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Section A
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Key Features at a Glance
Affordable coverage
that fulfills the requirments of the health care reform law.
Free in-network preventive care
with services such as annual physicals, recommended immunizations, and routine cancer screenings coverared at 100%.
Prescription drug coverage
included with each medical plan
Financial protection
through annual out-of-pocket maximums that limit the amount you'll pay each year.
Section B
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As an added bonus, Acme will contribute to your HSA - $500 for employee-only coverage or $1,000 if youcover dependents. With this plan, you can see any provider you wish, but you will pay less when you stay in network.
Static Callout
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- Prescriptions are shipped to you for free — no waiting in line at the pharmacy.
- You save money with a reduced cost for a three-month supply.
- You can set up automatic refills.
Static Callout
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- Prescriptions are shipped to you for free — no waiting in line at the pharmacy.
- You save money with a reduced cost for a three-month supply.
- You can set up automatic refills.
Dropdown Callout
A Health Care Flexible Spending Account (FSA) lets you take advantage of tax-free savings when paying for health care. But, be sure to plan your FSA contributions carefully: you can only carry over up to $570 of unused money in your FSA to the next year; you will forfeit any remaining amount above $570.
Dropdown Callout
A Health Care Flexible Spending Account (FSA) lets you take advantage of tax-free savings when paying for health care. But, be sure to plan your FSA contributions carefully: you can only carry over up to $570 of unused money in your FSA to the next year; you will forfeit any remaining amount above $570.
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H3 Header
H4 Header
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Plan Comparison Table
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Kaiser California HMO Plan
In-network
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Kaiser California HMO Plan
Out-network
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Kaiser Northwest HMO Plan
In-network
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Kaiser Northwest HMO Plan
Out-network
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Kaiser California HMO Choice Plan
In-network
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Kaiser California HMO Choice Plan
Out-network
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Kaiser Northwest HMO Choice Plan
In-network
|
Kaiser Northwest HMO Choice Plan
Out-network
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|---|---|---|---|---|---|---|---|---|
| HSA features | ||||||||
| HSA-eligible | Yes | Yes | No | No | No | No | No | No |
| Company contribution to HSA | $500 | $500 | None | None | None | None | None | None |
| Annual deductible (individual/family) | $2,850/$5,700 | $5,700/$11,400 | $900/$1,800 | $1,800/$3,600 | $750/$1,500 | $1,500/$3,000 | $400/$800 | N/A |
| Coinsurance | You pay 30%, plan plays 70% | You pay 20%, plan plays 80% | You pay 10%, plan plays 90% | You pay 10%, plan plays 90% | You pay 40%, plan pays 60% | You pay 40%, plan pays 60% | You pay 40%, plan pays 60% | N/A |
| Annual out-of-pocket maximum (individual/family) | $5,500/$11,000 | $3,000/$6,000 | $3,000/$6,000 | $2,000/$4,000 | $11,000/$22,000 | $6,000/$12,000 | $6,000/$12,000 | N/A |
| Preventive care | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing | Covered at 100% in-network, so you pay nothing |
| Office visit | ||||||||
| Primary care visit | You pay 30% after deductible | You pay 20% after deductible | $30 copay | $20 copay | You pay 40% after deductible | You pay 40% after deductible | You pay 40% after deductible | N/A |
| Specialist visit | You pay 30% after deductible | You pay 20% after deductible | $40 copay | $20 copay | You pay 40% after deductible | You pay 40% after deductible | You pay 40% after deductible | N/A |
| Behavioral health visit | You pay 30% after deductible | You pay 20% after deductible | $40 copay | $20 copay | You pay 40% after deductible | You pay 40% after deductible | You pay 40% after deductible | N/A |
| Other visits | ||||||||
| Telehealth visit In-network only |
You pay 30% after deductible | NA | You pay 20% after deductible | NA | $20 copay | NA | $20 copay | NA |
| Urgent care visit | You pay 30% after deductible | You pay 20% after deductible | $50 copay | $30 copay | You pay 40% after deductible | You pay 40% after deductible | You pay 40% after deductible | N/A |
| Emergency room visit (in- and out-of-network) | You pay 30% after deductible | You pay 30% after deductible | You pay 20% after deductible | You pay 20% after deductible | $150 copay | $150 copay | $50 copay | $50 copay |
| Prescriptions: Your costs: 30-day supply (retail pharmacy) | ||||||||
| Generic | 30% after deductible (deductible waived for some medications) | 30% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% (min $10/max $20)** | 20% (min $10/max $20)** | $10** | $10** |
| Formulary | 30% after deductible (deductible waived for some medications) | 30% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% (min $25/max $50)** | 20% (min $25/max $50)** | $30** | $30** |
| Nonformulary | 30% after deductible (deductible waived for some medications) | 30% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 45% (min $40/max $80)** | 45% (min $40/max $80)** | $60** | $60** |
| Prescriptions: Your costs: 90-day supply (mail order or retail pharmacy) | ||||||||
| Generic | 30% after deductible (deductible waived for some medications) | 30% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 30% (min $25/max $50)** | 30% (min $25/max $50)** | $25** | $25** |
| Formulary | 30% after deductible (deductible waived for some medications) | 30% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 30% (min $62.50/max $125)** | 30% (min $62.50/max $125)** | $75** | $75** |
| Nonformulary | 30% after deductible (deductible waived for some medications) | 30% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 20% after deductible (deductible waived for some medications) | 45% (min $100/max $200)** | 45% (min $100/max $200)** | $150** | $150** |
Section D
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