This section is for benefits-eligible employees living in California who have selected the Kaiser HMO plan as their Medical Plan for 2022.
Kaiser Permanente is a fully integrated health system that employs physicians and other medical staff and owns hospitals, facilities, and pharmacies. Your primary care physician (PCP) will be responsible for wholly managing your care and your family's care, including the coordination of care with other providers, such as specialists. Non-emergency services you receive from non-Kaiser doctors, facilities and affiliated providers will not be covered by the Kaiser HMO Option.
Under the Kaiser HMO option, most services — such as primary care and specialist office visits, urgent care visits, X-rays, and lab work — have copays and are not subject to the deductible. There is a deductible that applies to a small subset of services (e.g., hospital care, outpatient surgery). After meeting the deductible, you'll pay the applicable coinsurance amount. After you reach your annual out-of-pocket maximum, you won't have to pay a copay or coinsurance for covered services for the rest of the calendar year. Kaiser Permanente also administers prescription drug benefits for Kaiser HMO members.
You are encouraged to select a PCP for each covered family member and you generally need referrals to see a specialist in the Kaiser HMO plan. Go to Kaiser's website accessible through My Health > My Medical Plan Website or directly at kp.org to search for PCPs.
The information for the Kaiser Medical Plan is contained in the following PDFs, which are effective 1/1/2022:
- Kaiser HMO, CA Annual Enrollment Bulletin, available at https://www.jpmcbenefitsguide.com/2022_Annual_Enrollment_Bulletin_CA.pdf
- Kaiser HMO Medical Plan Overview, available at https://www.jpmcbenefitsguide.com/Kaiser_HMO_Overview.pdf
- Kaiser North California Summary Plan Description (SPD), available at https://www.jpmcbenefitsguide.com/KPNC_2022_JPMC_EOC - North Cal..pdf
- Kaiser South California Summary Plan Description (SPD), available at https://www.jpmcbenefitsguide.com/KPSC_2022_JPMC_EOC - South Cal..pdf
If you have specific questions about the Kaiser plan offered by JPMC, call Kaiser at (800) 204-6561, Monday through Friday, 8 a.m. to 6 p.m. Pacific Time
Be sure to see important additional information about the Plan, in the sections titled About This Guide, What Happens If…, Plan Administration, Health Care Participation, and Spending Accounts.
SPDs can also be found on My Health under 2022 Benefit Resources.