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Employee Benefits
SEP Health Plans
Medical Benefits

Kaiser Permanente HMO (#4015200)

This plan incorporates a specific network of physicians, hospitals and other health care providers into a single service organization. The plan covers preventative care, outpatient care, hospitalization, vision care and prescription drugs. You will be required to select a primary care physician (PCP) who will be responsible for coordinating all of your healthcare needs and providing you with referrals. This plan covers most medically necessary services at 100% or requires you to pay a small co-pay.  However, benefits are not available for services obtained outside of the network.

Kaiser Permanente HMO Employee Booklet (PDF)

Kaiser Permanente HMO Summary of Benefits and Coverage (PDF)


 Kaiser Permanente Access PPO Plan (#6453500)Medical Benefits

This plan provides you with added flexibility when seeking covered medicals services by allowing you to receive care within or outside of the network. You will not be required to elect a primary care physician (PCP).  You will also have the freedom to self-refer your care without consulting/receiving a referral from your PCP to both in-network and out-of-network providers.  However, self-referring your care results in lower benefit levels and higher out-of-pocket costs.

Kaiser Permanente Access PPO Employee Booklet (PDF)

Kaiser Permanente PPO Summary of Benefits and Coverage (PDF)

 

Related links:  Kaiser Permanente Website

 

Dental Benefits

Delta Dental/Washington Dental Service (#09385)Dental Benefits

The company offers two levels of dental coverage: the Basic and the Buy-up plan. The level of coverage you select will depend on the level of treatment you and your family require. The plan provides coverage for Preventative/Diagnostic Service, Basic Services, Major Services and Orthodontia.  It gives you the freedom to receive care from a participating Delta PPO Network, Delta Premier Network dentist or from any dentist of your choosing. Services provided by Delta Dental PPO or Premier dentists are based upon a negotiated fee schedule.  This means if you incur any out-of-pocket costs, they will be based on the Delta negotiated fees and not the dentist's actual charge. However, if you choose to go to an out-of-network dentist, not only will you pay your share of coinsurance and/or deductible, you may also pay the balance bill - the difference between what Delta says is the reasonable and customary cost and what the dentist actually charges. It is further incentive for you to use participating dentists.

Related links:  Delta Dental - Washington Website

 

 

Last Updated 12/28/2021 8:13 AM