Kaiser Group Health Insurance Plans

Thursday, February 10, 2022 15:49 Posted by Admin

Kaiser Permanente, or more commonly known as just ‘Kaiser,’ is an integrated managed care consortium in the United States. Based in Oakland California, Kaiser operates in eight U.S. states and is the largest managed care organization in the country. It is estimated that Kaiser currently provides insurance to 12.5 million people. With this number in mind, what is it that compels so many people to rely on Kaiser for their group health insurance coverage?

For starters, Kaiser’s mission is “to provide high-quality, affordable health care services and to improve the health of our members and the company [they] serve.” Though, there is much more to Kaiser than this singular mission. Let’s dive in to gain a deeper understanding of what this provider can offer you and your employees in terms of group health insurance coverage.

What is Group Health Insurance?

Before we continue, it’s very important to understand what group insurance is. Simply put, group health insurance is a form of insurance coverage that is specially designed to cover members of a group. In most cases, a group health plan delivers insurance to the employees of a company or the members of an organization, or other entity. Members also have the option of extending coverage to their immediate family members and dependents, if desired.

These types of plans help both employers and employees address their health care expenses. Though, in order for a group plan to be valid, 70% participation by group members is required. This means that individuals are not eligible to obtain coverage through a group health insurance plan and they can only be purchased by a group. The main advantage to choosing this type of insurance is that members generally receive insurance at a reduced rate than they would with an individual plan, as the insurer’s risk is spread between all policyholders.

That said, here’s a quick breakdown of group health insurance, or group health plans:

  • Members of the group get health insurance at a lower rate, since the insurer’s risk is dispersed between an entire group of covered members.
  • In order for a plan to be binding, they generally require not less than 70% participation by members.
  • By offering health insurance to employees, employers enjoy a number of tax advantages.
  • Premiums are divided between the organization and its members, with members also having the option to include their immediate family members and dependents for an additional monthly cost.

Kaiser Group Health Plans

Whether your business or organization is located in one city, or has multiple locations across the nation, you need a range of flexible options that suits your shifting needs. Kaiser offers adaptable health insurance plans for businesses of all sizes. However, their options vary slightly based on the size of the business. So, your first step in obtaining group health insurance is to know whether your business is small or large.

Is My Business Small or Large?

According to standards set by the Affordable Care Act, the size of your business depends on where you are located:

  • California & Colorado – small business is 1 to 100 employees; large business is 100+ employees.
  • District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia & Washington – small business is 1 to 50 employees; large business is 51+ employees.

Kaiser Small Business Insurance Plans

As a small business owner, it’s in your best interest to offer health insurance to your employees. Ideally, you want options that affordable, flexible, and simple and easy for both you and your employees. Fortunately, these are the solutions you receive when you choose Kaiser.

For small businesses, Kaiser has a number of plans to choose from and depending on the number of eligible employees, you may even be able to offer multiple plans so that they can select what’s best for them.

Traditional HMO Plans

HMO stands for Health Maintenance Organization. With these plans, you get an entire network of physicians, hospitals, and other care providers. Though, in order to receive the benefits of your plan, you must only use providers in the network. Kaiser’s HMO plans come with cost sharing and out-of-pocket maximums that are predictable. That way, employees can manage their health care expenses easier and have financial peace of mind.

  • Healthcare costs that are consistent and predictable.
  • Lower copays and no deductible.
  • When getting care at Kaiser facilities, there are no claim forms that employees have to manage.

Deductible HMO Plans

With Kaiser’s Deductible HMO Plans, you’ll receive more options but still at an affordable cost. The addition of an employee out-of-pocket cost results in lower monthly payments than the traditional HMO plans. Your employees will enjoy the benefit of reduced premiums, but with the same quality care and access to doctors and facilities.

  • Cheaper premiums than the traditional HMO plans.
  • Wide array of deductible amounts, based on your needs and preferences.
  • Can be combined with a health reimbursement arrangement (HRA) or a health savings plans (HAS), as desired.

HRA and HSA-Qualified Plans

Kaiser’s HRA and HSA-Qualified Plans come with premiums that are lower than other plan types, in addition to tax benefits. With either option, your employees have more control over their health care expenses and also have access to helpful online tools and the same services as members of traditional HMO plans.

  • Tax-free earnings can be used to pay for healthcare.
  • HRAs offer the most flexibility to employees
  • HSAs offer the most control to employees.

Deductible HMO with HRA Plans

These plans combine the affordability of traditional deductible HMO plans with the tax advantages of a health reimbursement arrangement (HRA). With this option, employees receive more jurisdiction over their health care spending, preventative care, and online support tools.

  • Cheaper premiums than traditional HMO plans.
  • Tax-deductible funds for employers; tax-free funds for employees.
  • Employees get tax-free benefits for qualified out-of-pocket costs.

PPO Plans

PPO plans, standing for “Preferred Provider Organization,” do not require you to choose a primary care physician to manage your care. Generally speaking, they offer the most flexibility to employees, as they get referral-free access to contacted PHCS Network doctors or any licensed provide of their choosing. These plans are ideal for employees who frequently find themselves outside of Kaiser’s service areas or simply want to receive care from an out-of-network doctor.

  • Access to any physician, with no referral needed.
  • Inclusive health care coverage, in or out of Kaiser’s service areas.
  • Single-carrier administration.

Point-of-Service Plans

Kaiser’s point-of-service (POS) plans pair one of their traditional HMO plans with their PPO to deliver the most comprehensive options within the KP service areas. These plans are ideal for people who want the option of going out-of-network but with the amount of savings that traditionally come with HMO plans.

  • “Best of both worlds” combination of flexibility and cost savings.
  • Employees have access to Kaiser providers and access to any provider they choose.
  • Employees have the option to save money with Kaiser provider or pay a marginally higher cost to go out of network.

Kaiser Large Business Insurance Plans

Considering the fact that your employees are your greatest investment, it’s crucial that you offer health insurance to help with recruiting and retaining the highest-quality workers. After all, the only way that your business moves forward is if your employees are performing at their best.

  • Traditional & Deductible Plans: These plans come with consistent, predictable cost sharing, allowing you to have control over monthly expenses.
  • Consumer-Directed Health Plans: Enjoy the benefit of reduced health care expenses for both your business and its employees.
  • Virtual Care Plans: Kaiser’s Virtual Care Plans give your employees care that is convenient and reasonably priced.
  • PPO, Point-of-Service, and Out-of-Area Plans: Give your employees convenient access to healthcare, with out-of-pocket maximums that deliver peace of mind.

Whatever Kaiser plan you choose, each option will allow you and your employees to live their healthiest and most successful lives. Have more questions about group health insurance and what plans Kaiser Permanent can offer your company? You’ve come to the right place.

The professional and experienced brokers at Taylor Benefits Insurance Agency can help – contact us now to get started.

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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