to keep your employees and your bottom line healthy. Colorado Small Business Enrollment Guide

Transcription

1 2016 SMALL BUSINESS HEALTH to keep your employees and your bottom line healthy.

2 Call us at or contact your agent or broker It s time for A BET TER WAY Choose a clear path to healthier people and a healthier business You face big challenges Costs keep going up You have a critical business decision to make every year how to select high-quality health care for your employees at a time when the cost of care continues to accelerate at an impossible rate. Since 2001, premiums for employer-sponsored health coverage have increased 113 percent. 1 Employees are getting sicker Many employers think of health care as just another line item a necessary expense. But on average, 90 percent of your employees have at least one chronic condition. 2 So a healthier workforce can be an investment in the future of your business. To successfully manage your costs and improve business performance, you need a healthcare partner who addresses the health of your employees before costs escalate. kp.org WHAT S INSIDE A BETTER WAY to manage costs...4 A BETTER WAY to keep your employees healthier...5 Your partner for better health Virtual Care novations...6 Employee Health and Wellness....7 Enhancing the Employee Experience...8 It starts with a plan Accessing care in Denver/Boulder...9 Accessing care in Northern Colorado HMO plans...14 POS and PPO Plans Offered in Colorado...16 Accessing care in Southern Colorado...18 KP Select...19 KP Select plans Accessing care in Mountain Communities...23 Medicare Coverage Adult & Pediatric Dental Plans Resources... 3

3 A BETTER WAY to manage costs. BETTER OUTCOMES, SATISFIED MEMBERS After caring for employees for more than 65 years, we re recognized as today s gold standard in high-quality, cost-effective care delivering value that other health care organizations just can t match. Kaiser Permanente Colorado ranked Highest Member Satisfaction among Commercial Health Plans in Colorado for the 8th year in a row in the J.D. Power 2015 Member Satisfaction Study. 3 BET TER ACCOUNTABILITY With our health plan, Kaiser Permanente physicians and affiliated provider partners work together to keep costs low while improving quality to keep your employees healthy at an affordable price. National Committee for Quality Assurance ranks Kaiser Permanente Colorado s #1 Private Health Plan and #1 Medicare Plan in Colorado for the 6th year in a row. 4 LOWER COSTS, HIGHER QUALITY We keep costs in line while achieving high standards of care and we re #1 in the nation on 17 out of 28 care measures, many of which target preventable conditions. 5 For the 6th year in a row, Aon Hewitt reports Kaiser Permanente offers the most cost-effective plan and outperforms other plans in clinical quality. 6 A BETTER WAY to keep your employees healthier We give you a better way to invest in your employees health. They get more effective support from our top doctors, clinical and hospital partners, leading workforce health programs, and award-winning disease management. The result is healthier, more engaged, and more productive employees. Healthy and engaged employees Healthy employees offer a higher return on investment. We make it easy and convenient for them to get better care in fewer office visits, so they have fewer sick days and emergency visits keeping them at work and more productive. They ll have access to tools and resources to actively participate in their health at home, online, with their smartphone, and at our one-stop, Kaiser Permanente facilities. Raising the bar for healthcare Kaiser Permanente is one of the largest health and research systems in the world. Our size and scale, combined with the industry s leading electronic health information system, allows us to deliver better care faster than most other organizations. We re a national and international model for cost-effective, high-quality, and innovative care and we re quickly advancing new best practices and saving lives. Award-winning chronic care Eighty-five percent of health care costs are due to chronic conditions and nine out of ten employees in the U.S. have chronic conditions. 7,8 Your employees will benefit from the latest thinking in disease management, reducing health emergencies, sick days, disability time, and overall costs. Top physicians Better doctors provide better care, and that s a smarter way to invest in employee health. Kaiser Permanente has world-class doctors from schools like Yale, Johns Hopkins, and Harvard. Additionally, year over year, 5280 Magazine recognizes many Kaiser Permanente Colorado physicians in its Top Doctors issue. DID YOU KNOW Weight management is an important factor in controlling lost productivity, health care costs, and chronic conditions. And obesity is the second-most-prevalent condition affecting productivity at work. On average, it costs an employer $1,500 more to insure an obese employee than a normal-weight employee. 9 Health care costs for patients with chronic conditions such as diabetes or congestive heart failure were percent higher when the patient was obese. 10 Obesity costs an estimated $64 billion in direct medical costs and $59 billion in indirect costs such as lost productivity. 11 $140,000 in total annual costs for 100 obese employees 4 5

4 DID YOU KNOW Virtual Care novations Employee Health & Wellness DID YOU KNOW BRINGING THE DOCTOR S OFFICE TO YOUR WORKFORCE This year, we re launching another convenient care option for your employees video visits. stead of seeing their Kaiser Permanente provider in person, they can have secure, convenient and personalized video consultations through a computer, smart phone or tablet.* Enhancing Physician e-visit* consultations For years, members have been able to their Kaiser Permanente physicians through My Health Manager. Now though, they can also attach photos and have virtual consultations. With our new store-and-forward functionality, a photo is taken, uploaded to their medical record, and viewed by a Kaiser Permanente specialist, who responds later with advice. Adding New RN e-visit capability addition to our 24/7 telephone nurse advice line, your employees have 24/7 access to online medical consultations with our Advice Call Center Registered Nurses. This new feature is available within our secure patient portal on kp.org. TIME-SAVING ALTERNATIVES TO OFFICE VISITS IN Q1 2015: 442,433 Kaiser Permanente Colorado members were seen in an office visit. 317,595 members accessed care through secure consultations. 79,806 members took advantage of telephone consultations with their primary care providers. Total Health Assessment Your employees can take a confidential, online health assessment on kp.org/succeed and receive a personalized report, along with their results, to share with their healthcare team. Healthy Lifestyle Programs We offer a complementary suite of online intervention programs, to help your employees achieve their health and wellness goals and thrive. Some of the topics include: Balance for weight management; Breathe for tobacco cessation and Care for Your Health for living with chronic conditions. To get started, visit kp.org/healthylifestyles. Wellness Coaching Whether your employees are trying to eat better, lose weight, get active or manage stress, getting started and staying motivated can be a challenge. With Kaiser Permanente, they can access free wellness coaching by phone, to get the extra support they need to make healthy changes and stick with them. Wellness Webinars With our convenient, live or recorded webinars, your workforce can take an active role in improving their health and fit wellness into their schedule, no matter how busy the day is. View free programs and register at kpwebinar.org. Complementary Medicine Kaiser Permanente s Center for Complementary Medicine offers chiropractic, acupuncture, massage, and mind/body medicine services for your employees. Visit kp.org/cam or kpccm.org, to learn more about network providers and complementary medicine services. ChooseHealthy Discounts Employees can find savings on many services, including preferred membership rates at select health clubs; % off regular rates for massage therapy, chiropractic care and acupuncture. Our ChooseHealthy online store offers 15-40% off suggested retail prices on hundreds of health products and, at FitnessCoach.com, there are many tools to help them achieve their health and fitness goals. Providers and services are detailed on kp.org/choosehealthy. Proactive Care We help your employees stay healthy, not just treat them when they are sick. Preventive screenings help keep you and your employees healthy by providing an early alert for many health conditions. That way, they can be treated before they become serious. Under health care reform, many are available at no charge. For a complete list of our preventive care services, visit kp.org/prevention. * This feature is available when you get care at Kaiser Permanente facilities or with Kaiser Permanente doctors. 6 7

5 DID YOU KNOW Enhancing the Employee Experience Accessing Care in Denver/Boulder NEW MEMBER CONNECT DEPARTMENT Whether it s finding a physician, transitioning prescriptions, understanding plan benefits or understanding kp.org, our newest service helps your employees navigate their plan and connect to the care they need New Online Treatment Cost Estimator Calculator To help your employees make more informed decisions about their health, they can now visit kp.org/costestimates, to get personalized estimates for out-of-pocket costs for some of the most common exams, tests, procedures, or treatment plans they may be discussing with their Kaiser Permanente physicians. They can continue to also call our financial counselors. An even Better Pharmacy As the second largest purchaser of pharmaceuticals in the nation, your employees will typically pay significantly lower costs for their generic and non-generic medications, when using Kaiser Permanente pharmacies and partners. We leverage our organizational purchasing power to manage costs from the start, negotiating prescription drug prices, buying drugs in bulk, and operating our own pharmacies and warehouses. With our newest pharmacy management system, prescriptions are still filled accurately; just in less time. Employee wait times have decreased, 97% of mail orders are shipped in less than 4 days and member satisfaction is at 94%. Upgraded Call Centers Each year, we assist millions of member calls, so we upgraded capabilities for our Appointment and Advice Call Center and Clinical Pharmacy Call Centers. With new speech voice recognition, your employees can quickly talk with a representative, or utilize self-serve options, such as scheduling appointments or refilling prescriptions. Employees have a choice of more than 1,000 primary care physicians and specialists at any Kaiser Permanente medical office in Colorado. With many locations to choose from and most offering multiple services under one roof, they can see their doctor, get a lab test or an X-ray, and pick up medications all without leaving the building. tegrated Care our integrated model, care teams are united for a single purpose better health. Your employees receive better care that s more efficient which means healthier outcomes for them and lower costs for you. Look at the advantages built into our care approach within our Kaiser Permanente medical offices. Fewer office visits employees save time and money by getting primary care, specialty care, lab, pharmacy, and many other services at a Kaiser Permanente medical office. Fewer sick days our team approach puts your employees at the center and helps them proactively manage their care so they re healthier, at work, and more productive. Satisfied workers consumers say we outperform all other health insurers in delivering high-quality customer service and making it easy to access care. 12 Dependable access to great doctors every one of our physicians goes through a rigorous selection process before we allow them to care for your employees. Colorado, that means we only hire 11% of the physicians who apply. Built-in health advice and programs disease management programs, health education, and nurse advice are part of your plan, so employees get consistent health information from one source. SAVING LIVES AND DOLLARS 89% Reduction in heart attack deaths in Colorado, avoiding related medical costs and productivity losses 13 Ensuring consistent care our doctors have created one of the world s largest, most inclusive electronic medical libraries, available only to our caregivers. Healthier employees primary care physicians and specialists can view each other s treatment notes in real time via an employee s electronic medical record. This allows for a thorough and accurate exchange of information, which can help keep your employees healthier. 8 9

6 E 470. ne D r N P i E 470 E 470 to keep your employees and your bottom line healthy. Kaiser Permanente Medical Offices To make an appointment at any medical office, call (TTY: 711), weekdays, 7 a.m. to 6 p.m. 1 Arapahoe Medical Offices 5555 E. Arapahoe Rd. Centennial, CO Aurora Centrepoint Medical Offices E. Exposition Ave. Aurora, CO Baseline Medical Offices 580 Mohawk Dr. Boulder, CO Brighton Medical Offices 9 S. 4th Ave. Brighton, CO Castle Rock Medical Offices 4318 Medical Trail Boss offices Dr. Castle Rock, CO East Denver Medical Offices E. Alameda Ave. Denver, CO H E U 7 Englewood Medical Offices 2955 Hospitals S. Broadway for scheduled Englewood, inpatient CO care; emergency 8 Evergreen care hospitals/departments; Medical Offices 2942 and Evergreen urgent Pkwy. care facilities Evergreen, CO Franklin Medical Offices 2045 Franklin St. Denver, CO Hidden Behavioral Lake Medical Health Offices offices 7701 (mental Sheridan health, Blvd. chemical Arvada, CO dependency, and eating 11 Highlands disorders) Ranch Medical Offices 92 Hepburn St. Highlands Ranch, CO Ken Caryl Medical Offices 7600 Shaffer Pkwy. Littleton, CO Lakewood Medical Offices 8383 W. Alameda Ave. Lakewood, CO Map is not to scale. Autumn Ridge Blvd Maple Rd Evergreen Pkwy 8 Evergreen 22nd St Logan St 7 Boulder Empire Rd 287 S Pointe Dr Campus Dr Pennsylvania S 24th St Park Ave 19th Ave 18th Ave Pearl St to Washington St P Longmont 3 Exempla Cir P Clarkson St H2 17 Nelson Rd P 24th Ave 23rd Ave P 22nd Ave 20th Ave Emerson St Ogden St 119 Valmont Rd 2 C diana St Arapahoe Rd Baseline Rd S Boulder Rd N 95th St 80th Ave 72nd Ave th Ave County Hwy Simms St 21st Ave 18 P 9 20th Ave P P Construction H3 Downing St Marion St Lafayette St Humboldt St H2 17 U3 Garrison St B1 Hampden E5 64th Ave Ken Caryl Ave E1 U2 Franklin St H E U C th Ave 112th Ave 104th Ave Wadsworth Gilpin St Sheridan Williams St H4 U1 g 21 Pecos St 7 Huron St 11 B H3 E1 U2 Evans Ave Federal Blvd Northwest Pkwy Washington St E4 S. Broadway Colorado Blvd 270 Alameda Ave University Blvd C County Line Rd Castle Rock 76 Colfax Ave 6th Ave Colorado Blvd E 470 Holly St 14 E3 7 88th Ave 56th Ave H1 B2 6 Belleview Ave 5 4 Arapahoe Rd E2 2 Founders Pkwy T r ail Boss D r. Peoria St Mississippi Ave S. 4th Sable Blvd Airport Rd Chambers Rd Sable 19 Parker Rd N Jordon Rd Lincoln Ave E Main St Tower Rd Peña Blvd Quincy Ave 16 E 160th Ave E 152nd Ave/E. Bromley Ln. Smoky Hill Rd E spiration Dr. 14 Lone Tree Medical Offices Park Meadows Dr. Lone Tree, CO Longmont Medical Offices Bent Way Longmont, CO Parker Medical Offices Parkglenn Way Parker, CO Rock Creek Medical Offices 280 Exempla Cir. Lafayette, CO Skyline Medical Offices 1375 E. 20th Ave. Denver, CO Smoky Hill Medical Offices E. Quincy Ave. Aurora, CO Southwest Medical Offices 57 S. Wadsworth Blvd. Littleton, CO Westminster Medical Offices Huron St. Westminster, CO Wheat Ridge Medical Offices 4803 Ward Rd. Wheat Ridge, CO After-Hours Care Hours and locations for after-hours care are subject to change. Please call (TTY: 711) at the time of need to confirm current hours and locations. 1 Arapahoe Medical Offices 6 p.m. 10 p.m., Mon. - Fri. 8 a.m. 9 p.m., Sat. 9 a.m. 9 p.m., Sun. 6 East Denver Medical Offices 8 a.m. 4 p.m., Sat. 9 a.m. 4 p.m., Sun. 13 Lakewood Medical Offices 8 a.m. 4 p.m., Sat. 9 a.m. 4 p.m., Sun. Pediatric Urgent Care U1 Children s Hospital Colorado Urgent Care North Campus, Broomfield 469 West Highway 7 Broomfield, CO U2 Children s Hospital Colorado Urgent Care, Uptown Denver 1835 Franklin Street Denver, CO U3 Children s Hospital Colorado Urgent Care, Wheat Ridge 55 Lutheran Parkway, Suite 230 Wheat Ridge, CO Emergency Care If you have an emergency medical condition, call 911 or go to the nearest hospital. Or, if time and safety permit, you can go to the Emergency Department at one of the following hospitals: H3 Saint Joseph Hospital 1375 East 19th Avenue Denver, CO H2 Good Samaritan Medical Center 200 Exempla Circle Lafayette, CO H3 Senior ER at Saint Joseph Hospital 1375 East 19th Avenue Denver, CO H1 Children s Hospital Colorado on Anschutz Medical Campus E. 16th Ave. Aurora, CO H4 Children s Hospital Colorado North Campus, Broomfield 469 West Highway 7 Broomfield, CO Medical offices Hospitals for scheduled Behavioral Health offices inpatient care; emergency (mental health, chemical 21 Westminster Medical Offices H3 Rocky Mountain Hospital care hospitals/departments; dependency, and eating 8 a.m. 4 p.m., Sat. for Children and Urgent Care facilities disorders) 9 a.m. 4 p.m., Sun E. 19th Ave. Denver, CO E1 Children s Hospital Colorado at Saint Joseph Hospital 1835 Franklin St. Denver, CO E3 E4 E5 E2 HealthONE Sky Ridge Medical Center Ridgegate Pkwy. Lone Tree, CO HealthONE Swedish Medical Center 501 E. Hampden Ave. Englewood, CO HealthONE Swedish Southwest ER 6196 S. Ammons Way Littleton, CO HealthONE Centennial Medical Plaza E. Arapahoe Rd. Centennial, CO Behavioral Health Offices For appointments, call B1 Hidden Lake Behavioral Health 7701 Sheridan Blvd. Arvada, CO B2 Highline Behavioral Health* E. Dakota Ave. Denver, CO * Entrance located on East side of building. B3 Ridgeline Behavioral Health Center 9139 S. Ridgeline Blvd. Highlands Ranch, CO Additional locations and access addition to the locations shown on this map, you have access to all Kaiser Permanente medical offices in Northern and Southern Colorado.

7 60 Aspen Ave Birch Ave Aspen Ave Birch Ave to keep your employees and your bottom line healthy. Accessing Care Northern Colorado Northern Colorado, we offer comprehensive health services and health care coverage to Loveland, Fort Collins, Greeley and surrounding areas. Currently, more than 27,000 Northern Colorado members use Kaiser Permanente as their partner in health. Take a look and you ll see why Kaiser Permanente is a better choice. tegrated Care Your employees can access care at any of our locations in Northern Colorado and at any of our 28 Kaiser Permanente locations throughout Colorado. With primary care, pharmacy, laboratory and medical imaging all under one roof receiving care at a Kaiser Permanente Medical Office can save your employees time. They ll also benefit from Kaiser Permanente s integrated approach to health care delivery, when receiving care at our Kaiser Permanente medical offices. My Health Manager on kp.org allows them the ability to schedule appointments, view most lab results, order prescriptions and their Kaiser Permanente doctors. With innovative web-based tools through kp.org and the recently launched app for mobile devices, your employees will have access to information in their secure medical record. The Power to Choose We also offer your employees and additional choice in Northern Colorado: they can visit a Kaiser Permanente medical office or see one of the 400+ network physicians from Banner Health and other community providers. Our network in Northern Colorado works collaboratively with Kaiser Permanente care teams to ensure quality, patient-centered care. Kaiser Permanente Medical Offices 1 Fort Collins Medical Offices 2950 E. Harmony Road, Suite 190 Fort Collins, CO Loveland Medical Offices 4901 Thompson Parkway Loveland, CO Greeley Medical Offices th Avenue Greeley, CO Emergency Care E1 Estes Park Medical Center 555 Prospect Avenue Estes Park, CO E2 E3 E4 McKee Medical Center 2000 Boise Avenue Loveland, CO North Colorado Medical Center th Street Greeley, CO Banner Fort Collins Medical Center 4700 Lady Moon Drive Fort Collins, CO Urgent Care U4 T aft Hill R d W 29th St W 1st St 287 E Mulberry St E Prospect Rd Fort Collins Loveland E Estes Park E1 E Harmony Rd CO Rd 74 CO Rd 74 E Eisenhower Blvd B oise A v e U1 Ziegler Rd E4 Centerra Pkwy Medical offices Additional locations and access U3 Banner Health Clinic Windsor Urgent Hospitals Care for scheduled inpatient addition care to the H locations shown on Medical offices 1300 Main Street the map, you have access to hundreds Windsor, CO of network providers throughout the service area; however, they are not represented on this map. H E U4 The Healthcare Clinic of provider information and locations can Fort Collins be found at kp.org/facilities W. Harmony Road #102 Fort Collins, CO Additionally, you have access to all Kaiser Permanente medical offices in Denver/Boulder or Southern Colorado. W Elkhorn Ave MacGregor Ave U3 W Elkhorn Ave 36 Moccasin Cir Dir Stanley Cir Dir E1 Highland Ln Map is not to scale. Prospect Ave High St Driftwood Ave 7 Stanley Ave 7 MacGregor Ave St. Vrain Av Moccasin Cir Dir 392 Stanley Cir Dir Estes Park W 20th St U2 5 9th A v e 3 W 37th St Highland Ln 4th St Prospect Ave High St Driftwood Ave 14 Ponderosa Dr Greeley 2 3rd A v e E3 16th St 6 6 Stanley Ave 7 N 8th Ave St. Vrain Av. U1 Banner Health Clinic Skyline Urgent Care 55 E 13th Street, Suite 110 Loveland, CO Ponderosa Dr U2 Banner Health Clinic Summit View Urgent Care th Ave., Suite 110 Greeley, CO

8 HMO Plans Offered in Colorado Plan Metal Tier Deductible HMO (Simple and straightforward coverage for your employees) KP CO Platinum 0/ KP CO Gold 0/30 KP CO Silver 0/50 Deductible HMO (Deductible-based plans designed to fit any budget) KP CO Platinum 0/20 KP CO Gold 500/30 KP CO Gold 1000/30 KP CO Gold 1500/30 KP CO Silver 00/30 Coinsurance (Member's Cost) Out-of-Pocket Maximum PCP Specialist After Hours Emergency Room Outpatient Surgery patient Hospital Platinum None 10% $3,000 $ $45 $75 $300 $500 $500 per day (up to 4 days) Gold None 30% $4,500 $30 $60 $75 $300 $1,000 $1,000 per day (up to 4 days) Silver None 40% $6,0 $50 $70 $100 $500 40% $1,500 per day (up to 4 days) Platinum $0 10% $2,000 $20 $40 $75 $200 10% after Gold $500 20% $4,000 $30 $50 $75 $300 Gold $1,000 10% $3,500 $30 $50 $75 $300 10% after Gold $1,500 10% $3,500 $30 $50 $75 $300 10% after Silver $2,500 20% $5,800 $30 $50 $100 $350 Lab & X-ray 10% after 10% after 10% after 10% after 10% after 10% after MRI, CT, & PET Prescription Drugs Generic/Brand/ Non-Preferred/Specialty Relativity to KP CO Platinum 0/ 10% $200 $10/$35/$0/$0 0% 30% $500 $15/$45/$375/$375-6% 40% $500 $15/$50/$570/$570-12% 10% after 10% after 10% after $10/$/10%/10% 2% $15/$45/$3/$3-9% $15/$45/10%/10% -6% $15/$45/10%/10% -8% $15/$45/20%/20% Non-Generic drugs are subject to a separate $0 prescription drug -18% KP CO Silver 3500/30 Silver $3,500 20% $5,500 $0 for the first visit, then $30 per visit $50 $100 $350 $15/$45/$450/$450-19% KP CO Bronze 5500/50 Bronze $5,500 40% $6,0 $50 per visit for 3 visits, then $/$110/$570/$570-36% KP CO Bronze 60/50 Bronze $6,0 0% $6,0 $50 per visit for 3 visits, then no charge after No charge after No charge after -33% Consumer-Driven Health Plans (Empower your employees by allowing them to use health savings accounts (HSAs) and Health Reimbursement Accounts (HRAs) to pay for routine health care expenses) KP CO Gold HRA 1500/30 ($500, $600, $700) Gold $1,500 % $6,350 $30 $50 $100 % after % after % after % after % after $15/$45/50%/% -15% KP CO Silver HRA 3500/50 ($500, $600, $700) Silver $3,500 40% $6,350 $50 after $70 after $15/$45/40%/ -33% KP CO Silver 2750/30/HSA Silver $2,750 15% $5,500 $30 after $50 after $10/$30/15%/ -26% KP CO Bronze 4750/50/HSA Bronze $4,750 30% $6,500 $50 after $70 after $500 after $20/$45/30%/ -39% KP CO Bronze 6500/100%/HSA Bronze $6,500 0% $6,500 No charge after No charge after -36% 14 15

9 POS and PPO Plans Offered in Colorado Plan Metal Tier Deductible Coinsurance (Member's Cost) Out-of-Pocket Maximum PCP Specialist After Hours Emergency Room Outpatient Surgery patient Hospital Lab & X-ray MRI, CT, & PET Prescription Drugs Generic/Brand/ Non-Preferred/Specialty Relativity to KP CO Platinum 0/ POS (Offer your employees the value of a HMO plan combined with the flexibility of a PPO plan to make the transition to Kaiser Permanente easier) KP CO Platinum POS 0/ Platinum $0 $1,000 10% 30% $2,000 $4,000 $ $45 $45 $65 $75 $75 $200 $200 10% 10% 10% 10% $10/$/10%/10% Covered in network only 22% KP CO Gold POS 1500/30 Gold $1,500 $3,000 20% 40% $3,500 $7,000 $30 $50 $50 $70 $75 $75 $350 $350 $10/$35/20%/20% Covered in network only 7% KP CO Silver POS 00/35 Silver $2,500 $5,000 30% 50% $5,500 $11,000 $35 $55 $55 $75 $100 $100 $400 $400 $15/$45/30%/30% Non-Generic drugs are subject to a separate $0 prescription drug Covered in network only -6% KP CO Bronze POS 5750/60 Bronze $5,750 $11,500 40% 50% $6,0 $13,700 3 visits at $60, then 3 visits at $80, then $/$110/ $570/$570 Covered in network only -26% PPO (For employees located outside Kaiser Permanente s service area) KP CO Silver PPO 1500/40 Silver $1,500 $4,500 30% 50% $6,350 $16,000 $40 $60 $300 after Ded $15/$45/ $5/$5 Covered in network only -36% 16 17

10 Accessing Care in Southern Colorado Southern Colorado, more than 61,000 people turn to us as their trusted partner in total health. We offer comprehensive health services and health care coverage to Colorado Springs, Pueblo, Cañon City and surrounding areas. Take a look and you ll see why Kaiser Permanente is a better partner in health. tegrated Care We ve expanded, to bring good health closer to our Southern Colorado members. We opened a new Kaiser Permanente medical office in central Colorado Springs; launched new, affordable health insurance plans; expanded specialty services at our Briargate location, where patients of all ages can be seen. Your employees can access care at any of our locations in Southern Colorado and at any of our 28 Kaiser Permanente locations throughout Colorado. With primary care, pharmacy, laboratory and medical imaging all under one roof receiving care at a Kaiser Permanente Medical Office can save your employees time. They ll also benefit from Kaiser Permanente s integrated approach to health care delivery, when receiving care at our Kaiser Permanente medical offices. My Health Manager on kp.org allows them the ability to schedule appointments, view most lab results, order prescriptions and their Kaiser Permanente doctors. With innovative web-based tools through kp.org and the recently launched app for mobile devices, your employees will have access to information in their secure medical record. The Power to Choose We also offer your employees an additional choice in Southern Colorado: they can visit any Kaiser Permanente medical office in Colorado or choose from a comprehensive network of local physicians in their plan. Collaborative Care We re partnering in new ways with network providers to bring best practices to your employees through innovative, personalized care programs. A care team that s informed and focused on your employees can lead to better health. Kaiser Permanente Care Connection is a team of local Kaiser Permanente nurses and health professionals who work with our network providers and your employees, to manage their health, help with care coordination, preventative care, wellness coaching, educational resources, and medication management. Pay for Value: We identify nationally recognized quality metrics that align with best practices for certain preventive measures and disease states, such as hypertension and diabetes. Through this program, we re seeing great results and showing improvements in quality of care for patients with chronic conditions, such as Type 2 diabetes and hypertension, as well as improving rates of prevention screenings (breast, colorectal, and cervical cancer). Kaiser Permanente Select An affordable, high-quality health care plan for Colorado Springs and surrounding areas. Kaiser Permanente Select (KP Select) is all about keeping your employees healthy and keeping your health care costs down. Employees who choose the KP Select plan will benefit from the same high-quality care from Kaiser Permanente at an affordable price, while following a few guidelines. Employees can receive care at any Kaiser Permanente medical office in Colorado, with three located in Southern Colorado, and have access to more than 400 KP Select providers in the Colorado Springs area. Scheduled inpatient hospital care and outpatient care is available at select facilities and refills for maintenance medications must be filled at a Kaiser Permanente medical office pharmacy or through mail order

11 KP Select Plans Offered in Colorado Springs Plan Metal Tier Deductible HMO (Simple and straightforward coverage for your employees) Coinsurance (Member's Cost) Out-of-Pocket Maximum PCP Specialist After Hours KP Select CO Platinum 0/ Platinum None 10% $3,000 $ $45 $75 $300 $500 $500 per day (up to 4 days) KP Select CO Gold 0/30 Emergency Room Outpatient Surgery patient Hospital Gold None 30% $4,500 $30 $60 $75 $300 $1,000 $1,000 per day (up to 4 days) KP Select CO Silver 0/50 Silver None 40% $6,0 $50 $70 $100 $500 40% $1,500 per day (up to 4 days) Deductible HMO (Deductible-based plans designed to fit any budget) KP Select CO Platinum 0/20 Platinum $0 10% $2,000 $20 $40 $75 $200 10% after KP Select CO Gold 500/30 KP Select CO Gold 1000/30 KP Select CO Gold 1500/30 KP Select CO Silver 00/30 Gold $500 20% $4,000 $30 $50 $75 $300 Gold $1,000 10% $3,500 $30 $50 $75 $300 10% after Gold $1,500 10% $3,500 $30 $50 $75 $300 10% after Silver $2,500 20% $5,800 $30 $50 $100 $350 KP Select CO Silver 3500/30 Silver $3,500 20% $5,500 $0 for the first visit, then $30 per visit KP Select CO Bronze 5500/50 Bronze $5,500 40% $6,0 $50 per visit for 3 visits, then $50 $100 $350 Lab & X-ray 10% after 10% after 10% after 10% after 10% after 10% after MRI, CT, & PET Prescription Drugs Generic/Brand/ Non-Preferred/Specialty Relativity to KP CO Platinum 0/ 10% $200 $10/$35/$0/$0 0% 30% $500 $15/$45/$375/$375-6% 40% $500 $15/$50/$570/$570-12% 10% after 10% after 10% after $10/$/10%/10% 2% $15/$45/$3/$3-9% $15/$45/10%/10% -6% $15/$45/10%/10% -8% $15/$45/20%/20% Non-Generic drugs are subject to a separate $0 prescription drug -18% $15/$45/$450/$450-19% $/$110/$570/$570-36% KP Select CO Bronze 60/50 Bronze $6,0 0% $6,0 $50 per visit for 3 visits, then no charge after -32% Consumer-Driven Health Plans (Empower your employees by allowing them to use health savings accounts (HSAs) and Health Reimbursement Accounts (HRAs) to pay for routine health care expenses) KP Select CO Gold HRA 1500/30 ($500, $600, $700) Gold $1,500 % $6,350 $30 $50 $100 % after % after % after % after % after $15/$45/50%/% -15% KP Select CO Silver HRA 3500/50 ($500, $600, $700) Silver $3,500 40% $6,350 $50 after $70 after $15/$45/40%/ -32% KP Select CO Silver 2750/30/ HSA Silver $2,750 15% $5,500 $30 after $50 after $10/$30/15%/ -26% KP Select CO Bronze 4750/50/ HSA Bronze $4,750 30% $6,500 $50 after $70 after $500 after $20/$45/30%/ -39% KP Select CO Bronze 6500/100%/HSA Bronze $6,500 0% $6,500-36% 20 21

12 Co Rd 501 Peyton Hwy Meridian Rd Curtis Rd S Peyton Hwy to keep your employees and your bottom line healthy. Kaiser Permanente Medical Offices 1 Briargate Medical Offices 4105 Briargate Pkwy, Suite 1 Colorado Springs, CO Parkside Medical Offices 215 Parkside Drive Colorado Springs, CO Pueblo North Medical Offices 3670 Parker Boulevard, Suite 200 Pueblo, CO Emergency Care COLORADO SPRINGS H1 Children s Hospital at Memorial Hospital* 1400 East Boulder Street Colorado Springs, CO H1 Memorial Hospital Central* 1400 East Boulder Street Colorado Springs, CO H2 Memorial Hospital North* 4050 Briargate Parkway Colorado Springs, CO H3 Penrose Hospital 2222 North Nevada Avenue Colorado Springs, CO H4 St. Francis Medical Center 6001 East Woodmen Road Colorado Springs, CO PUEBLO H5 Parkview Medical Center 400 West 16th Street Pueblo, CO H6 St. Mary-Corwin Medical Center 1008 Minnequa Avenue Pueblo, CO H7 Central Ave Co Rd 17 Map is not to scale CAÑON CITY 24 Cañon City H7 St. Thomas More Hospital 1338 Phay Avenue Cañon City, CO WOODLAND PARK Woodland Park 115 H8 Pikes Peak Regional Hospital* U.S. Highway 24 Woodland Park, CO *KP Select members have access to these hospitals for scheduled inpatient care. 67 H8 24 Colorado Springs State Hwy H N Powers Blvd 1 H2 Briargate Pkwy H1 E Platte Ave 2 50 Additional locations and access 78 H4 E Woodmen Rd 21 Black Forest Rd Marksheffel Rd 3 H5 W Northern Ave H6 addition to the locations shown on the map, you have access to hundreds of network providers throughout the service area; however, they are not represented on this map. provider information and locations can be found at kp.org/facilities. Additionally, you have access to all Kaiser Permanente medical offices in Denver/Boulder or Northern Colorado. 94 Squirrel Creek Rd Hanover Rd 3 Meridian Rd Falcon Hwy 47 E 4th St 50 Doyle Rd 24 Pueblo Accessing Care in Mountain Communities At Kaiser Permanente, we believe there s no better choice than choosing good health. That s why we re expanding our mission to provide high-quality, affordable health care services into Mountain communities for the first time, opening our Frisco medical office in Summit County, in early 2016, and a second location in Eagle County. tegrated Care Your employees can access care at our locations in the mountains and at any of our 28 Kaiser Permanente locations throughout Colorado. With primary care, laboratory and medical imaging all under one roof receiving care at a Kaiser Permanente Medical Office can save your employees time. They ll also benefit from Kaiser Permanente s integrated approach to health care delivery, when receiving care at our Kaiser Permanente medical offices. My Health Manager on kp.org allows them the ability to schedule appointments, view most lab results, order prescriptions and their Kaiser Permanente doctors. With innovative web-based tools through kp.org and the recently launched app for mobile devices, your employees will have access to information in their secure medical record. 96 Map is not to scale. 1 Lusher Ct. Meadow Drive 6 9 Dillon Reservoir Kaiser Permanente Medical Offices 1 Kaiser Permanente Frisco Medical Offices 226 Lusher Court Frisco CO Eagle County location opening in 2016.

13 Medicare Coverage Kaiser Permanente offers group and individual Medicare Advantage and Prescription Drug Plans. For information on our individual plans, contact a licensed sales specialist toll free at (TTY 711) seven days a week, 8 a.m. to 8 p.m. or visit kp.org/medicare. Adult and Pediatric Dental Care Kaiser Permanente and Delta Dental of Colorado know good oral health is an important component of overall health, so we ve partnered to provide small group employers pediatric dental benefits and adult-only dental plans to complement Kaiser Permanente s medical plans. NEW 2016 Embedded Pediatric Dental Benefit Separate Annual Deductible (applies to all services) Diagnostic & Preventive Services Oral Exams & Cleanings (Limited to 2 per calendar year) Fluoride Treatments (Limited to 2 per calendar year) Sealants (1 per lifetime per tooth per year) Bitewing X-rays (1 set per calendar year) $50 Basic Services (limited to 2 basic procedures per year) Fillings, Oral Surgery, Endodontics Major Services (limited to 1 major procedure per year) Crowns Covered 100% after Deductible Covered 100% after Deductible Covered 100% after Deductible Covered 100% after Deductible Covered Deductible Covered Deductible Embedded Pediatric Employee s children (up through the month they turn 19) can receive any of the procedures listed below each calendar year. Adult Dental Our adult-only plans complement the embedded pediatric dental coverage and are not tied to medical. The lowest-cost plan starts at $13/month. These plans also offer: No waiting period Dual option choices $2,000 benefit maximum on the high plan For more information, Delta Dental directly at [email protected] Monday-Friday, 8 a.m.-5 p.m. Important: The pediatric dental benefit is embedded in all Small Group plans EXCEPT the KP CO Silver PPO 1500/40 plan. The KP CO Silver PPO plan does not include pediatric dental coverage Resources Kaiser Permanente is committed to supporting you and your business. Below, you ll find important contact information and business resources to save you time. Calling the right person should be...easy Our goal is to have one-call resolution whenever possible. Communicating with the right department is the first step. With that in mind, we ve set up ONE Number. Easy ( ). If your question is about Group Billing and voicing: Account Reconciliation Adds, Drops, Cancels or Changes SG Contracts: Brochures, Forms, New Employee Packets, Group Cancellation Benefits, Eligibility: Service Resolution, Escalated Issues, Employee-level Claims Customer Experience Department You need to talk to Consolidated Service Center Option 1 Small Group Sales & Service Option 2 Client Services Unit (CSU) Option 4 We re here to help you transition to Kaiser Permanente. Our Customer Experience Team will visit your employees on-site and help them: Understand new plans & benefits Find & choose physicians Connect to the care they need Transition prescriptions To reach our Customer Experience team, [email protected] or call Customer Account Services An easy-to-use web site link that provides online account management for you and your broker. You can view group eligibility and billing information, update employee data, or pay your invoices. If you would like to set up an account, please contact your Account Executive or Associate Account Manager for assistance. 24

14 2016 Reference 1 Employer Health Benefits 2011 Annual Survey, Kaiser Family Foundation and Health Research & Educational Trust, September Kaiser Family Foundation is a nonprofit, private organization not affiliated with Kaiser Permanente. 2 Dan Witters and Sangeeta Agrawal, Unhealthy U.S. Workers Absenteeism Costs $153 Billion, Gallup-Healthways Well-Being dex, January 2 October 2, 2011, aspx. 3 Kaiser Foundation Health Plan of Colorado, c. received the highest numerical score among commercial health plans in the Colorado region in the proprietary J.D. Power U.S. Member Health Plan Studiessm. Study based on 31,543 total member responses, measuring four plans in Colorado (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed November-December Your experiences may vary. Visit jdpower.com. 4 Please refer to NCQA s Private Health surance Plan Rankings posted online at 5 Kaiser Permanente 2012 HEDIS scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass and represent all non- PPO lines of business. Kaiser Permanente combined region scores were provided by the Kaiser Permanente Department of Care and Service Quality. The source for data contained in this publication is Quality Compass 2012 and is used with the permission of NCQA. Quality Compass 2012 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass and HEDIS are registered trademarks of NCQA. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality. 6 The 2014 Hewitt Health Value itiative TM showed Kaiser Permanente is the most cost-efficient plan across all markets served for the sixth year in a row 12% more cost-effective than the average HMO and 17% more cost-effective than the allplan average. Kaiser Permanente also outperformed other plans in clinical quality, scoring 49% better than the average HMO and 209% better than the all-plan average. Hewitt Health Value itiative TM benchmarking study Kaiser Foundation Health Plan, c., Aon Hewitt, April 3, To get a copy of the Hewitt Health Value itiative report for your region, contact your account manager. 7 Chronic Care: Making the Case for Ongoing Care, Robert Wood Johnson Foundation, Dan Witters and Sangeeta Agrawal, Unhealthy U.S. Workers Absenteeism Costs $153 Billion, Gallup-Healthways Well-Being dex, January 2 October 2, 2011, aspx. 9 Worksite Wellness, Preventdisease.com, wellness/worksite_wellness.html, accessed November 2, See Note Obesity by the Numbers, obesityinamerica.org, accessed March 24, See Note #3 13 Thomas Delate, PhD, et al., Reduced Health Care Expenditures After Enrollment in a Collaborative Cardiac Care Service, Pharmacotherapy, November Results from our cardiac rehabilitation program in Colorado. Call us at or contact your agent or broker kp.org 26

15 Kaiser Foundation Health Plan, c., of Colorado and Kaiser Permanente surance Group are Qualified Health Plans in the Connect for Health Colorado marketplace Kaiser Permanente _15_SBEnrollmentGuide_CO