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Northern California Region | Federal Employees and Annuitants 2014 Rates and Benefits kp.org/feds Not a member yet? Visit kp.org/feds or call 1-855-315-1009, Monday through Friday, 8 a.m. to 5 p.m., for more information. Statements above relate to Kaiser Permanente physicians and services only. This is an advertisement I can choose my doctor excellent prenatal care a wide range of specialists test results online

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Page 1: I can choose my doctor - Kaiser Permanentehealthplans.kaiserpermanente.org/federalemployees/wp-content/... · Statements above relate to Kaiser Permanente physicians and services

Northern California Region | Federal Employees and Annuitants2014 Rates and Benefits

kp.org/feds

Not a member yet? Visit kp.org/feds or call 1-855-315-1009, Monday through Friday, 8 a.m. to 5 p.m., for more information.

Statements above relate to Kaiser Permanente physicians and services only.

This is an advertisement

I can choose my doctor

excellent prenatal care

a wide range of specialists

test results online

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* Many features discussed in this book are available only to members receiving care at Kaiser Permanente medical facilities.

A better choice for good healthWith care and coverage working seamlessly together, Kaiser Permanente is uniquely designed to give you the information and support you need to live healthy.

a better experience*

We care about the whole you— body, mind, and spirit. Our doctors, health plans, and medical facilities all work as one, so your experience is smoother and simpler.

everything under one roof *

You can do more and drive less because most of our locations include pharmacy, lab, X-ray services, and more.

personalized care and attention*

Your doctors, nurses, and specialists are connected to your electronic health record, so they can work together to deliver great care that’s right for you.

online access anytime, anywhere* Use your computer, smartphone, or mobile device to email your doctor’s office, schedule routine appointments, view lab test results, refill prescriptions, and more.

lots of healthy extrasStay at your best with healthy resources like farmers markets and wellness classes, many of which are free.

your choice of top doctorsOur doctors are among the best, and caring for people is their passion. Plus, you’ve got the power to change doctors anytime.

kp.org/feds

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Better Informed. Better Together.Nationwide, over 9 million people turn to us as their trusted partner for better-informed care and support for total health. Take a look, and you’ll see why Kaiser Permanente is your best choice.

The power to choose ...................................................................................2

Excellent care ..................................................................................................3

Online access anytime, anywhere ..........................................................4

Convenient classes, resources, and more ..........................................5

Federal Employees Health Benefits (FEHB) Options ....................6

Kaiser Permanente Senior Advantage (HMO)

for Federal Members ............................................................................7

Your supplemental dental options ........................................................8

Additional benefit highlights ...................................................................9

Your benefits summary for 2014 .........................................................10

How to enroll ................................................................................................12

Our locations ................................................................................................13

Prefer to see this information online? Go to kp.org/feds.

Already a member?If you’re currently a member and have questions, please call our Member Service Contact Center at 1-800-464-4000, 24 hours a day, 7 days a week (closed holidays). For TTY for the hearing/speech impaired, call 1-800-777-1370.

Watch members share why they chose Kaiser Permanente at kp.org/thrive.

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Your choice of top doctors

We’ve carefully selected our doctors so you can make the right choice for you and your family. Many of our highly respected doctors come from the top medical schools in the country. And it’s easy to take your pick—just go online to view our doctor profiles.1 You can choose or change your doctor anytime.

Under-one-roof convenience

Save time and avoid driving all over town for care. You have many locations to choose from, and most of them offer multiple services under one roof. You can see your doctor, get a lab test or an X-ray, and pick up your medications—all without leaving the building. And when you get care with fewer delays, you can get better faster.

What you need, when you need it1

g Email your doctor’s office with nonurgent questions.

g Refill prescriptions online with free shipping.

g Make routine appointments with a call or click.

g View recent office visits and most test results online.

g Get same-day, after-hours, and weekend services at many locations.

g Call for advice from a registered nurse, 24 hours a day.

g Travel freely; you’re covered for emergency care worldwide.2

The power to choose Stay in charge of your health. It’s simple to make the right choice when you’ve got great doctors, convenient facilities, and care when you need it.

Your doctor’s officeYour record gets updated with each visit to our Kaiser Permanente facilities, so it’s always current.

Pharmacy, lab, X-rayNo need for paperwork when you get services at our facilities—your doctor’s orders are already there.

Your electronic health record brings it all together1

See how Kaiser Permanente has helped members at kp.org/carestories.

1 Online features available when you receive care at Kaiser Permanente facilities.2 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.

2

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Excellent careTeamwork and expertise combined help make our doctors, nurses, and specialists better informed to provide the best care for your needs.

Personalized care and attention

A care team that’s informed and focused on you can lead to better health. Supported by your secure electronic health record, your doctors, nurses, and specialists are better prepared to deliver the right care at the right time— even if you go to different Kaiser Permanente locations in your area.1

Easy access to specialty care

Specialists at our facilities are connected to real-time updates on your electronic health record, so they can diagnose and treat conditions more efficiently. And because they work with your doctor, referrals are easier. You can even request a referral by emailing your doctor’s office.

A focus on you and your family

With medical care and health coverage working together, there are fewer administrative hassles for you and your care team. You’re empowered to get the care you need, and your doctors, nurses, and specialists can focus on what they do best. With caring, compassion, and a love for what they do, your team is united by one shared goal—to help you get well and stay well.

Learn more about the doctors available in your area at kp.org/doctorsandlocations.

Specialty careYour specialists are up-to- speed and ready to take care of you.

At home or on the goGet your health information on your computer or mobile device to stay informed and in charge.

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For a guided tour of My Health Manager, visit kp.org/experience.

Online access anytime, anywhereAt home or on the go, we’ve got you covered. Plug into your health with our online and mobile tools that help you get what you want, when you want it.

It’s easy to stay connected

Members registered on kp.org have secure access to My Health Manager, the online tool that helps you manage the care you receive at Kaiser Permanente facilities.g Email your doctor’s office.g Refill prescriptions.g View most lab test results.g Schedule or cancel routine appointments.

g Care for a family member using these features.

A website full of healthy ideas

Get informed and inspired on our award-winning website, kp.org. Take charge of your health with articles, wellness topics, and health calculators. Our music channels, podcasts, fitness videos, and recipes from world-class chefs can help you find new ways to live well.

Good health on the go

Manage your care at home, work, or play with our mobile app. It puts all the convenient features of My Health Manager right in the palm of your hand. You can download the free Kaiser Permanente app from the App StoreSM or Google Play®.

App Store is a service mark of Apple, Inc., and Google Play is a trademark of Google, Inc.

Great careA care team that’s coordinated and focused on you.

Great doctorsChoose from top doctors who are in it because they care.

Top reasons to join Kaiser Permanente

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Find tools, tips, and information for living well at kp.org/livehealthy.

Convenient classes, resources, and moreWe have a passion for prevention. That’s why we give you lots of healthy extras that can help you stay informed about ways to live healthier in body, mind, and spirit.

Learn something new

With the many health classes offered at our facilities, there’s something for everyone. Try classes on yoga, eating well, baby care, and much more. Classes vary by location and some may require a fee.1, 2

Fresh food in the parking lot

Eating well is easier when you bring home fresh food from our farmers markets. They’re conveniently located at many of our facilities, so you can pick up some healthy fruits and veggies after your visit.

Maximize your health

Our personalized online wellness programs can help you lose weight, stay active, reduce stress, sleep better, and much more.1, 2 Programs and certain drugs for tobacco-cessation are available to you, without a copay.2 You can also download the free Every Body Walk! app from the App Store or Google Play. It’s a fun, interactive tool to help you create and maintain a daily walking routine.

Great accessEmail your Kaiser Permanente doctor’s office, call for advice, get appointments when you need them.

Great visitsDoctor, lab, X-rays, and pharmacy all in one place at most of our locations.

Watch members share why they chose Kaiser Permanente at kp.org/thrive.

1 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.

2 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.

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Federal Employees Health Benefits (FEHB) Options1

Now you can choose between three Kaiser Permanente FEHB plan options. With each option you’ll receive all your care from Kaiser Permanente, including a wide range of services and resources to help you maximize your health.

Kaiser Permanente FEHB High Option

If you expect to receive care often, this option may be right for you. You’ll pay higher premiums but lower copays for most health care services and prescription drugs.

You’ll pay:g nothing for most preventive care services

g lowest copays for most covered services, including office visits and most prescription drugs

g no deductibles

Kaiser Permanente FEHB Standard Option

This option has lower premiums than the High Option. You’ll pay higher copays for office visits and urgent care visits, as compared to the High and Basic options. You’ll also pay a deductible and then copayments for certain services—like inpatient hospital services, labs, and X-rays.

You’ll pay:g nothing for most preventive care services

g copays for most primary and specialty care office visits and most prescription drugs

g a lower deductible for certain services as compared to the Basic Option

Kaiser Permanente FEHB Basic Option

This option has the lowest premiums. As compared to the Standard Option, you’ll pay lower copays for office visits and urgent care visits. You’ll also pay a higher deductible and then coinsurance for certain services.

You’ll pay:g nothing for most preventive care services

g copays for most primary and specialty care office visits and most prescription drugs

g a deductible then coinsurance for certain services, such as inpatient hospital services, labs, and X-rays

6

For more plan details, see the benefits and rates summary on page 10. For help deciding which health plan option best fits your needs, visit kp.org/feds and click on “Choose a Health Plan.”

You might choose this option if you and your family expect to receive services often and you prefer predictable costs.

You might choose this option if you and your family are in good overall health and want lower premiums, but are willing to pay more when you receive certain services.

You might choose this option if you and your family are in great overall health, don’t expect to receive major services, and want to pay the lowest premiums.

NEW

A deductible is defined as a set dollar amount you’ll need to pay before we start paying for certain services.

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.

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With Senior Advantage for Federal Members, your benefits are subject to Medicare rules and you may have to receive care from different plan providers than with your FEHB coverage.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premiums, and copayments/coinsurance may change on January 1 of each year and at other times in accord with your group’s contract with us. To join a Kaiser Permanente Medicare health plan, you must reside in the Kaiser Permanente Senior Advantage service area in which you enroll. 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.

Kaiser Permanente Senior Advantage (HMO) for Federal MembersIf you’re enrolled in Medicare Parts A and B (or Part B only), Kaiser Permanente Senior Advantage for Federal Members may be right for you. Your FEHB premiums stay the same when you enroll, but you’ll have a lower share of the cost for most services and better benefits. And you don’t need to suspend your FEHB coverage to enroll in this option.

Give us a callFor details about Senior Advantage for Federal Members benefits, cost sharing, limitations, services, and how to enroll, please call our licensed sales specialist at 1-855-366-9013, 8 a.m. to 8 p.m., seven days a week. For TTY for the deaf, hard of hearing, or speech impaired, call 711.

Maximize your health plan

After you enroll in Senior Advantage for Federal Members, you’ll enjoy all the benefits of Medicare, plus all the benefits of your FEHB program, without any increase in your FEHB premiums.

Review the benefits chart in this brochure for details about the lower cost sharing and the extra benefits you receive with this option.

High Option

This option has the lowest copays of all our Senior Advantage for Federal Members plans, when you enroll in both the High Option and Senior Advantage for Federal Members.

Standard Option

With the Standard Option, you’ll pay lower copays than the Basic Option and no deductibles.

Basic Option

With this option, you’ll pay the highest copays and no deductibles.

Better benefits

Senior Advantage for Federal Members offers:

g reduced copays for office visits, inpatient hospital admissions, most prescription drugs, and most other services

g up to a 100-day supply of prescription drugs at Plan pharmacies for one copay (High Option only)

g additional credit toward the purchase of eyewear, including eyeglasses

g preventive dental coverage through DeltaCare at no additional premium (High and Standard Option only)

7

NEW

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Kaiser Permanente Insurance Company (KPIC) Dental Insurance Plan

This plan gives you the freedom to see any licensed dentist you choose, with no deductible for preventive and diagnostic services. When you visit a participating Delta dentist in California, all claims paperwork will be handled for you.

If you have any questions about enrolling for the first time, call Delta Dental at 1-800-933-9312, Monday through Friday from 8 a.m. to 4 p.m., and give your group number, 9874. If you’re currently enrolled and want more information, call 1-800-835-2244, Monday through Friday from 5 a.m. to 6 p.m. This plan is administered by Delta Dental of California and underwritten by KPIC.

DeltaCare USA

With this plan, you’ll select a dentist from the DeltaCare USA network. There are no claim forms to fill out and no deductibles. Most preventive and diagnostic services are available at little or no cost to you. For other covered services, including orthodontic services, you’ll pay a simple copay.

If you have questions about enrolling for the first time, call Delta Dental at 1-800-933-9312, Monday through Friday from 8 a.m. to 4 p.m., and give your group number, 1114. If you’re currently enrolled and want more information, call 1-800-422-4234, Monday through Friday from 5 a.m. to 6 p.m. DeltaCare USA is a dental HMO program administered by Delta Dental of California.

Find out more

For more information about your choices for dental coverage, see the FEHB brochure (RI 73-003), visit kp.org/feds, or return the reply card at the back of this brochure. Details about your dental benefits are included in the dental program directory.

1 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.

KPIC Dental Insurance Plan DeltaCare USA

Monthly Monthly Quarterly

Self $30.80 $12.83 $38.49

Self + one $54.59 $21.48 $64.44

Self + two or more $82.06 $32.56 $97.68

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Your supplemental dental options1

Whether you choose the High, Standard, or Basic Option, Kaiser Permanente offers you a choice of two dental plans to supplement your health coverage.

2014 dental rates

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Chiropractic benefits

These benefits are administered by American Specialty Health Plans of California, Inc. (ASH Plans). You can visit any ASH Plans participating provider, and no referral is needed.

1. Find a participating provider at ashcompanies.com/kp or call 1-800-678-9133, Monday through Friday from 5 a.m. to 6 p.m. For TTY for the hearing/speech impaired, call 1-877-710-2746.

2. Schedule an appointment with the chiropractor.

3. Pay your office visit copay when you arrive.

Benefits are summarized in the table below. Chiropractic services are covered if they’re medically necessary to diagnose or treat neuromusculoskeletal disorders, as prescribed and provided by an ASH Plans participating provider. For definitions, limitations, and exclusions, see the FEHB brochure (RI 73-003).

Getting care while traveling

Wherever your work takes you, we’ve got you covered. As a Kaiser Permanente Federal Employees Health Benefits (FEHB) member, your benefit goes even further than your home service area. All Kaiser Permanente FEHB members get:• Coverage for emergency

care worldwide at emergency rooms and urgent care centers.

• Care from any Kaiser Permanente location in another Kaiser Permanente region through the Visiting Member Program.

• Coverage for certain outpatient follow-up care and outpatient continuing care outside of Kaiser Permanente service areas through the FEHB travel benefit.

Benefit changes in 2014

Here are some of the key benefit changes for 2014. For a complete list, see the FEHB brochure (RI 73-003).

High and Standard Options• Added coverage for certain

prescribed over-the-counter medications and contraceptives.

• No charge for genetic testing and counseling for breast cancer.

• More services that apply to your out-of-pocket maximum.

• No exclusions for services, drugs, or supplies related to sex transformations.

Basic Option See page 6 for a brief description of our new Basic Option.

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Additional benefit highlights2

Whichever option you choose, your Kaiser Permanente health plan comes with chiropractic and benefits when you’re traveling. You’re free to see any participating provider for chiropractic services, and you have access to care in any other Kaiser Permanente region in the United States.

Your Chiropractic Benefits Summary

Office visits $15 copay per visit Limit of 20 visits per calendar year

Chiropractic appliances $50 benefit maximum per calendar year

2 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.

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Your benefits summary for 2014 Kaiser Permanente Kaiser Permanente Senior Advantage (HMO)for Federal Members

Benefits and services High Option Standard Option Basic Option High Option Standard Option Basic Option

The benefits and services below are NOT subject to applicable plan deductibles

Office visits

Preventive care $0 $0 $0 $0 $0 $0Primary/specialty care visit $15/$25 $30/$40 $25/$35 $5/$5 $15/$15 $25/$25

Prenatal care and first scheduled postpartum visit $0 $0 $0 $0 $0 $0

Urgent care at an urgent care center $15 $30 $25 $5 $15 $25

Most Prescription drugs1

Generic drugs

Picked up from Plan pharmacy

$10 (up to 30-day supply)

$15 (up to 30-day supply)

$15 (up to 30-day supply) $10 (up to

100-day supply)

$10 (up to 30-day supply)

$10 (up to 30-day supply)

Delivered by our mail-order service

$20 (up to 100-day supply)

$30 (up to 100-day supply)

$30 (up to 100-day supply)

$20 (up to 100-day supply)

$20 (up to 100-day supply)

Brand-name drugs

Picked up from Plan pharmacy

$30 (up to 30-day supply)

$35 (up to 30-day supply)

$35 (up to 30-day supply) $20 (up to

100-day supply)

$25 (up to 30-day supply)

$25 (up to 30-day supply)

Delivered by our mail-order service

$60 (up to 100-day supply)

$70 (up to 100-day supply)

$70 (up to 100-day supply)

$50 (up to 100-day supply)

$50 (up to 100-day supply)

Chiropractic visit Up to 20 visits per year2 $15 $15 $15 $153 $153 $153

Dental benefit Coverage through DeltaCare Not covered Not covered Not covered$15 per cleaning, $0 oral exams and X-rays (2 per year)

$15 per cleaning, $0 oral exams and X-rays (2 per year)

Not covered

The benefits and services below ARE subject to applicable plan deductibles

Deductible None $200 per person (up to $400 per family)

$500 per person (up to $1,000

per family)None None None

Most labs and X-rays, such as blood tests and ultrasounds $0 $10 20% of our allowance $0 $10 $0 per lab or

X-ray4

Emergency care at a hospital5 You are covered for medical emergencies anywhere in the world $100 $150 20% of our

allowance $50 $50 $654

Ambulance $50 per trip $150 per trip 20% of our allowance $50 per trip $125 per trip $150 per trip4

Inpatient hospital $250 per admission

$500 per admission

20% of our allowance

$100 per admission

$250 per admission

$250 per day up to $1,0004

Out-of-pocket maximum (applies to certain covered services)$1,500 per person$3,000 per family

$2,000 per person$4,000 per family

$5,500 per person$11,000 per family

$1,500 per person$3,000 per family

$1,500 per person$3,000 per family

$1,500 per person$3,000 per family

Rates you pay6 High Option Standard Option Basic Option

Enrollment Code

Your Share

Enrollment Code

Your Share

Enrollment Code

Your Share

Non-Postal Premium, biweeklySelf Only 591 $163.13 594 $105.10 KC1 $84.43

Self and Family 592 $421.27 595 $268.54 KC2 $220.18

Non-Postal Premium, monthlySelf Only 591 $353.45 594 $227.72 KC1 $182.93

Self and Family 592 $912.75 595 $581.83 KC2 $477.05

Postal Premium, biweekly, Category 1

Self Only 591 $141.27 594 $83.24 KC1 $62.57

Self and Family 592 $372.65 595 $219.92 KC2 $171.56

Postal Premium, biweekly, Category 2

Self Only 591 $154.93 594 $96.90 KC1 $76.23

Self and Family 592 $403.04 595 $250.31 KC2 $201.95

This is a summary of the features of the Kaiser Permanente health plan, including Kaiser Permanente Senior Advantage for Federal Members. Before making a final decision, please read the Federal Employees Health Benefits (FEHB) brochure, RI 73-003, and the Kaiser Permanente Senior Advantage for Federal Members Evidence of Coverage (EOC). All benefits are subject to the definitions, limitations, and exclusions set forth in the FEHB brochure and the Kaiser Permanente Senior Advantage for Federal Members EOC.

1 If you request a brand-name drug in place of a generic drug prescribed by your doctor, you may be required to pay full charges.

2 For chiropractic services, you self- refer to a participating American Specialty Health (ASH) network chiropractor. To find a participating chiropractor, call 1-800-678-9133.

3 These chiropractic services are separate from the chiropractic services that we cover in accordance with Medicare guidelines.

4 Your share of the cost will not exceed the amount you pay as a Kaiser Permanente Basic Option member without Kaiser Permanente Senior Advantage for Federal Members.

5 The emergency copay is waived if you are admitted to the hospital within 24 hours for the same con- dition or if you are admitted directly to the hospital as an inpatient.

6 These rates do not apply to all enrollees. If you are in a special enrollment category, please refer to your special FEHB Guide or contact the agency that maintains your health benefits enrollment.

If you have Medicare Parts A and B (or Part B only) you have the option to enroll in Senior Advantage for Federal Members without increasing your FEHB premiums. For more information, see page 7.

10 11

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How to enrollBecoming a member is easy. Just follow the three simple steps below. The information in this booklet can help you pick the right plan that meets your needs.

1. Choose an option

Select Kaiser Permanente’s High Option, Standard Option, or Basic Option. Brief descriptions of these options are on page 6. You will find details about benefits and rates on pages 10 and 11.

2. Select the type of enrollment you want

Select “Self Only” or “Self and Family.” Self and Family enrollment provides benefits for you and your eligible family members. Then look at the “Rates you pay” chart on page 10 and note your enrollment code.

3. Enroll in Kaiser Permanente*

Most employees and annuitants can enroll online. Visit opm.gov or contact your employing agency or retirement office for FEHB enrollment procedures and other information.

Annuitants can contact the Retirement Information Center at 1-888-767-6738 or for TTY, 1-855-887-4957, or [email protected].

* 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 enrollment, complete and return an Enrollment Change Form to us. These forms can be obtained at kp.org/feds or by calling Member Services.

If you’re eligible for Medicare, or will be soon, you may be able to pay a lower share of the cost for most services and get better benefits by enrolling in Kaiser Permanente Senior Advantage for Federal Members. See additional details on page 7.

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Our locations When construction at our Oakland Medical Center is completed in 2014, East Bay members will have better access to a wide range of care and services. The expanded facility will include a new 12-story hospital with a comprehensive pediatric center and 14 inpatient operating rooms. Scheduled to open in 2014, our new San Leandro Medical Center will offer a 24-hour pharmacy, urgent care with extended hours, and 116 primary and specialty care provider offices.

San Mateo

Fresno County

n Kaiser Permanente medical centers (hospital and medical offices)● Kaiser Permanente medical offices Affiliated plan hospitals Affiliated medical offices

Maps not to scale

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Our locations

City Facility Address

Alameda ● Alameda Medical Offices 2417 Central Ave.

Antioch n Antioch Medical Center 4501 Sand Creek Road

● Delta Fair Medical Offices 3400 Delta Fair Blvd.

Bolinas Bolinas Family Practice 88 Mesa Road

Campbell ● Campbell Medical Offices 220 E. Hacienda Ave.

Clovis ● Clovis Medical Offices 2071 E. Herndon Ave.

Daly City ● Daly City Medical Offices 395 Hickey Blvd.

Davis ● Davis Medical Offices 1955 Cowell Blvd.

Elk Grove ● Elk Grove Medical Offices 9201 Big Horn Blvd.

● Elk Grove Promenade Medical Offices 10305 Promenade Pkwy.

Fairfield ● Fairfield Medical Offices 1550 Gateway Blvd.

Folsom ● Folsom Medical Offices 2155 Iron Point Road

Fremont n Fremont Medical Center 39400 Paseo Padre Pkwy.

Fresno n Fresno Medical Center 7300 N. Fresno St.

● First Street Medical Offices 4785 N. First St.

Gilroy ● Gilroy Medical Offices 7520 Arroyo Circle

Hayward n Hayward Medical Center 27400 Hesperian Blvd.

Lincoln ● Lincoln Medical Offices 1900 Dresden Drive

Livermore ● Livermore Medical Offices 3000 Las Positas Road

Manteca n Manteca Medical Center 1777 W. Yosemite Ave.

● Manteca Medical Offices 1721 W. Yosemite Ave.

Martinez ● Martinez Medical Offices 200 Muir Road

n Kaiser Permanente medical centers (hospital and medical offices)● Kaiser Permanente medical offices Affiliated plan hospitals Affiliated medical offices

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City Facility Address

Mill Valley ● Mill Valley Medical Offices 750 Redwood Hwy.

Milpitas ● Milpitas Medical Offices 770 E. Calaveras Blvd.

Modesto n Modesto Medical Center 4601 Dale Road

● Bangs Avenue Medical Offices 4125 Bangs Ave.

● Dale Road Medical Offices 3800 Dale Road

● Modesto Medical Offices 4601 Dale Road

● Standiford Avenue Medical Offices 1320 Standiford Ave.

Cornerstone Family Practice Medical Group

1444 Florida Ave.

Family Health Care Medical Group 1320 Celeste Drive

Mountain View ● Mountain View Medical Offices 555 Castro St. 565 Castro St.

Napa ● Napa Medical Offices 3285 Claremont Way1675 Permanente Way

Novato ● Novato Medical Offices 97 San Marin Drive

Oakhurst ● Oakhurst Medical Offices 40595 Westlake Drive

Oakland n Oakland Medical Center 280 W. MacArthur Blvd.

Patterson First Care Medical Center 101 N. Third St.

Petaluma ● Petaluma Medical Offices 3900 Lakeville Hwy.

Pinole ● Pinole Medical Offices 1301 Pinole Valley Road

Pleasanton ● Pleasanton Medical Offices 7601 Stoneridge Drive

Point Reyes Station Point Reyes Medical Clinic 3 Sixth St.

West Marin Medical Center 11150 State Route 1

Rancho Cordova ● Rancho Cordova Medical Offices 10725 International Drive

Our locations

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City Facility Address

Redwood City n Redwood City Medical Center 1150 Veterans Blvd.

Richmond n Richmond Medical Center 901 Nevin Ave.

Rohnert Park ● Rohnert Park Medical Offices 5900 State Farm Drive

Roseville n Roseville Medical Center 1600 Eureka Road

● Roseville Medical Offices – Riverside 1001 Riverside Ave.

Sacramento n Sacramento Medical Center 2025 Morse Ave.

n South Sacramento Medical Center 6600 Bruceville Road

● Fair Oaks Boulevard Medical Offices 2345 Fair Oaks Blvd.

● Point West Medical Offices 1650 Response Road

San Bruno ● Bayhill Medical Offices 801 Traeger Ave. 851 Traeger Ave.

● San Bruno Medical Offices 901 El Camino Real

● Sneath Lane Medical Offices 1001 Sneath Lane1011 Sneath Lane

San Francisco n San Francisco Medical Center 2425 Geary Blvd.

San Jose n San Jose Medical Center 250 Hospital Pkwy.

San Leandro n San Leandro Medical Center (Scheduled to open spring 2014)

2500 Merced St.

San Mateo ● San Mateo Medical Offices 1000 Franklin Pkwy.

San Rafael n San Rafael Medical Center 99 Montecillo Road

● Downtown San Rafael Medical Offices – 3rd St.

1033 Third St.

San Ramon ● San Ramon Medical Offices (Scheduled to open fall 2013)

2500 Merced St.

Santa Clara n Santa Clara Medical Center 700 Lawrence Expwy.

● Santa Clara Arques Medical Offices 1263 Arques Ave.

● Santa Clara Medical Offices 710 Lawrence Expwy.

n Kaiser Permanente medical centers (hospital and medical offices)● Kaiser Permanente medical offices Affiliated plan hospitals Affiliated medical offices

16

Our locations

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*Affiliated plan facilities provide selected inpatient and/or outpatient hospital and emergency services.1 The information in this guide is current as of the date of publication. If you have questions about the information in this guide, please contact our Member Service Contact Center at 1-800-464-4000 (1-800-777-1370 for the hearing/speech impaired), 24 hours a day, 7 days a week (closed holidays).

City Facility Address

Santa Rosa n Santa Rosa Medical Center 401 Bicentennial Way

● Santa Rosa Richard Stein Medical Offices

3925 Old Redwood Hwy. 3975 Old Redwood Hwy.

Selma ● Selma Medical Offices 2651 Highland Ave.

South San Francisco n South San Francisco Medical Center 1200 El Camino Real

Stinson Beach Stinson Beach Medical Center 3419 State Route*Stockton ● Stockton Medical Offices 7373 West Lane

Dameron Hospital* 525 W. Acacia St.

Tracy ● Tracy Medical Offices 2185 W. Grant Line Road

Turlock Rodney Avilla, DO 2101 Geer Road

Jagmohan Bhinder, MD 1860 Colorado Ave.

Maryam Esho, MD 1729 N. Olive Ave.

Nirbhai Hundal, MD 1516 Colorado Ave.

Puliadi Kumar, MD 1110 Delbon Ave.

Turlock Pediatric Medical Group 1100 Delbon Ave.

Union City ● Union City Medical Offices 3551 Whipple Road3553 Whipple Road 3555 Whipple Road

Vacaville n Vacaville Medical Center 1 Quality Drive

Vallejo n Vallejo Medical Center 975 Sereno Drive

Walnut Creek n Walnut Creek Medical Center 1425 S. Main St.

● Park Shadelands Medical Offices 320 Lennon Lane

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Our locations

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Please recycle. This material was produced from eco-responsible resources.

Member and Marketing Communications 87045 September 2013

kp.org/feds

Kaiser Foundation Health Plan, Inc.1950 Franklin St. Oakland, CA 94612

A website just for youAt kp.org/feds you’ll find your Kaiser Permanente 2014 enrollment materials, including the Federal Employees Health Benefits brochure (RI 73-003). You can also connect to our facility and physician directories and learn more about our services.

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, free of charge, by calling 1-800-464-4000 (a toll-free number).

To find out more information about plans available under the FEHB Program, including SBCs for other FEHB plans, please visit opm.gov.