In California Kaiser Permanente will be offering ten different health plans for 2016. Six of the plans are the standard benefit design that will be offered through the Covered California Marketplace. Four of the plans are of a non-standard benefit design and will only be available off-exchange directly from Kaiser.
To Download 2016 plan documents visit: Kaiser ACA Health Plans
Kaiser will offer a non-standard Bronze 60 H.S.A. with a deductible of $5,500 which is higher than the standard $4,500 H.S.A. deductible. There will also be a non-standard Silver 70 H.S.A that will have a $2,700 deductible with 15% coinsurance. Another off-exchange Silver plan will be the Silver 70 1500/40 that has a $1,500 deductible and $40 office visit copayments. Finally, Kaiser will offer a $0 deductible Gold 80 Coinsurance plan that will have 20% coinsurance for high cost health care services such MRIs, outpatient surgery, and maternity. The standard Gold 80 Copay plan has set dollar amount for all those services.
Kaiser’s dental insurance will be handled by Delta Dental. There is a set copayment amount for each dental service so there are no surprises. A table of dental procedure allowances can be downloaded to review the cost of each service.
Kaiser health plans are offered either partially or completely in eighteen of the nineteen California regions. Kaiser will service the entire counties of Alameda, Contra Costa, Los Angeles SW Region 16, Orange, San Francisco, and San Mateo. They provide a zip code finder for download to check for availability in other counties. They have published and enrollment and premium rate guide for each region they offer plans.
Also available for download are the Evidence of Coverage (EOC) and Member Agreement documents. When combined with the Summary of Benefits documents you can get a complete picture of how the health plan works and the member costs associated with the health plan. There is a separate EOC for each of the non-standard off-exchange plans and the six standard benefit designed plans that can be purchased directly from Kaiser or through Covered California.
If an individual or family qualifies for an Enhanced Silver benefit design plan with reduced cost sharing, they will want to download the Silver 70 EOC with the Summary of Benefits for either the Silver 73, 87, or 94. Review and download 2016 Kaiser documents.