Kaiser is an HMO (Health Maintenance Organization) with a closed network of providers.

Plan changes

  • Cost sharing is eliminated for low- to moderate-dose statins for cardiovascular disease prevention, provided certain criteria are met. 
  • Cost sharing for behavioral health treatment for pervasive developmental disorder or autism will be charged on a per day basis for any combination of individual or group sessions.

How the plan works

  • You choose a primary care physician (PCP) from Kaiser’s network.
  • The PCP coordinates your care and refers you to specialists.
  • The plan covers the cost of services only when your primary care physician authorizes it.
  • Kaiser provides coverage for services outside of the network only in cases of emergency.
  • Behavioral health benefits are provided by Kaiser and Optum.

Best fit for you if:

  • You want low monthly premiums
  • You want low, predictable out-of-pocket costs
  • You like having one doctor manage your care
  • You are happy with the selection of providers within the Kaiser system

Monthly plan costs for faculty and staff

Retiree plan costs chart »

Pay Band
(per annum)
Self Self +
Child(ren)
Self +
Adult
Family
$54,000 and under $18.97 $34.15 $41.55 $56.71
$54,001–$107,000 $55.02 $99.04 $123.85 $167.85
$107,001–$161,000 $92.02 $165.64 $197.61 $271.21
$161,001 and above $130.33 $234.60 $274.03 $378.28
Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.


Typical out-of-pocket costs

  • Office visits/Urgent care: $20
  • Emergency room visits: $75
  • Hospital stay: $250
  • Prescription drugs: $5 generic; $25 brand name