthly premium, and everything else is covered for free. I like that!

3. Are you looking for a cheap health insurance plan?
If you just want a low monthly premium on your medical insurance plan, there are a couple ways you can go. The cheapest health plan is the $5,000 Deductible Plan without Rx. This plan covers doctor visits right away for $30, which is really nice. You get such a low premium because there is no prescription drug coverage and because the deductible and out-of-pocket maximum are so high. However, if you really want prescription drug coverage, for a little bit more on your monthly premium, you can bump up your plan selection to the $3,000 Deductible Plan. Another option is to get the $5,000 Deductible Plan with HSA. This plan is around the same price as the two I just mentioned, but it has a lower out-of-pocket maximum by far. Once you reach $5,000 in one year, you have 100% coverage for the rest of the year, and you have the option of opening a health savings account which allows you to deduct many of your medical expenses from your federal taxes.

Posted: June 25th, 2009 under Colorado Individual.
Comments: none