your Benefits in Brief American Federation of Nurses-United Healthcare Workers Southern California June 2007
The information presented here is a brief summary of the benefits in effect when this booklet went to press. In case of any omission or conflict between what is written in this booklet and in the official plan documents, the plan documents always govern. Kaiser Permanente reserves the right to modify, amend, change, replace, or terminate any or all of the benefits or benefit plans described in this booklet at any time. In addition, benefits may be modified or eliminated through the negotiation process. You will be advised of any significant changes in your benefit program.
Kaiser Permanente is committed to providing its employees with a comprehensive benefits package that is competitive with what is offered in the external market. This package includes health and dental plans, paid time off, retirement plans, as well as other benefits. Health Care Kaiser Permanente provides you and your eligible dependents with comprehensive medical care through the Kaiser Foundation Health Plan (KFHP). Coverage includes basic and major medical care, such as hospitalization, surgery, maternity care, X-ray and laboratory expenses, durable medical equipment, as well as emergency care. There is a $5 copayment for each medical office visit. KFHP coverage becomes effective on the first day of the month after your date of hire, if you are regularly scheduled to work 20 hours or more per week. The plan covers you, your spouse or domestic partner, and unmarried dependent children up to age 25. Kaiser Permanente pays the full premium cost for this coverage. KFHP covers prescriptions written by a Kaiser Permanente physician or a dentist. There is a $5 copayment for each prescription that is filled at a Kaiser Permanente pharmacy. Prescriptions filled at non-kaiser Permanente pharmacies are not covered. In addition, you may purchase over-the-counter drugs at a discount from any Kaiser Permanente pharmacy. The plan also provides vision care, which includes eye examinations and a $175 benefit every two years for standard lenses, frames, and/or contact lenses. Your coverage also includes inpatient and outpatient mental health services. There is a $5 copayment for mental health office visits. However, copayments for the first 20 outpatient mental health office visits may be reimbursed. No Coverage You have the option to waive medical coverage.
Special Enrollment Rights If you waive medical coverage and you subsequently lose your other coverage for any reason, you and your eligible dependents may enroll in KFHP within 31 days of losing your other coverage. In addition, if you have new dependents as a result of birth, marriage, adoption, or placement for adoption, you may enroll yourself and your newly eligible dependents within 31 days of the qualifying event. Dental Care Dental coverage is an important part of your comprehensive benefits program. If you are regularly scheduled to work 20 hours or more per week, you, your spouse or domestic partner, and unmarried dependent children up to age 25 are eligible for dental coverage. Your dental coverage becomes effective on the first day of the month after six months of employment. You are offered a choice of pre-paid dental plan options during your first three years of employment: DeltaCare USA United Concordia Dental plan Under the pre-paid dental plans, most dental services are covered at 100%. However, to be covered, you must receive dental care through a panel provider. There is no annual maximum benefit under the pre-paid dental plan options. After three years of employment, in addition to the above, you have the option to enroll in the Delta Dental plan. The Delta Dental plan, if elected, begins on the first day of the month after the third anniversary of your date of hire, if you make your election within 31 days of when you become eligible. The plan covers 100% of preventive services, 70% of reasonable and customary charges for basic services such as oral surgery, periodontics, endodontics and restorative dentistry, and 50% for major services such as crowns, jackets and cast restorations, prosthodontic services, and construction or repair of bridges and dentures. The Delta Dental plan allows you to select any dentist. However, to receive full benefits, you must visit a participating Delta dentist. The majority of California dentists participate in the Delta Dental plan. The maximum Delta Dental benefit is $1,000 per person each calendar year. The premiums for dental coverage are employer-paid.
Default Coverage Kaiser Permanente believes it s important for you to have a minimum level of certain benefit coverage to protect you in case of an unexpected illness or catastrophe. If you do not enroll in benefits coverage during your initial enrollment period, you will receive default coverage for yourself only which includes KFHP and DeltaCare USA. This default coverage will stay in effect for the rest of the year, unless you make a change during the next open enrollment period, or when you have a qualified family or employment status change (e.g., birth, marriage, adoption, change in scheduled hours etc.) during the year. Life Insurance Your life insurance benefits at Kaiser Permanente provide financial assistance in the event of death. Your life insurance coverage is effective on your 61st day of continuous employment, provided you are actively at work. Basic Life Insurance If you are regularly scheduled to work 32 hours or more per week, you are automatically enrolled in Basic Life insurance. You will receive $6,000 in Basic Life insurance coverage, with a provision for $6,000 in additional benefits for accidental death and dismemberment. If you are regularly scheduled to work less than 32 hours per week, you are eligible for $1,000 in Basic Life insurance coverage, with a provision for $1,000 in additional benefits for accidental death and dismemberment. Kaiser Permanente provides this benefit at no cost to you. Optional Life Insurance If you are regularly scheduled to work 32 hours or more per week, you have the opportunity to purchase additional life insurance coverage at the following levels, to supplement the coverage that Kaiser Permanente provides you. You pay the premiums for this coverage. $10,000 $20,000 $30,000 $40,000 If you purchase Optional Life insurance, you also automatically receive an additional $10,000 of accidental death and dismemberment insurance. If you choose to purchase Optional Life insurance within 31 days of eligibility, you do not need to provide Evidence of Insurability (EOI), which is proof of your good health. However, you will be required to provide EOI if you wish to purchase coverage at a later date.
Survivor Assistance While you are employed at Kaiser Permanente, Survivor Assistance provides financial assistance to your beneficiary in the event of your death. This benefit is equal to one month of your base pay. If you are a regularly scheduled employee, you are automatically enrolled on your date of hire. Malpractice You are provided with professional liability protection on your date of hire, subject to the terms and limitations of the coverage, if you provide patient care. All employees of the Southern California Permanente Medical Group, Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc., and KP OnCall, LLC are included in this blanket coverage. Disability Income Disability benefits provide you with financial protection in the event you are unable to work for an extended period of time because of a serious illness or injury. These benefits may be coordinated with paid time off benefits and other sources to provide income protection in the event of disability. You must be actively at work for these plans to become effective. Income Protection Plan During your first two years of employment, if you are regularly scheduled to work 20 hours or more per week, you are automatically enrolled in the Income Protection (IP) plan on your date of hire. Benefits are payable after you use all hours in your Annual and Banked Sick Leave accounts and any vacation hours (converted to sick leave) or Flexible Personal Days you elect to use prior to commencing a Medical or Occupational Leave. IP provides 50% of your base pay, or up to 60% if combined with other disability income, such as State Disability Insurance, Workers Compensation and/or Social Security. IP benefits may be paid up to a maximum of one year from the date of disability with continued physician certification. This is an employer-paid benefit. Extended Income Protection Plan After two years of employment, if you are regularly scheduled to work 20 hours or more per week you are automatically enrolled in the Extended Income Protection (EIP) plan. Benefits are payable after three months of disability provided you use all hours in your Annual and Banked Sick Leave accounts and any vacation hours (converted to sick leave) or Flexible Personal Days you elect to use prior to commencing a Medical or Occupational leave. EIP provides 50% of your base pay, or up to 60% if combined with other disability income such as State Disability Insurance, Workers Compensation, and/or Social Security. EIP benefits may be paid up to a maximum of ten years from the date of disability with continued physician certification. This is an employer-paid benefit.
Total and Permanent Disability Total and Permanent Disability (T&PD) coverage is provided through the employerpaid Basic Life insurance. T&PD provides for a payout of the value of your Basic Life insurance and, if purchased, the first $10,000 of your Optional Life insurance if you become totally disabled. Flexible Spending Accounts Kaiser Permanente offers you a choice of flexible spending accounts that allow you to set aside pre-tax dollars to pay for certain expenses. Certain IRS restrictions govern these accounts, so you should carefully estimate your spending account needs each year. You may enroll within 31 days of hire, during the annual open enrollment period, or if you have a qualified family or employment status change (e.g., birth, marriage, change in scheduled hours, etc.). In addition, you must re-enroll in these accounts each year during the annual open enrollment period to continue participation. Health Care Spending Account The Health Care Spending Account allows you to contribute up to $3,000 annually on a pre-tax basis to pay for eligible health care expenses for yourself and/or your dependents. Examples of such expenses include deductibles and copayments for medical and dental services, or expenses exceeding your medical and dental plan limits. You must be regularly scheduled to work 20 hours or more per week to participate in this benefit. Dependent Care Spending Account The Dependent Care Spending Account allows you to contribute up to $5,000 annually on a pre-tax basis to pay for eligible dependent care expenses. Examples of such expenses include care at a licensed day care center, or practical nursing care for an adult. You are eligible to participate in this benefit regardless of your work schedule.
Time Off Benefits Kaiser Permanente offers you a number of programs to help you keep your home and work life in balance. You are eligible for time off benefits on your date of hire if you are regularly scheduled to work. Work/Life Balance Time Off Program The Work/Life Balance Time Off (WLB) program at Kaiser Permanente consists of: Observed Holidays Vacation Sick Leave Flexible Personal Days Observed Holidays You are eligible for the following paid holidays: New Year s Day Memorial Day Independence Day Labor Day Thanksgiving Day Christmas Day Vacation You may use vacation hours for leisure, hobbies, family matters or other activities of your choice. You are eligible for vacation according to the accrual schedule below: Vacation Accrual Schedule Years of Service Hours per Month* Days per Year* 0-4 6.66 10 5-8 10.00 15 9-10 13.33 20 11+ 16.66 25 *Prorated for part-time employees. The maximum number of vacation hours you may accumulate is twice the amount of your annual accrual. For example, if you accrue 10 days per year, your maximum accumulation is 20 days.
In-Service Cash-Out The In-Service Cash-Out program lets you cash out some of your vacation hours and receive the money for those hours in your paycheck as taxable income. During the annual open enrollment period, you may elect to cash out a minimum of 24 hours or 40-hour increments up to 160 hours, as long as you do not exceed your expected annual accrual for the following year. Sick Leave Sick leave benefits may be used for those times when you have an illness or injury and cannot come to work. You have two sick leave accounts: Annual Sick Leave You may use your Annual Sick Leave hours when you are ill, injured or for medical appointments. You may also use a portion of your hours to care for an eligible ill family member (see Banked Sick Leave for more information). If you are regularly scheduled to work 40 hours per week, you will receive 15 days of Annual Sick Leave per year credited to you on the first pay period of each year. Annual Sick Leave is prorated if you are hired after the first pay period of the year or if you are a part-time employee. Each year, during the Annual Sick Leave Cash-Out election period, you have the option to roll over unused Annual Sick Leave to your Banked Sick Leave at 100% of value. You also have the option to cash out up to 80 hours of unused Annual Sick Leave at 50% of value if you have at least 80 hours in your Banked Sick Leave or choose a combination of both options cashing out and rolling over (hours are prorated if you are a part-time employee). Banked Sick Leave Your Banked Sick Leave holds any unused Annual Sick Leave hours you decide to roll over during the Annual Sick Leave Cash-Out election period. There is no limit to the number of Banked Sick Leave hours you may accumulate. You may use your Banked Sick Leave when you are ill or injured after you have used your Annual Sick Leave. You may use your Banked Sick Leave right away if you are hospitalized or for certain statutory leaves of absence such as Family Leave. In addition, you may use up to 7.5 days of Banked Sick Leave per calendar year to care for an eligible ill family member. If you have used your Banked Sick Leave, you may use Annual Sick Leave hours or a combination of Banked and Annual Sick Leave for a maximum of 7.5 days.
Flexible Personal Days Flexible Personal Days (FPDs) may be used for any purpose, such as for personal, sick, or family needs. FPDs may be used in increments of less than one day, so you do not have to take a whole day off to attend a parent-teacher meeting, for example, or to run an errand. If you are an employee regularly scheduled to work 40 hours per week, you receive five FPDs per year, credited to your account on the first pay period of each year. FPDs are prorated if you are hired after the first pay period of the year, and for part-time employees. At the end of each year, up to 40 hours of unused FPDs will automatically roll over to your vacation account at 100% of value. Any remaining hours will stay in your FPD account and be added to next year s allotment. Other Time Off In addition to your WLB program, you may be eligible for: Bereavement Leave: You may be eligible for paid Bereavement Leave in the event of the death of an eligible family member or domestic partner. Educational Leave: You may be eligible for Educational Leave to help you maintain your professional license(s) or to upgrade and maintain professional skills. Family Leave: You are eligible for up to 12 weeks of Family Leave per year (12-month rolling period) after one year of employment and working 1,250 hours to care for a newborn or foster/adopted child, or certain family members who are seriously ill. You may also use Family Leave for your own serious illness. Jury Duty: Kaiser Permanente provides paid leave when you are called to jury duty. Kaiser Permanente also provides certain types of paid and unpaid leaves, such as Medical, Military, Occupational, Personal and Union leaves.
Retirement Preparing for a financially secure future during your working years is just as important as funding your lifestyle today. Kaiser Permanente offers retirement programs especially designed to help provide you with financial security down the road. Kaiser Permanente Southern California Employees Pension Plan You automatically become a participant in the employer-paid Kaiser Permanente Southern California Employees Pension Plan on your date of hire, regardless of your work schedule. This defined-benefit pension plan provides you with retirement income based on your length of service and compensation. If you terminate employment after you have at least five years of service or if you earn at least one hour of service at age 65, you are entitled to a benefit from this plan. Kaiser Permanente 401(k) Retirement Plan You may elect to participate in the Kaiser Permanente 401(k) Retirement (KP401K) plan on your date of hire or anytime thereafter regardless of your employment status and work schedule. The KP401K plan is designed to help you save additional money for retirement and reduce your current taxable income. You may contribute a percentage of your pre-tax earnings into the plan. You may invest your contributions in a broad range of investment funds. If you have one year of employment, Kaiser Permanente may make a 1% employer contribution to your account provided the Southern California region meets its preset performance goals and you meet certain eligibility requirements. Additionally, starting in January 2008, Kaiser Permanente will match 100% of your contribution to the KP401K plan, up to 1.25% of your salary. Retiree Benefits When you retire, you may be eligible for retiree medical benefits at age 65 if you have 15 or more years of service with Kaiser Permanente. Your dependents may also be covered under your medical benefits. Retiree medical coverage is coordinated with Medicare. You may also be eligible for retiree life insurance.
Alternate Compensation Program You may be eligible to participate in the Alternate Compensation Program (ACP) upon hire if you are regularly scheduled to work 20 hours or more per week. You are required to provide annual proof that you have medical coverage from another source in order to participate in the ACP. As an ACP participant, you receive 25% above your base wage rate instead of enrolling in certain benefit plans, such as medical, dental, disability, paid time off benefits etc. You will be able to enroll in or withdraw from the ACP during the annual open enrollment period, or if you have a qualified family or employment status change (e.g., birth, marriage, change in scheduled hours) during the payroll year. In addition, you will be able to withdraw from the ACP if you lose your other medical coverage for any reason. Other Benefits Domestic Partner Benefits You may extend certain benefits, such as medical and dental coverage, to your domestic partner and his or her dependents. In order to extend these benefits, you and your domestic partner must either sign a Kaiser Permanente Affidavit of Domestic Partnership or submit a copy of your certified domestic partner registration filed with a local or state government. Some of the provided benefits may be taxable. Employee Assistance Program You are eligible for the Employee Assistance Program on your date of hire regardless of your work schedule. The program offers confidential counseling and referral to professional resources for issues with alcohol or drugs, marital difficulties, family crises, financial or legal questions, or emotional or other concerns. 10
Child and Elder Care Referral You are eligible on your date of hire for child and elder care referral services regardless of your work schedule. This program offers help in locating and selecting child and elder care providers by giving you information on the resources available locally. Consultation is available through the Employee Assistance Program. Tuition Reimbursement Program You are eligible to participate in the Tuition Reimbursement program after six months of employment, if you are regularly scheduled to work 20 hours or more per week. The Tuition Reimbursement program helps you to continue your education in subjects that improve your job performance and increase your potential for advancement and employability. You can be reimbursed for preauthorized expenses, which include the cost of tuition and textbooks, up to a maximum of $2,000 per calendar year, depending on the number of hours you are regularly scheduled to work. Commuter Spending Account You are eligible to participate in the Commuter Spending Account regardless of your work schedule. This program allows you to set aside pre-tax dollars to pay for your qualified public transportation, vanpooling, and parking expenses to and from work. You can elect to participate on your date of hire or at anytime thereafter. Parent Medical Coverage You may cover your eligible parents, stepparents, parents-in-law and parents domestic partners under a group health plan. In order for your eligible parent to qualify, you must be an active employee and eligible for KFHP coverage. You and your eligible parent must reside in the same Kaiser Permanente region. Your parent must enroll in Medicare Parts A & B, assign his or her Medicare benefits to Kaiser Permanente, and meet eligibility requirements for Kaiser Permanente Senior Advantage. Your eligible parent will be responsible for the entire amount of the monthly premium, applicable administration fees, and copayments. Your eligible parent may enroll within 31 days of your date of hire, your qualified family or employment status change, when he or she moves into the region where you live, if he or she becomes newly eligible for Medicare during the year or during the annual open enrollment period. 11 11
Kaiser Permanente Activity Program You are invited to take advantage of the Kaiser Permanente Activity Program that offers discounted rates as well as customized packages and other specials on a variety of entertainment venues and events, travel, gifts, products, and services for yourself and your family. The True Value of Benefits Kaiser Permanente believes that benefits are an integral and extremely important part of your employment package. Kaiser Permanente provides a comprehensive benefits package to you and your family, including medical, dental, life insurance and disability plans, retirement benefits, and much more. Take the time to know and appreciate your benefits. 12
Employer s Funding of Your Benefits and percentage of Salary (based on years of service) American Federation of Nurses-United Healthcare Workers with an annual base income of $0, YEARS OF SERVICE Health and Welfare Kaiser Foundation Health Plan Dental Plan Employer-Paid Life Insurance Accidental Death & Dismemberment Survivor Assistance Benefit Disability Plans 0 to years to years to years to 0 years + years $10,375 $10,863 $10,863 $10,863 $10,863 11.49% 12.03% 12.03% 12.03% 12.03% Retirement Program Kaiser Permanente Retirement Plan Employer-Paid Pension Plan Federal/State Tax Social Security Medicare Employer Contributions Time Off Program Observed Holidays Vacation Flexible Personal Days Sick Leave (based on usage) GRAND TOTAL $7,043 $7,043 $7,043 $7,043 $7,043 7.80% 7.80% 7.80% 7.80% 7.80% $6,889 $6,889 $6,889 $6,889 $6,889 7.65% 7.65% 7.65% 7.65% 7.65% $10,602 $10,602 $12,338 $14,074 $15,811 11.74% 11.74% 13.66% 15.59% 17.51% $34,908 38.68% $35,397 39.22% $37,133 41.15% $38,869 43.07% $40,606 44.99% The Benefits Value Statement reflects values of the Employer s funding of your benefits. Add these benefit dollars to your annual base income to estimate the value of your Kaiser Permanente total compensation (pay and benefits). Remember, in addition to these benefit dollars, you may also be eligible to receive other benefits such as Tuition Reimbursement, Jury Duty pay, Educational and other leaves as applicable, Workers Compensation, Malpractice, and the Kaiser Permanente Activity Program. Also, the administrative costs for the Dependent Care, Health Care and Commuter Spending Accounts and the Kaiser Permanente Tax-Deferred Retirement Savings are employer-paid. The figures provided in this Benefits Value Statement represent a typical benefits package for regular full-time employees and are based on available costs and rates at the time this brochure went to print. The actual value of your individual benefits package will vary based on your age, salary, work schedule, years of employment, etc. The intangible values of your benefits provides you and your family with job security, career development opportunities, short and long-term financial assistance, and quality time to spend on yourself and with your loved ones.
A publication of Benefits Communications Benefits Practice, HR SSO June 2007