We’re proud to offer you the following medical plan choices, designed to help you and your family get the care you need at an affordable price. Be sure to download the mobile apps for access on-the-go.
The HDHP Plan offers health coverage with the ability to choose to visit in-network or out-of-network providers. You must satisfy a higher deductible before the carrier will begin paying toward your medical services. However, you may be eligible to enroll in a Health Savings Account (HSA) which allows you to pay for certain medical expenses with tax-free money. Find an in-network provider at anthem.com/ca.
Anthem PPO Plan offers the flexibility to choose an in-network or out-of-network provider each time you need care. Keep in mind, you will save money when you visit in-network providers. Find an in-network provider at anthem.com/ca.
Presciption drug search
This can be used for both medical plans. You can enter in the name of any drug and it will tell you how it is covered. On the result page click on the drug name and it will provider more information on how it is covered—if it needs a prior authorization or step therapy or quantity limit.
The Kaiser HMO plans are only available to employees in California and Colorado. These plans provide coverage through in-network doctors from which you will select a primary care physician (PCP) who refers you to specialists if you need them. You are responsible for copays when you receive services.
Coverage for out-of-network providers is not available with this plan. If you seek treatment from an out-of-network provider, you will be responsible for the full cost of treatment. Find an in-network provider at kp.org.
When deciding which medical plan is right for you and your family, it is important to consider the total cost of coverage. This includes what you pay in premiums and what you pay for services out of your pocket.
| Benefit | Anthem Prudent Buyer Plan | Anthem HDHP Plan | Kaiser HMO |
|---|---|---|---|
| Annual deductible to satisfy | ✔ | ✔ | X |
| Coinsurance for services | ✔ | ✔ | X |
| Copay for services | ✔ | ✔ | ✔ |
| Eligible to enroll in a Health Savings Account (HSA) | X | ✔ | X |
| Eligible to enroll in the Health Care FSA | ✔ | X | ✔ |
| Eligible to enroll in the Dependent Care FSA | ✔ | ✔ | ✔ |
| In-network coverage | ✔ | ✔ | ✔ |
| Out-of-network coverage | ✔ | ✔ | X |
| Primary Care Physician required | X | X | ✔ |
| Referrals for specialists required | X | X | ✔ |
| Company HSA contributions | X | ✔ | X |
| Plan Features | Anthem Prudent Buyer (PPO/EPO) | Anthem HDHP | ||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Annual Deductible Individual/Family |
$500 / $1,500 | $500 / $1,500 | $1,650 / $3,500 | $1,650 / $3,500 |
| Annual Out-of-Pocket Maximum Individual/Family |
$3,500 / $7,000 | $7,000 / $14,000 | $3,500 / $5,000 | $5,000 / $10,000 |
| Alteryx Biweekly HSA Contribution Individual/Family |
N/A | $38.46 / $76.92 | ||
| Calculated Maximum Annual Cost (In-Network) |
Single: $624 + $3,500 – $0 = $4,124 Family: $8,358.74 + $7,000 – $0 = $15,358.74 |
Single: $312 + $3,500 – $1,000 = $2,812 Family: $6,819.54 + $5,000 – $2,000 = $9,819.54 |
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| Â | You pay: | You pay: | ||
| Preventive Care Visit | Covered in full | Not covered | Covered in full | 30% after deductible |
| Telemedicine Visit | $20 copay | Not covered | 10% after deductible | Not covered |
| Primary Care Visit | $20 copay | 40% after deductible | 10% after deductible | 30% after deductible |
| Specialist Visit | $20 copay | 40% after deductible | 10% after deductible | 30% after deductible |
| Diagnostic Test (x-ray, blood work) |
No Charge | 40% after deductible | 10% after deductible | 30% after deductible |
| Imaging (CT/PET scans, MRI) |
20% after deductible | 40% after deductible | 10% after deductible | 30% after deductible |
| Urgent Care | $20 copay | 40% after deductible | 10% after deductible | 30% after deductible |
| Emergency Room (copay waived if admitted) |
$150 copay | 10% after deductible | ||
| Inpatient/ Outpatient Hospital Services | 20% after deductible | 40% after deductible | 10% after deductible | 30% after deductible |
| Outpatient Mental Health Services | $20 copay | 40% after deductible | 10% after deductible | 30% after deductible |
| Chiropractic, Acupuncture & Wellness Massage | 20% after deductible | 40% after deductible | 10% after deductible | 30% after deductible |
| Prescription Drug – Retail (30-day supply) | ||||
| Generic | $10 copay | 40% after deductible | $10 copay after deductible | 30% after deductible |
| Preferred Brand | $30 copay | $30 copay after deductible | ||
| Non-Preferred Brand | $50 copay | $50 copay after deductible | ||
| Prescription Drug – Retail & Home Delivery (90-day supply) | ||||
| Generic | $30 copay | Not covered | $30 copay after deductible | Not covered |
| Preferred Brand | $90 copay | $90 copay after deductible | ||
| Non-Preferred Brand | $150 copay | $150 copay after deductible | ||
| Plan Features | Kaiser Permanente HMO – Southern California |
|---|---|
| In-Network Only | |
| Annual Deductible Individual/Family |
None |
| Annual Out-of-Pocket Maximum Individual/Family |
$1,500 / $3,000 |
| Â | You pay: |
| Preventive Care Visit | Covered in full |
| Primary Care Visit | $20 copay |
| Specialist Visit | $20 copay |
| Diagnostic Lab & X-ray | Covered in full |
| Urgent Care | $20 copay |
| Emergency Room (copay waived if admitted) |
$50 copay |
| Inpatient Hospital Services | $250 per admission |
| Outpatient Hospital Services | $20 per procedure |
| Outpatient Mental Health Services | Individual: $20 copay / Group: $10 copay |
| Chiropractic & Acupuncture (combined total of 20 visits per year for both Chiro and Acupuncture) |
$20 copay |
| Prescription Drug – Up to 100-day supply | |
| Generic | $10 copay |
| Brand-Name | $20 copay |
| Specialty (30-day supply) | $20 copay |
| Plan Features | Kaiser Permanente HMO – Northern California |
|---|---|
| In-Network Only | |
| Annual Deductible Individual/Family |
None |
| Annual Out-of-Pocket Maximum Individual/Family |
$1,500 / $3,000 |
| Â | You pay: |
| Preventive Care Visit | Covered in full |
| Primary Care Visit | $20 copay |
| Specialist Visit | $20 copay |
| Diagnostic Lab & X-ray | Covered in full |
| Urgent Care | $20 copay |
| Emergency Room (copay waived if admitted) |
$50 copay |
| Inpatient Hospital Services | $250 per admission |
| Outpatient Hospital Services | $20 per procedure |
| Outpatient Mental Health Services | Individual: $20 copay / Group: $10 copay |
| Chiropractic & Acupuncture (combined total of 20 visits per year for both Chiro and Acupuncture) |
$20 copay |
| Prescription Drug – Up to 100-day supply | |
| Generic | $10 copay |
| Brand-Name | $20 copay |
| Specialty (30-day supply) | $20 copay |
| Plan Features | Kaiser Permanente HMO – Colorado |
|---|---|
| In-Network Only | |
| Annual Deductible Individual/Family |
None |
| Annual Out-of-Pocket Maximum Individual/Family |
$2,000 / $4,000 |
| Â | You pay: |
| Preventive Care Visit | Covered in full |
| Primary Care Visit | $20 copay |
| Specialist Visit | $20 copay |
| Diagnostic Lab & X-ray | Covered in full |
| Urgent Care | $30 copay |
| Emergency Room (copay waived if admitted) |
$250 copay |
| Inpatient Hospital Services | $500 per admission |
| Outpatient Hospital Services | $100 per procedure |
| Outpatient Mental Health Services | $20 copay |
| Chiropractic & Acupuncture (combined total of 20 visits per year for both Chiro and Acupuncture) |
$20 copay |
| Prescription Drug – Retail (Up to 30-day supply) | |
| Generic | $15 copay |
| Brand-Name | $30 copay |
| Prescription Drug – Mail Order (Up to 90-day supply) | |
| Generic | $30 copay |
| Brand-Name | $60 copay |
See the benefit summaries for detailed information.