Federal Employees and Annuitants
2017 Rates and Benefits
Northern California Region
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• Top-rated health plan
• Earn healthy rewards
• Get care anywhere you go
• New medical facilities
Healthy together
See how our care and coverage can help you thrive
kp.org/feds
Not a member yet?
For more information, visit kp.org/feds or call 1-855-315-1009,
Monday through Friday, 8 a.m. to 5 p.m.
Open Season hours: 7 days a week, 5 a.m. to 7 p.m.
Kaiser Permanente
Experience the
Kaiser Permanente difference
With Kaiser Permanente1
Without Kaiser Permanente
Choosing
your doctor
Learn about our doctors
by reading their profiles
and biographies on
kp.org/searchdoctors,
then choose the one
who’s right for you.
You may not know anything
about your doctor. Or you
may be offered a simple
provider directory with
minimal information.
Choosing how
you get care
For minor concerns, you
have the option to request
a phone appointment or
email your doctor’s office
with routine questions.
Even for minor concerns,
you usually make an
appointment, drive to
the doctor’s office, and
sit in the waiting room.
Making
a routine
appointment
You’ve got options: You
can use your phone,
computer, or mobile device
— anytime, anywhere.
You’ll likely have to call
during business hours, which
can interrupt your work day.
Calling for
medical advice
Our specially trained nurses
can help you 24/7. They have
access to your health record,
and can also help you make
an appointment at the facility
nearest you, if needed.
If medical advice is available
by phone, the person you
speak with won’t have access
to your medical history and
won’t be able to connect
you directly to care.
Getting the
convenient
care you need
In most of our facilities,
you can see your doctor,
get a lab test, and
pick up prescriptions
all under one roof.
Seeing your doctor, getting
a lab test, and picking
up medication probably
means 3 separate trips.
Viewing your
medical records
and test results
You and your providers have
access to your electronic
health record — which
includes your medical
history and most test
results — keeping everyone
connected and in the know.
You have to collect or
request all your medical
records on your own, and
your providers are not
likely to be connected
to each other.
Getting care in
your language
We have multilingual doctors
and staff, and we offer
interpretation services by
phone in 150+ languages.
Some health plans
offer limited access to
interpreter services and
multilingual doctors.
See how our care and coverage can help you thrive
The right choice for your health
Get great care and the resources you need to live healthier — all in one
convenient package. Check out everything that comes with your health plan,
and see why more than 10 million people nationwide choose Kaiser Permanente.
Why Kaiser Permanente?
Your 2017 benefits
A healthy partnership..................... P. 2
Benefit highlights ................................................... P. 8
Great care, great results............. P. 3
Additional health
care services .................................................................... P. 9
Care the way you want it ............ P. 4
Care for a range of needs........ P. 5
Healthy resources ................................. P. 6
our 2017 benefits
Y
summary ............................................................................. P. 10
Ready to enroll with
Kaiser Permanente? ......................................... P. 11
Senior Advantage (HMO)
for Federal Members ..................................... P. 12
What‘s new in
Northern California? ....................................... P. 14
Locations near you .............................. P. 7
Once you join …
Visit kp.org/newmember to get started.
It’s easy to choose your doctor, register for
kp.org, and transfer your prescriptions. If you
have questions or need help making your first
routine appointment, just give us a call.
Already a member?
Manage your care online at kp.org. If you
haven’t already, register at kp.org/registernow.
Once you’ve registered, you can email your
doctor’s office with nonurgent questions,
request routine appointments, order most
prescription refills, and more.
1
Kaiser Permanente
A healthy partnership
At Kaiser Permanente, your personal physician is the biggest advocate for
your health. You choose your own doctor, and that doctor coordinates your
care with specialists as needed.
Choose your doctor —
and change anytime
We believe nothing should stand between
you and total health. That’s why we provide
care that’s sensitive to the various ethnicities,
cultural values, and languages of our
members. To do this, we:
You can choose your doctor from:
•  Adult medicine/internal medicine
•  Family medicine
•  Pediatrics/family medicine
(for children up to 18)
• 
Quality care starts
with quality doctors
No matter which physician you choose, your
health is in highly capable hands. Our doctors
come from top medical schools, and many
teach at world-renowned universities.
Since we hire and train our own doctors,
they are all held to the same quality standards
and committed to the same vision: making
lives better by being your trusted partners in
total health.
Focus on hiring doctors and staff who speak
more than one language
•  Offer telephone interpretation services in
more than 150 languages
•  Train our providers in how to connect with,
and care for, people of all backgrounds
Through our culturally responsive care
programs, we’ve been able to improve health
outcomes among diverse populations for
conditions like high blood pressure, diabetes,
and colon cancer.2
Coordinated and
connected care
Your doctor, nurses, and other specialists
work together as a team, sharing information
to give you the care you need. They’re
connected to each other, and to you, through
your electronic health record. They know your
medical history, test results, medications, and
allergies. So you get personalized care.
Did you know?
2
Culturally responsive care
for diverse communities
Connecting you with a doctor who suits
your needs is our top priority. At kp.org/
searchdoctors, you can find information on a
wide range of top-notch physicians, including
their education, credentials, and specialties.
Select one doctor for your whole family or a
different doctor for each family member. You
can also change your doctor anytime.
In 2015, Kaiser Permanente led the nation in 21 effectiveness-of-care measures, including
controlling high blood pressure, managing diabetes, breast cancer screening, and
nutrition and exercise counseling for children.3 To learn more, visit thrive.kp.org/quality.
See how our care and coverage can help you thrive
Great care, great results
Get the care you need to get and stay healthy. From preventive screenings
to care for serious conditions, we’ve got you covered. And your care is backed
by cutting-edge research and advanced medical technology.
Preventive care to
keep you healthy
We believe prevention plays a vital role in
health care. That’s why we offer so many
resources to help you stay healthy and happy,
and avoid getting sick. (For examples, see
“Healthy resources” on page 6.)
To catch problems early, we offer preventive
screenings, routine appointments, and more.
Your electronic health record plays a key
role in this, tracking the services you get and
reminding your doctor when you’re due
for care.
Comprehensive care
when you need it
Along with our commitment to prevention,
we’re here for you if you get sick. You get
great doctors, state-of-the-art facilities, and
the latest technology — all combined to help
you recover quickly.
If you have a condition like diabetes or heart
disease, we’ll work with you to manage it
using proven best practices and treatment
guidelines. Our well-rounded approach
supports you physically and emotionally to
help you continue living life to the fullest.
Hear from members about their care
experiences at kp.org/carestories.
Advanced research
working for you
We’re always looking to improve care for
our members. Through our ongoing medical
research, we discover new and better ways to
prevent and treat illness.
To make this work possible, we have:
•  More than 4,500 studies underway
•  7 regional research centers and
1 national center
•  More than 1,200 research staff members
As one of the nation’s largest research
programs, we conduct and share our
learnings from groundbreaking studies and
clinical trials. Our areas of focus span a wide
range of health issues, including cancer, heart
disease, diabetes, childhood obesity, and
autism. Learn more at share.kp.org/research.
The only 4-star quality
ratings in California
For a record-setting eighth year in a row,
Kaiser Permanente Northern and Southern
California are the only plans to achieve perfect
scores for clinical quality in the California
Office of the Patient Advocate’s Health Care
Quality Report Card. That’s a benchmark
no other health plan in the state has been
able to reach.4
3
Kaiser Permanente
Care the way you want it
From the way you interact with your doctor to the device you use
to stay on top of your care, you’ve got many convenient options.
Choose how you connect to care
In person
Because most of our locations offer many services under one roof,
you can see your doctor, get lab services and X-rays, and pick up your
prescriptions — all in one trip.
By phone
Where telephone appointments are available, you can save yourself
a trip to our medical offices and talk with your doctor by phone. And
if you’re not sure what kind of care you need, you can also call our
advice nurses 24/7.
By email
For nonurgent questions, you can simply email your doctor’s office.
You’ll get a reply usually within 2 business days, if not sooner. You can
also email a pharmacist for questions about medications, or Member
Services for questions about your benefits.
By video
For some conditions and symptoms, you can connect with your doctor
face-to-face by video — from your computer, smartphone, or tablet.
Choose how you manage your care
4
At home
Stay on top of your care from home or work 24/7, through My Health
Manager at kp.org. View your medical record, refill most prescriptions,
schedule and cancel routine appointments, get vaccination records,
pay medical bills, and more.
On the go
Wherever you are, you can access most of the features of My Health
Manager on any mobile device through the KP app.5 You can also find
a facility near you and get directions. Learn more at kp.org/mobile.
See how our care and coverage can help you thrive
Care for a range of needs
Get the right care for any situation. Have an urgent care need?
Want health advice after hours? Support is just a call or a click away.
Quality care, when and where you need it
Emergency care
If you ever need emergency care, you’re covered — anywhere, anytime.6
You can get care at any Kaiser Permanente or non–Kaiser Permanente
hospital emergency department.
Urgent care
If you have urgent care needs, we’re here for you. You can walk in or make
same-day or next-day appointments. You can also call our advice nurses,
who will assess your situation and help you decide what to do.
Specialty care
Need to see a specialist? We have one of the largest multispecialty medical
groups in the country, so you get access to the right specialist quickly.
You don’t need referrals for certain specialized departments, including
obstetrics-gynecology, psychiatry, and drug dependency services.
24/7 nurse
advice
If you’re not sure what kind of care you need, you can call our advice nurses
anytime. They’ll help you figure out what type of care is best for your
symptom or condition, help you decide where to go for care, and even
schedule a routine appointment for you, if appropriate.
Travel care
As a Kaiser Permanente FEHB member, your benefits go farther than
your home service area. Wherever you go, you’re covered for:
•  Emergency room and urgent care visits — anywhere in the world
•  Care at any Kaiser Permanente location in another region
•  Coverage for certain outpatient follow-up care and outpatient
care outside of Kaiser Permanente service areas through the
FEHB travel benefit.
To learn more, call our 24/7 Away from Home Travel Line at
951-268-39007 or visit kp.org/travel.
5
Kaiser Permanente
Healthy resources
Good health goes beyond the doctor’s office. Take a look at all the healthy
tools and resources available online, by phone, and at our facilities — and
choose the ones that work for you.
Get the most out of your health plan
Online
wellness
tools
Visit kp.org/healthyliving for helpful articles, wellness information,
health calculators, fitness videos, music channels, podcasts, and
recipes from world-class chefs.
Take steps to improve your well-being and earn up to $150 in rewards to
pay qualified medical expenses.8 FEHB subscribers and their enrolled
spouses (age 18 and over) are eligible for the following rewards:
Earn healthy
rewards
• $50 for taking the Total Health Assessment, an online
questionnaire that gives you a wellness action plan
• $25 for completing a healthy lifestyle program, an online
class to help you reach your health goals
Go to kp.org/feds to learn more and get started.
Choose from a large variety of classes and support groups offered
right at our facilities, and get help improving your health. Find
classes near you at kp.org/classes. Some classes may require a fee.
Personal
wellness
coaching
Work one-on-one by phone with a personal wellness coach —
at no cost. You can get help and inspiration for reaching a variety of
health goals. Find out more at kp.org/wellnesscoach.
Reduced
rates for
members
Our members get special rates on a variety of health-related
products and services — like gym memberships, massage therapy,
and more. Check out your options at kp.org/choosehealthy.
Help to quit
smoking
Let us help you succeed in quitting. You pay nothing for classes,
telephone coaching, online programs, and prescriptions, including
prescribed over-the-counter tobacco-cessation drugs. Ask your
doctor about your treatment options.
Did you know?
6
On-site
health
classes
We feature over 500 seasonal, doctor-recommended recipes on our Food for Health
blog. Get inspired at kp.org/recipes.
See how our care and coverage can help you thrive
Locations near you
It’s easy to get the care you and your family need. There are many
Kaiser Permanente facilities in your area, offering convenient hours and
a wide range of care and services.
Easy access
for easier care
With convenient hours and locations, it’s
simple to get the care you and your family
need. Many of our locations offer same-day,
next-day, after-hours, and weekend services,
along with ob-gyn, pediatrics, and other
specialty departments.
Most of our facilities offer a variety of care and
services, so you can take care of several health
care needs in one visit. You can see your
doctor or specialist, get a lab test or an X-ray,
and pick up your medications — all without
leaving the building.
Getting care
anywhere
With so many locations to choose from, you’re
sure to find one near your home or work —
whatever’s best for you.
You can also see different doctors at different
locations, either for yourself or your family. For
example, you can choose a personal doctor
close to work and an optometrist close to
home, and your child can see a pediatrician
near school.
Finding
convenient locations
Choosing the right location is as easy as
hopping online or pulling out your smartphone.
Visit kp.org/kpfacilities to search by ZIP
code, keyword, or the service you want.
•  To search with your smartphone or mobile
device, use our location finder on the
Kaiser Permanente app.5
• 
Healthy change in
Santa Cruz
We’re excited to open 3 new medical offices
in Santa Cruz County in January 2017: in
downtown Santa Cruz, Scotts Valley, and
Watsonville. Plus, we‘re joining with
Watsonville Community Hospital to offer
you more local access to emergency
services, labor and delivery, and other
hospital services. For more information,
visit kp.org/santacruz.
See page 14 for a list of our
locations in your area.
Did you know?
Kaiser Permanente has nearly 700 hospitals, medical offices, and other facilities across our
7 regions. To get the latest news on facility openings and much more, visit share.kp.org.
7
Kaiser Permanente
Benefit highlights
2017 benefit changes — what’s new?
Save on prescription drugs
Key benefit changes to High, Standard and
Basic Options include:
Save time and money by ordering prescription
refills online or by phone. We can mail most
prescription drugs to you within 10 days. You
don’t pay for U.S. mail delivery. And when
you order refills by mail, you get a 100-day
supply and pay only two 30-day supply plan
pharmacy copays.
Adding coverage for applied behavioral
analysis (for treatment of autism)
•  No charge for specialist consultation and
biopsy when provided along with preventive
colonoscopy
•  Rewards program Visa card is changing
to a health payment card for qualified
medical expenses.
To learn more, see the 2017 benefits summary
on page 10, download our FEHB brochure at
kp.org/feds, or call us at 1-800-464-4000,
TTY 711, 24 hours a day, 7 days a week
(closed holidays).
• 
Be sure to review the important information
about the Self Plus One enrollment tier
on page 11.
8
Chiropractic without a referral
You can receive up to 20 chiropractic
visits per year, without a referral, with any
American Specialty Health (ASH) Plans
of California, Inc., participating provider.
To find a participating provider, visit
ashlink.com/ash/kp or call 1-800-678-9133,
Monday through Friday, 5 a.m. to 6 p.m.
For TTY for the hearing/speech impaired,
call 1-877-710-2746.
See how our care and coverage can help you thrive
Additional health care services*
When you join Kaiser Permanente, you get additional discounts and services.
Eyewear
Dental coverage
High Option members get a 25% discount
on eyeglasses and contact lenses
at Vision Essentials by Kaiser Permanente
Optical Centers.
You can choose from 2 dental plans to
supplement your health coverage:
•  Kaiser Permanente Insurance Company
(KPIC) and administered by Delta Dental of
California. With this plan you have the freedom
to see any licensed dentist you choose.
•  DeltaCare® USA and administered by Delta
Dental. You’ll choose a dentist from the
DeltaCare USA network with this HMO plan.
Current members call KPIC Dental Insurance
Plan at 1-800-835-2244 (group number 09874)
or DeltaCare USA at 1-800-422-4234 (group
number 71114). You can also view dental plans
and enrollment materials at kp.org/feds. New
dental member? Call us at 1-800-933-9312
for more information. Rates are listed below.
2017 Dental Rates
Self Only
Self + 1
Self + 2 or more
KPIC
Monthly
$32.69
$57.93
$87.08
DeltaCare USA
Monthly
$14.26
$23.87
$36.18
Quarterly
$42.77
$71.60
$108.53
*These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all
enrollees and family members who become members of Kaiser Permanente.
9
Your 2017 benefits summary
Benefits and Services
High Option
Standard Option
Basic Option
The benefits and services below are NOT subject to applicable plan deductibles.
Outpatient services (per visit or procedure)
Preventive care
$0
$0
$0
Primary care/specialty care office visit
$15/$25
$30/$40
$25/$35
Urgent care
$15
$30
$25
Chiropractic services (up to 20 visits per year)*
$15
$15
$15
Prescription drugs (up to a 30-day supply at plan pharmacies, or up to a 100-day supply for 2 copays through mail order) †
Generic
$10
$15
$15
Preferred brand/non-preferred brand
$40
$50
$60
Specialty
20% up to $100
30% up to $150 30% up to $200
The benefits and services below ARE subject to applicable plan deductibles.
Deductible (2x per family maximum)
None
$200
$500
Hospital and facility
20%**
Outpatient surgery
$50
$200† †
†
†
Inpatient hospital care (per admission)
$250
$500
20%**
Maternity
Routine prenatal care visit, first postpartum visit (no deductible)
$0
$0
$0
†
†
Delivery (per admission)
$250
$500
20%**
Emergency and urgent care (per visit or trip)
Emergency care
$100
$150† †
20%**
†
†
Ambulance
$50
$150
20%**
†
†
Most X-rays and lab tests
$0
$10
20%**
$3,000
$5,500
$2,000
Out-of-pocket maximum (2x per family maximum)
per person
per person
per person
Your Premium Share‡
High Option
Standard Option Basic Option
Biweekly Non-Postal
$174.78
$110.10
$74.06
Biweekly Postal Category 1
Biweekly Postal Category 2
Monthly Non-Postal
Biweekly Non-Postal
Biweekly Postal Category 1
Self Plus One
Biweekly Postal Category 2
Monthly Non-Postal
Biweekly Non-Postal
Biweekly Postal Category 1
Self and Family
Biweekly Postal Category 2
Monthly Non-Postal
Self Only
*See page 8 for information on chiropractic services.
†Plan providers determine the drug that is medically
necessary. If you request another drug, you pay prices
charged to members for non-covered drugs.
10
$165.55
$162.47
$378.69
$470.57
$450.74
$444.14
$1,019.57
$441.14
$420.08
$413.07
$955.81
$100.87
$97.79
$238.55
$300.57
$280.74
$274.14
$651.23
$271.14
$250.08
$243.07
$587.47
$64.83
$61.75
$160.46
$216.22
$196.39
$189.79
$468.48
$186.79
$165.73
$158.72
$404.72
‡These rates do not apply to all enrollees. If you are in a special
enrollment category, please contact the agency or Tribal
Employer which maintains your health benefits enrollment.
**Of our allowance after deductible
††After deductible
Ready to enroll with Kaiser Permanente?
1. Choose an option.
2. Select the type of
enrollment you want.
3. Sign up online or call.
High Option: Higher
premiums, but lower
copays for most services
and prescription drugs
•  Standard Option: Lower
premiums, but higher
copays and coinsurance
for most services and
prescription drugs
•  Basic Option: Lowest
premiums and lower
copays for office visits
and urgent care services
compared to the Standard
Option; higher deductible
and coinsurance
• 
elf Only covers you.
S
•  Self Plus One covers
you and 1 eligible family
member.
•  Self and Family covers
you and all eligible family
members.
Find your enrollment
code in the chart below.
Then, visit opm.gov to
enroll online or contact
your employing agency or
retirement office for next
steps and other information.
• 
Annuitants can contact the
Retirement Information
Center at 1-888-767-6738
or 1-855-887-4957 (TTY), or
[email protected].
If you qualify for Medicare, or will soon, see page 12 for more information.
Self Plus One
Enrollees covering themselves and one other
eligible family member may choose either
the “Self Plus One” or ”Self and Family“
enrollment type, whichever has a lower
premium. You should decide which enrollment
type is best for you.
FEHB enrollees can make changes during Open
Season. Outside Open Season, you may be able
to change your enrollment if you experience
a Qualifying Life Event. To change enrollment
types, you must change your enrollment by
following Step 3 above.
Choose the right enrollment code
Enrollment Code
Self Only
Self Plus One
Self and Family
High Option
591
593
592
Standard Option
594
596
595
Basic Option
KC1
KC3
KC2
Need help? Call us at 1-800-464-4000, 24 hours a day, 7 days a week (closed holidays).
For TTY for the hearing/speech impaired, call 711.
These are highlights of the FEHB enrollment process. Please refer directly to opm.gov and your employing agency or retirement
office for FEHB coverage effective dates, enrollment procedures and deadlines, and other information. To add an eligible family
member to your Kaiser Permanente Self and Family or Self Plus One enrollment, complete and return an Enrollment Change
Form to us. These forms can be obtained at kp.org/feds or by calling Member Services.
11
Kaiser Permanente
Kaiser Permanente Senior Advantage (HMO) for Federal Members
High Option
2017 Benefits and Services
Outpatient services
Preventive care
Primary care/specialty care office visit
Most X-rays and lab tests (per encounter)
Chiropractic services (up to 20 visits per year)*
Hospital and facility
Outpatient surgery (per procedure)
Inpatient hospital care (per admission)
Emergency and urgent care (per visit or trip)
Emergency care
Urgent care
Ambulance
Prescription drugs†
Picked up from
plan pharmacy
Generic
Delivered by our
mail-order service
Picked up from
plan pharmacy
Preferred brand/
non-preferred brand
Delivered by our
mail-order service
Specialty
Additional Senior Advantage benefits
Eyeglasses and contact lenses (every 24 months)
Hearing aids
Silver&Fit®
Dental cleaning (twice per year)
Out-of-pocket maximum
(2x per family maximum)
Part B premium reimbursement‡
12
Standard
Option
Basic
Option
$0
$10
$0
$15
$0
$15
$10
$15
$0
$25
$0
$15
$5
$50
$15
$100
$250
$250
$25
$250 per day
up to $1,000
per admission
$75
$5
$50
$75
$10
$50
$75
$15
$125
Senior
Advantage 1
Senior
Advantage 2
$0
$5
$0
$15
$75
$25
$150
20% up to $100
$10 (up to a
30-day supply)
$20 (up to a
100-day supply)
$40 (up to a
30-day supply)
$80 (up to a
100-day supply)
20% up to $100
$10 (up to a
$10 (up to a
30-day supply) 30-day supply)
$20 (up to a
$20 (up to a
100-day supply) 100-day supply)
$40 (up to a
$47 (up to a
30-day supply) 30-day supply)
$80 (up to a
$94 (up to a
100-day supply) 100-day supply)
30% up to $150 30% up to $200
$200 allowance
Not covered
Not covered
$15
$2,000
per person
$0
Not covered
$500 allowance
$0
Not covered
$2,000
per person
Up to $125
$150 allowance
Not covered
Not covered
$15
$2,000
per person
$0
$10 (up to a
100-day supply)
$30 (up to a
100-day supply)
$150 allowance
Not covered
Not covered
Not Covered
$2,000
per person
$0
mail-order pharmacy. You should receive them within 10
*See page 8 for information on chiropractic services. These
business days. If not, please call 1-800-548-9809, Monday
chiropractic services are separate from the chiropractic
services that we cover in accordance with Medicare guidelines. through Friday, 8 a.m. to 4:30 p.m. The pharmacy network may
change at any time. You will receive notice when necessary.
†Plan providers determine the drug that is medically necessary.
‡We will not reimburse you for any extra charges added to
If you request another drug, you pay prices charged to
your standard Part B premium, such as the Late-Enrollment
members for non-covered drugs. For certain drugs, you can get
Penalty or Income-Related Monthly Adjustment Amount.
prescription refills mailed to you through our Kaiser Permanente
See how our care and coverage can help you thrive
Why Senior Advantage for
Federal Members is right for you
If you decide to enroll in Senior Advantage for
Federal Members, you’ll get better benefits
than with your FEHB coverage alone. You’ll
get all of your FEHB benefits plus:
Lower copayments for office visits and
for most other services, such as inpatient
hospital visits, most prescription drugs, and
many other benefits
•  Up to a 100-day supply of prescription
drugs at plan pharmacies for 1 copayment
(Senior Advantage 1 only)
•  No deductibles (Standard and
Basic Options only)
•  Extra credit toward the purchase of
eyewear, including eyeglasses
(Senior Advantage 1 only)
•  Extra coverage for preventive dental
care through DeltaCare USA at no extra
cost (Senior Advantage 1 and Standard
Options only)
• 
New for 2017
If you currently have the Kaiser Permanente
FEHB High Option plan, you have 2 great new
Medicare choices:
• 
Senior Advantage 1: Get the lowest
copayments for covered services, plus
extras like eyewear and preventive
dental coverage.
• 
Senior Advantage 2: Get lower copayments
and reimbursement for your Medicare Part
B premium every month,* plus extras like
the Silver&Fit® fitness program and hearing
aid coverage.
How can you sign up for Senior
Advantage for Federal Members?
To enroll in Senior Advantage for Federal
Members, you must first enroll in the
Kaiser Permanente FEHB plan (either the High,
Standard, or Basic Option), plus Medicare
Parts A and B (or Part B only). After that, you
can apply for Senior Advantage for
Federal Members.
We'll enroll you in the plan option that matches
the Kaiser Permanente FEHB option you have
now. For example, if you're a Kaiser Permanente
High Option member, you'll be enrolled in
Senior Advantage for Federal Members High
Option. Be sure to choose the right enrollment
code on page 11. When you become eligible
for Medicare, you may be able to change
your current plan or option. To learn more
about making enrollment changes outside
of Open Season:
• 
Go to opm.gov or
•  Contact your employing agency or retirement office.
We can help you make an easy transition. For
more information, download our brochure,
Your Guide to Choosing a Kaiser Permanente
Medicare Health Plan, at kp.org/feds. For
questions or help with the enrollment process,
or to have information sent to you, please
call Member Services at 1-800-443-0815
(TTY 711), 7 days a week, 8 a.m. to 8 p.m.
*You must pay the Medicare Part B premium to join a Kaiser Permanente Medicare health plan.
Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal.
To join a Kaiser Permanente Medicare Health Plan, you must reside in the Kaiser Permanente Senior Advantage service area in
which you enroll. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year and at other times
in accord with your group’s contract with us. This information is not a complete description of benefits. Contact the plan for more
information. Limitations, copayments, and restrictions may apply. You must pay the Medicare Part B premium to join a Kaiser
Permanente Medicare health plan. Enrolling in Senior Advantage for Federal Members will not affect the benefits you receive
through the Federal Employees Health Benefits (FEHB) Program, although the network and other rules of Medicare may apply.
13
Kaiser Permanente
Kaiser Permanente medical centers
(hospital and medical offices)
Kaiser Permanente medical offices
Affiliated plan hospitals
Affiliated medical offices
Map not to scale
What‘s new in Northern California:
Mission Bay Medical Offices: New medical
offices with internal and family medicine,
pediatrics, ob-gyn, lab, pharmacy, and more —
now open.
Scotts Valley Medical Offices: New medical
offices in Scotts Valley with internal and family
medicine, pediatrics, ob-gyn, lab, pharmacy,
and more — scheduled to open early 2017.
St. Joseph’s Medical Center: New plan
hospital in Stockton, co-owned by Dignity
Health and Kaiser Permanente. Members will
have access to emergency care and other
hospital services recommended by their
doctor, including labor and delivery.
Watsonville Medical Offices: New medical
offices in Watsonville with internal and family
medicine, pediatrics, ob-gyn, lab, pharmacy,
and more — scheduled to open early 2017.
Santa Cruz Medical Offices: New medical
offices in Santa Cruz with internal and family
medicine, pediatrics, and ob-gyn — scheduled
to open early 2017.
14
Watsonville Community Hospital: In early
2017, new plan hospital in Watsonville to offer
you additional access to emergency services,
labor and delivery, and other hospital services
recommended by your doctor.
See how our care and coverage can help you thrive
CITY
Alameda County
Alameda
Fremont
Hayward
Livermore
Oakland
Pleasanton
San Leandro
FACILITY
ADDRESS
● Alameda Medical Offices
n Fremont Medical Center
● Hayward–Sleepy Hollow Medical Offices
● Livermore Medical Offices
n Oakland Medical Center
● Pleasanton Medical Offices
n San Leandro Medical Center
Union City
● Union City Medical Offices
2417 Central Ave.
39400 Paseo Padre Pkwy.
27303 Sleepy Hollow Ave.
3000 Las Positas Rd.
3600 Broadway
7601 Stoneridge Dr.
2500 Merced St.
3551 Whipple Rd.
3553 Whipple Rd.
3555 Whipple Rd.
Contra Costa County
Antioch
n Antioch Medical Center
● Delta Fair Medical Offices
● Martinez Medical Offices
Martinez
● Pinole Medical Offices
Pinole
Richmond
n Richmond Medical Center
● San Ramon Medical Offices
San Ramon
● Park Shadelands Medical Offices
Walnut Creek
n Walnut Creek Medical Center
Marin County
Bolinas
Bolinas Family Practice
● Mill Valley Medical Offices
Mill Valley
● Novato Medical Offices
Novato
Point Reyes Station
Point Reyes Medical Clinic
West Marin Medical Center
San Rafael
n San Rafael Medical Center
San Rafael Medical
● Downtown
Offices – 3rd St.
Stinson Beach
Stinson Beach Medical Center
Napa County
● Napa Medical Offices
Napa
Placer County
Lincoln
Roseville
Lincoln Medical Offices
Roseville Medical Center
Roseville Medical Offices – Riverside
n Kaiser Permanente medical centers
(hospital and medical offices)
● Kaiser Permanente medical offices
4501 Sand Creek Rd.
3400 Delta Fair Blvd.
200 Muir Rd.
1301 Pinole Valley Rd.
901 Nevin Ave.
2300 Camino Ramon
320 Lennon Ln.
1425 S. Main St.
88 Mesa Rd.
750 Redwood Hwy., Ste. 1206
97 San Marin Dr.
3 Sixth St.
11150 State Rte. 1
99 Montecillo Rd.
3419 State Rte. 1
3285 Claremont Way
1675 Permanente Way
1900 Dresden Dr.
1600 Eureka Rd.
1001 Riverside Ave.
Affiliated medical offices
Affiliated plan hospitals
15
Kaiser Permanente
CITY
FACILITY
Sacramento County
Elk Grove
Elk Grove Medical Offices
Elk Grove Promenade Medical Offices
Folsom
Folsom Medical Offices
Rancho Cordova
Rancho Cordova Medical Offices
Sacramento
Fair Oaks Boulevard Medical Offices
Point West Medical Offices
Sacramento Medical Center
South Sacramento Medical Center
San Francisco County
San Francisco
Mission Bay Medical Offices
San Francisco Medical Center
San Joaquin County
Manteca
Manteca Medical Center
Manteca Medical Offices
Stockton
Stockton Medical Offices
St. Joseph’s Medical Center
Tracy Medical Offices
Tracy
San Mateo County
Daly City
2001 DC Station Medical Offices
Redwood City
San Bruno
Daly City Medical Offices
Redwood City Medical Center
Bayhill Medical Offices
San Bruno Medical Offices
Sneath Lane Medical Offices
San Mateo
South San Francisco
Santa Clara County
Campbell
Gilroy
Milpitas
San Mateo Medical Offices
South San Francisco Medical Center
Mountain View
Mountain View Medical Offices
San Jose
San Jose Medical Center
Campbell Medical Offices
Gilroy Medical Offices
Milpitas Medical Offices
n Kaiser Permanente medical centers
(hospital and medical offices)
16
● Kaiser Permanente medical offices
Affiliated plan hospitals
ADDRESS
9201 Big Horn Blvd.
10305 Promenade Pkwy.
2155 Iron Point Rd.
10725 International Dr.
2345 Fair Oaks Blvd.
1650 Response Rd.
2025 Morse Ave.
6600 Bruceville Rd.
1600 Owens St.
2425 Geary Blvd.
1777 W. Yosemite Ave.
1721 W. Yosemite Ave.
7373 West Ln.
1800 N. California St.
2185 W. Grant Line Rd.
2001 Junipero Serra Blvd.
6th Floor, Ste. 650
395 Hickey Blvd.
1100 Veterans Blvd.
801 and 851 Traeger Ave.
901 El Camino Real
1001 Sneath Lane, Ste. 204
1011 Sneath Lane, 2nd Floor
1000 Franklin Pkwy.
1200 El Camino Real
200 and 220 E. Hacienda Ave.
7520 Arroyo Circle
700 and 770 E. Calaveras Blvd.
589 Los Coches St.
611 S. Milpitas Blvd.
555 Castro St.
565 Castro St.
250 Hospital Pkwy.
Affiliated medical offices
See how our care and coverage can help you thrive
CITY
Santa Clara
FACILITY
Santa Clara Arques Medical Offices
Santa Clara Medical Center
Santa Clara Medical Offices
ADDRESS
1263 E. Arques Ave.
700 Lawrence Expwy.
710 Lawrence Expwy.
Santa Cruz County
Santa Cruz
Scotts Valley
Watsonville
Solano County
Fairfield
Vacaville
Vallejo
Sonoma County
Petaluma
Rohnert Park
Santa Rosa
Stanislaus County
Modesto
Patterson
Turlock
Yolo County
Davis
Santa Cruz Medical Offices
(opening 2017)
Scotts Valley Medical Offices
(opening 2017)
Watsonville Medical Offices
(opening 2017)
Watsonville Community Hospital
(coming 2017)
5615 Scotts Valley Dr.
1931 Main St.
75 Nielson St.
Fairfield Medical Offices
Vacaville Medical Center
Vallejo Medical Center
1550 Gateway Blvd.
1 Quality Dr.
975 Sereno Dr.
Petaluma Medical Offices
Rohnert Park Medical Offices
Santa Rosa Medical Center
Santa Rosa Medical Offices
3900 Lakeville Hwy.
5900 State Farm Dr.
401 Bicentennial Way
3925 Old Redwood Hwy.
3975 Old Redwood Hwy.
Bangs Avenue Medical Offices
Dale Road Medical Offices
Modesto Medical Center
Modesto Medical Offices
Standiford Avenue Medical Offices
First Care Medical Center
Rodney Avilla, DO
Jagmohan Bhinder, MD
Maryam Esho, MD
Nirbhai Hundal, MD
Puliadi Kumar, MD
Turlock Pediatric Medical Group
4125 Bangs Ave.
3800 Dale Rd.
4601 Dale Rd.
4601 Dale Rd.
1320 Standiford Ave.
101 N. 3rd St.
2101 Geer Rd., Ste. 303
1860 Colorado Ave.
1729 N. Olive Ave., Ste. 7
1516 Colorado Ave.
1110 Delbon Ave.
1100 Delbon Ave.
Davis Medical Offices
1955 Cowell Blvd.
n Kaiser Permanente medical centers
(hospital and medical offices)
115 Locust St.
● Kaiser Permanente medical offices
Affiliated medical offices
Affiliated plan hospitals
17
1These features are available when you get care at Kaiser Permanente facilities.
2W
e improved blood pressure control in our Black/African American members, raised colon
cancer screening rates in our Hispanic Latino members, and improved blood sugar control
(HbA1c levels under 9%) in our Hispanic/Latino and Black/African American members with
diabetes. Self-reported race and ethnicity data are captured in KP HealthConnect, and HEDIS®
measures are updated quarterly in the interregional CORE Datamart.
3K
aiser Permanente 2015 HEDIS® scores. Benchmarks provided by the National Committee
for Quality Assurance (NCQA) Quality Compass® and represent all 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
2015 and is used with the permission of NCQA. Quality Compass 2015 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.
4Health Care Quality Report Card, 2008–16, California Office of the Patient Advocate.
2015–16 results are based on 2014 performance data. View the complete report at
reportcard.opa.ca.gov/rc/hmorating.aspx. The study was not endorsed by Medicare.
5To
use the Kaiser Permanente app, you must be a Kaiser Permanente member registered on kp.org.
6I f you reasonably believe you have an emergency medical condition, call 911 or go to the nearest
emergency department. An emergency medical condition is a medical or psychiatric condition that
requires immediate medical attention to prevent serious jeopardy to your health. For the complete
definition of an emergency medical condition, please refer to your Evidence of Coverage.
7This
number can be dialed from inside and outside the United States. Outside, you must dial the
U.S. country code “001” for land lines and “+1” for mobile before the phone number. Long-distance
charges may apply and we cannot accept collect calls. This phone line is closed on major holidays.
8If you‘re eligible, we will send you a Kaiser Permanente health payment card 4 to 6 weeks after
you complete your first activity, and load additional rewards when you complete your second
activity. You must keep your card for use throughout the year and use rewards you earn to pay for
qualified medical expenses by March 31 of the next calendar year. Go to kp.org/feds to learn
more and get started. This is a summary of the features of the Kaiser Permanente health plan. Before making a final
decision, please read the plan’s Federal brochure (RI 73-003). All benefits are subject to the
definitions, limitations, and exclusions set forth in the Federal brochure. The services listed on page
6 (“Healthy resources,” except “Health classes”) and on page 9 (eyewear and dental coverage) are
neither offered nor guaranteed under contract with the FEHB Program, but are made available to all
enrollees and family members who become members of Kaiser Permanente.
Kaiser Foundation Health Plan, Inc.
300 Lakeside Drive, 26th Floor
Oakland, CA 94612
Notice of Summary of Benefits and Coverage (SBC): Availability of Summary Health Information
The Federal Employees Health Benefits (FEHB) Program offers numerous health benefits plans and
coverage options. Choosing a health plan and coverage option is an important decision. To help
you make an informed choice, each FEHB plan makes available a Summary of Benefits and Coverage
(SBC) about each of its health coverage options, online and in paper. The SBC summarizes important
information in a standard format to help you compare plans and options. This plan’s SBC is available
on the internet at kp.org/feds. A paper copy is also available, at no charge, by calling 1-800-464-4000.
For TTY, call 711. To find out more information about plans available under the FEHB Program,
including SBCs for other FEHB plans, please visit opm.gov.
Please recycle. 60532809 October 2016
©2016 Kaiser Foundation Health Plan, Inc.