Kaiser Permanente has competetive rates that make it easy for you to keep your employees healthy and on the job -
starting at just $165* per month! With no Deductable

  • Doctor-directed health care

  • Preventive care (including check-ups)

  • Emergency care worldwide

  • No deductibles; virtually no paperwork

  • Affordable monthly premiums

  • Low office visit and prescription copayments
Plan 20
FEATURES MEMBER PAYS
Calendar Year Deductible
Individual/Family
$0
Out-of-Pocket Maximum
(per calendar year) 		$1,500 individual
$3,000 family
In the Medical Office
Office Visits
Physical Exams
Maternity/Paternity Care *
Scheduled Well-Child Visits
Immunizations
Lab, Imaging, Other Tests
(mammography and Pap smear included)
$20
$20
No charge
No charge **
No charge
No charge
Emergency Services
In or out of our Service Area,
in a Plan or Out-Of-Plan facility 		$100
Prescriptions
Covered prescription drugs in accord with our
formulary when obtained at Plan Pharmacies.
$10 Generic
$30 Name Brand
per prescription
Services Provided in Hospital
Physicians' Services, Room and Board,
Tests, and supplies
Skilled Nursing, Home Health and Hospice
No charge

No charge
Mental Health ***
In the Medical Office
(20-visit maximum per calendar year)
In the Hospital
(30-day maximum per calendar year)
$20

No charge
Alcoholsim/Drug Dependency Care
In the medical office
(counseling for dependency; medical
management of withdrawal symptoms)
In the Hospital (medical management
of withdrawal symptoms)
Transitional Residential Recovery Services
(in a non-medical setting)
$30 individual
$15 group therapy

No charge

$200
per admission
Durable Medical Equipment,
Orthotics, and Prosthetics
No charge

.... Other plans available, inc one with Deductables
* Scheduled prenatal visits and the first postpartum visit.
** After age 24 months, regular copayments apply.
*** Visit or day limits do not apply to certain mental health care described in the Evidence of Coverage.





Plan 20 Rate Chart - Northern California
 FOR GROUPS WITH 6 OR MORE SUBSCRIBERS *
AGE EMPLOYEE
ONLY 		EMPLOYEE
+ SPOUSE 		EMPLOYEE
+ CHILDREN 		EMPLOYEE
+ SPOUSE
+ CHILDREN
< 30 $165 $461 $458 $641
30-39 $182 $495 $465 $708
40-49 $235 $541 $446 $714
50-54 $306 $636 $521 $830
55-59 $385 $811 $598 $967
60-64 $477 $906 $638 $1057
65+ $566 $1203 $812 $1283
Spouse/
Dependent
Code 		EE EE+S EE+C EE+S+C
FOR GROUPS WITH 5 OR FEWER SUBSCRIBERS *
AGE EMPLOYEE
ONLY 		EMPLOYEE
+ SPOUSE 		EMPLOYEE
+ CHILDREN 		EMPLOYEE
+ SPOUSE
+ CHILDREN
< 30 $201 $562 $559 $782
30-39 $223 $605 $569 $856
40-49 $287 $660 $545 $871
50-54 $374 $777 $637 $1041
55-59 $472 $991 $731 $1182
60-64 $582 $1106 $779 $1291
65+ $692 $1471 $993 $1569
Spouse/
Dependent
Code 		EE EE+S EE+C EE+S+C

Rates shown are for new small groups only, located within the Kaiser Permanente Northern California Service Area.
* For new business effective rates 1-1-06 California Service Area 1. Rates subject to change.


email: rich@richsuess.com