A better way to take care of business

Transcription

1 A BETTER WAY SMALL GROUP A better way to take care of business Kaiser Permanente Health Plans for Small Groups At Kaiser Permanente, our mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. Our small group plans are built to keep the workforce at its healthiest, which helps employers move business forward. Through smart benefit design, coordinated care, chronic condition management, and preventive medicine, we help improve the health of employees and the company's bottom line. kp.org/wa/producer

2 A BETTER WAY Coordinated, connected care At Kaiser Permanente our collaborative approach empowers our care teams to achieve better outcomes for our members. The result is healthier employees and lower total cost of care. A team approach Led by the member's personal physician, our health care professionals and support staff work together to meet each member's individual health needs. Focus on prevention Lab MEMBER Specialist Connected care Our doctors, specialists, pharmacists, and care teams are all connected to the member s electronic health record. 1 Our integrated approach helps deliver better outcomes through preventive care and disease management, keeping employees healthier and on the job. We help employees stay well. Catching issues early prevents more expensive care later and reduces absenteeism and lost productivity. Evidence-based care By using scientific evidence we can provide treatment that s proven to be effective and efficient, helping keep health costs down. Nurse Doctor Pharmacy Medical excellence Washington Permanente Medical Group is the highest-ranked medical group in Washington state. 3 We provide care in more than 60 specialties and subspecialties. Plus, we have 12 dedicated occupational health locations. More effective care, even beyond our walls Easy ways to access care These options help employees get the right care at the right time: Consulting Nurse Service: a 24/7 phone service for advice. CareClinics: walk-in clinics for minor issues, located at several Bartell Drugs in the Seattle area. your doctor: an easy way for members to connect with care teams for non-urgent issues. 1 Online visits: members can receive diagnoses and even prescriptions for several common conditions all online and typically within an hour. Care management Employers consistently rank hospital costs as the #1 contributor to rising health care costs. Our care management program helps reduce the need for hospital stays and readmissions. Kaiser Permanente hospitalists and nurses are on-site at our seven highest-volume network hospitals. By using preferred facilities and providers, we re able to direct members to more effective care at lower costs. Formulary and managed medications Because prescription drugs have such a big impact on members health and health care costs, we keep a close eye on drug safety, effectiveness, and value. We assess costs and use generics when possible. We dispense trial doses of specialty drugs to ensure efficacy. We monitor for potential interactions. We evaluate all drugs before including them in our formulary. This approach results in 20 to 30 percent lower drug costs for members. 4

3 SMALL GROUP The right mix of care and coverage for your business Central to every one of our plans is giving your employees access to providers at Kaiser Permanente medical offices. This lets employees better engage in their health while minimizing their health care costs. And the more employees who see physicians at our medical offices, the lower the total cost of care. Small group plans include: Core HMO Featuring Kaiser Permanente physicians and medical offices, our Core HMO is our highest-performing plan in terms of quality and cost. Highlights include: Top-performing health plan in America. 2 Access to Washington Permanente Medical Group, the top-ranked medical group in Washington state. 3 Similar to an ACO with a not-so-narrow network focused on superior care management. Available as an HMO only or together with our Access PPO for employers with 10 to 50 employees. Access PPO Offering one of the largest PPO networks in the state, 5 our Access PPO is the only such plan with access to the high-performing 6 Washington Permanente Medical Group. Highlights include: Offers employees broad choice of providers, as well as access to Washington Permanente Medical Group, the highest-ranked medical group in the state. 3 Includes access to most providers in our service area, including UW Medicine, Swedish Physicians, MultiCare, CHI Franciscan, PeaceHealth, Providence, and more. Includes access to regional and national network providers in the First Choice Health network and First Health Network. Available as a PPO or as part of a dual choice with our Core HMO plan, for groups with 10 or more employees. Alternate purchasing options Kaiser Permanente also participates in private exchanges and trusts to provide additional ways to give employees choice of products alongside other ancillary offerings: Liazon Fully insured Defined contribution Multiple Kaiser Permanente HMO and PPO plans can be offered Ancillary products available Business Health Trust Fully insured Multiple Kaiser Permanente HMO and PPO plans can be offered Ancillary products available Dental plans available We've teamed up with Delta Dental of Washington to offer broad dental benefits to our members. This collaboration allows for consolidated enrollment and billing, making Kaiser Permanente the single point of contact for these services. Highlights of purchasing dental coverage through Kaiser Permanente include: Consolidated enrollment: Dental coverage is selected on the medical enrollment application Family plan: Includes federally mandated pediatric dental, allowing families to be covered under the same plan. Consolidated billing: One bill for medical and dental premiums 1 Available when members receive care at Kaiser Permanente medical offices (formerly Group Health Medical Centers). 2 Formerly Group Health Cooperative; 2016 evalue8 survey. Managed by the National Business Coalition on Health, evalue8 is an evidence-based resource created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. 3 Washington Health Alliance, 2016 Community Checkup. Scores listed under Group Health Cooperative. 4 The 2014 Drug Trend Report Commercial, The Express Labs, March 2015; Pharmacy Trend Executive Summary, Group Health Pharmacy Division, August Source: OIC Provider Form A 6 Criteria established by American Medical Group Association. 3

4 A BETTER WAY Quality that gets noticed We strive to deliver the best health plans possible to you, and the best health care possible to our members. When we re recognized for our achievements, it means that we re doing our part to help keep businesses healthy. Highest-Ranked Medical Group #1 Health Plan in America Washington Health Alliance 2016 Community Checkup Based on more than 50 clinical measures of quality, including cancer screenings, immunizations, diabetes care, and more evalue8 Survey Our commercial HMO was rated the top-performing health plan in the country in the 2016 evalue8 survey. 2 1 Washington Permanente Medical Group; Washington Health Alliance, 2016 Community Checkup. Scores listed under Group Health Cooperative. 2 Formerly Group Health Cooperative evalue Managed by the National Business Coalition on Health, evalue8 is an evidence-based resource created by business coalitions and employers like Mariott and General Motors to measure and evaluate health plan performance. All medical plans offered and underwritten by Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc. kp.org/wa/producer 2017 Kaiser Foundation Health Plan of Washington SG

5 Kaiser Permanente Nondiscrimination Notice and Language Access Services KAISER PERMANENTE NONDISCRIMINATION NOTICE Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. ( Kaiser Permanente ) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. Kaiser Permanente does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. Kaiser Permanente: Provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, contact Kaiser Permanente Member Services. If you believe that Kaiser Permanente has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity, you can file a grievance by phone, mail, fax, or . If you need help filing a grievance, a Kaiser Permanente Member Services Representative is available to help you. Language assistance is provided free of charge. The Kaiser Permanente Civil Rights Coordinator will be notified of all grievances related to discrimination on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. Phone: Toll-free: TTY Washington Relay Service: or 711 TTY Idaho Relay Service: or 711 Fax: or toll-free Address: Kaiser Foundation Health Plan of Washington Civil Rights Coordinator, Quality GNE-D1E-07 P.O. Box 9812 Renton, WA csforms@ghc.org You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue SW., Room 509F HHH Building Washington, DC , (TDD) Complaint forms are available at For Medicare Advantage Plans Only: Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal Kaiser Foundation Health Plan of Washington H5050_XB _55_17 accepted 2017-XB-6_ACA_Notice_Taglines

6 LANGUAGE ACCESS SERVICES English: ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call (TTY: or 711). Español (Spanish): ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: / 711). 中文 (Chinese): 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (TTY: / 711) Tiếng Việt (Vietnamese): CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (TTY: / 711). 한국어 (Korean): 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 (TTY: / 711) 번으로전화해주십시오. Русский (Russian): ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (телетайп: / 711). Filipino (Tagalog): PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (TTY: / 711). Українська (Ukrainian): УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером (телетайп: / 711). ភ ស ខ ម រ (Khmer) របយ ត ប ស នអកន ខ យមរ, សជ ន ខ យផក យម នគ តល គ ចនស ប ប រអក ច រទ រស ព (TTY: / 711) 日本語 (Japanese): 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます (TTY: / 711) まで お電話にてご連絡ください አማርኛ (Amharic) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (መስማት ለተሳናቸው: / 711). Oromiffa (Oromo): XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (TTY: / 711). ਪ ਜ ਬ (Punjabi) ਧ ਆਨ ਧ ਓ: ਜ ਤ ਸ ਪ ਜ ਬ ਬ ਲ ਹ, ਤ ਭ ਸ ਧ ਚ ਸਹ ਇਤ ਸ ਤ ਹ ਡ ਲਈ ਮ ਫਤ ਉਪਲਬ ਹ (TTY: / 711) ਤ ਕ ਲ ਕਰ العربية (Arabic): لديكم حق الحصول على مساعدة ومعلومات في ملحوظة :إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان.اتصل برقم رقم هاتف الصم والبكم: ( ) /. Deutsch (German): ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (TTY: / 711). ພາສາລາວ (Lao): ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາລາວ, ການບ ລການຊ ວຍເຫອດ ານພາສາ, ໂດຍບ ເສ ຽຄ າ, ແມ ນມ ພ ອມ ໃຫ ທ ານ. ໂທຣ (TTY: / 711). Srpsko-hrvatski (Serbo-Croatian): OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite (TTY- Telefon za osobe sa oštećenim govorom ili sluhom: / 711). Français (French): ATTENTION: Si vous parlez français, des services d aide linguistique vous sont proposés gratuitement. Appelez le (ATS: / 711). Română (Romanian): ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la (TTY: / 711). Adamawa (Fulfulde): MAANDO: To a waawi Adamawa, e woodi ballooji-ma to ekkitaaki wolde caahu. Noddu (TTY: / 711). فارسی (Farsi): توجه :اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما فراهم می باشد.با 711) / (TTY: تماس بگيريد. XB