What you need to know
Imagine the convenience of having all your health care providers under one roof. Now, if you're in California, Colorado, Georgia, or Hawai‘i, stop imagining—'cause this dream becomes a reality when you enroll in a Kaiser plan. Check out the highlights below, but keep in mind: The plans do not cover care from non-Kaiser providers except in the case of a life-threatening emergency.
Wanna get smart?
Set aside pretax dollars in a Health Savings Account (HSA). Get free money from Workday. Feel secure in knowing you and your family are covered. What more could you want from a medical plan? Learn how a plan with an HSA works.
No cost for COVID-19 treatment
We hope it doesn't happen to you, but if a doctor thinks you should get tested for COVID-19, you won't have to pay for the test or any related follow-up treatment. Your Kaiser plan will pay 100%, with no deductible or copay.
Kaiser Smart Plan With HSA
- Your per-paycheck contributions are the lowest of the Kaiser plans ($0 for employee-only coverage!).
- For in-network preventive care services, the plan pays 100% (no copay or deductible).
- For in-network doctor visits and services, the plan pays 80% after you meet the $1,600 individual / $3,200 family deductible.
- Out-of-network services: The plan does not cover non-Kaiser providers, except in emergencies.
- In-network prescription drugs:
- Retail: $10 generic / $30 brand after deductible (30-day supply)
- Mail-order: $20 generic / $60 brand after deductible (100-day supply)
- This plan is available to Workmates in California, Colorado, Georgia, and Hawai‘i.
Bonus! There’s a reason they call this the Smart Plan. When you enroll in it, you’re eligible for a Health Savings Account (HSA), and that lets you set aside pretax dollars to pay for eligible medical expenses. Can you say “ka-ching”? Plus, Workday chips in, so you get free money: $1,000 for employee-only coverage or $2,000 if you're also covering dependents. Pretty smart, huh?
What you pay for care
Calendar-year deductible
| Coverage | Deductible |
|---|---|
| Individual | $1,600 |
| Individual in Family | $3,200 |
| Entire Family | $3,200 |
Calendar-year out-of-pocket maximum
| Coverage | Out-of-Pocket Maximum |
|---|---|
| Individual | $4,000 |
| Individual in Family | $4,000 |
| Entire Family | $6,850 |
Select medical services
This is what you pay for care for certain services. For other medical expenses and more information, review the medical plan comparison chart.
| Service | Cost |
|---|---|
| Preventive Care | $0 |
| Office Visits | 20% after deductible |
| Emergency Room (ER) | 20% after deductible |
| Urgent Care | 20% after deductible |
| Outpatient Surgery | 20% after deductible |
| Behavioral Health | 20% after deductible |
| Physical Therapy | 20% after deductible |
| Family Planning Services | Infertility coverage available.* |
* Please contact Kaiser for coverage details. Family planning benefits are administered for Workday by Maven Wallet and include reimbursement allowance for IVF or IUI, egg freezing, adoption, or surrogacy.
Your first step to free money
If you enroll in the Kaiser Smart Plan, you need to elect the HSA during enrollment to receive the company contributions (even if you don't want to contribute to your account right now). Then, be sure to open your account with Fidelity.
Kaiser Traditional Plan
- Your per-paycheck contributions are moderate.
- For in-network preventive care services, the plan pays 100% (no copay or deductible).
- For in-network doctor visits, you pay a $20 copay and a set copay for certain other in-network services with no deductible. After your copay, the plan pays 100%.
- Out-of-network services: The plan does not cover non-Kaiser providers, except in emergencies.
- In-network prescription drugs:
- Retail: $10 generic / $30 brand (30-day supply)
- Mail-order: $20 generic / $60 brand (100-day supply)
- This plan is available to Workmates in California, Colorado, Georgia, and Hawai‘i.
What you pay for care
Calendar-year deductible
| Coverage | Deductible |
|---|---|
| Individual | $0 |
| Individual in Family | $0 |
| Entire Family | $0 |
Calendar-year out-of-pocket maximum
| Coverage | Out-of-Pocket Maximum |
|---|---|
| Individual | $1,500 |
| Individual in Family | $1,500 |
| Entire Family | $3,000 |
Select medical services
This is what you pay for care for certain services. For other medical expenses and more information, review the medical plan comparison chart.
| Service | Cost |
|---|---|
| Preventive Care | $0 |
| Office Visits | $20 PCP / $20 specialist |
| Emergency Room (ER) | $100 (waived if admitted) |
| Urgent Care | $20 |
| Outpatient Surgery | $100 per procedure |
| Behavioral Health | $20 copay |
| Physical Therapy | $20 per outpatient visit |
| Family Planning Services | Infertility coverage available.** |
** Please contact Kaiser for coverage details. Family planning benefits are administered for Workday by Maven Wallet and include reimbursement allowance for IVF or IUI, egg freezing, adoption, or surrogacy.
Your one-stop health-management tool
Once you’re enrolled in a Kaiser plan, be sure to register for My Health Manager. Here are just a few of the tasks you can handle—anytime, anywhere—through My Health Manager:
- Email your doctor
- View lab test results
- Order prescription refills
- Request routine appointments
- Access your temporary ID card while you wait for the printed ID card to arrive. ID cards can take up to two to three weeks to be printed and mailed.
Sky-high-quality care
Cloud Care, the health clinic just for Workmates, is available at our onsite health center in Pleasanton. We also have free virtual visits available to all U.S. Workmates. These services are for everyone enrolled in a Workday medical plan.
FYI
Learn more about your plan by reviewing the Kaiser Benefit Summaries and other plan documents.