Kaiser Medical Plan HMO (CA Only)

Kaiser is an HMO medical plan offered to employees based in California only. This plan requires you to designate a Kaiser primary care doctor who manages your care and refers you to specialists. Coverage is for in-network services at Kaiser facilities only. This plan features co-pays for most services and some services, such as lab and x-rays, are offered with no out-of-pocket cost.

Insurance cards

You will receive your medical ID card about 2 weeks after you enroll in benefits. You can also call Kaiser at (800) 464-4000 and advise you are a new enrollee calling for your ID number. You’ll need to provide your personal identifying information, and they will provide your Kaiser ID number.

How to get care

With Kaiser, you’ll need to choose a primary care provider from the provider directory and schedule an appointment with them. You can register for an account for online access to your ID cards, medical and Rx benefits, to message your provider, and more.

Traveling Internationally?

To get care away from home 24/7, you may call Kaiser’s Away from Home Travel line at 951-268-3900. You may also visit Kaiser’s website for more information.

Kaiser Resources

Have questions on your benefits?

Contact the UMG
Benefit Service Center
at (888) 526-2794
from 8 am – 5 pm PT.

Kaiser (Plan #227476)
Phone: (800) 464-4000
Website: kp.org

Medical plan comparison

Anthem PPO
Anthem PPO
Anthem Co-Pay
Anthem HDHP
Anthem HDHP
Kaiser HMO
Plan Features
In-Network
Out-of-Network
In Network Only
In Network
In Network
In Network Only
Annual Deductible
None
$750 per member
$2,000 per family
None
$1,700 per member
$3,400 per family
$3,400 per member $6,800 per family
None
Annual Out-of-Pocket Maximum
$1,500 per member $3,000 per family
$3,000 per member
$9,000 per family
$800 per member
$2,400 per family
$3,400 per member
$6,800 per family
$6,800 per member $13,400 per family
$1,500 per member
$3,000 per family
Lifetime Maximum
Unlimited

Unlimited

Unlimited
Unlimited
Unlimited
Unlimited
Preventive Care
No co-pay
30% coinsurance*
No co-pay
No co-pay
30% coinsurance**
No co-pay
Primary Care
$20 co-pay
30% coinsurance*
$20 co-pay
10% coinsurance**
30% coinsurance**
$15 co-pay
Telehealth
No co-pay (LiveHealth Online)
Not covered
No co-pay (LiveHealth Online)
No co-pay (LiveHealth Online)
Not covered
No co-pay (Kaiser Video Visit)
Specialist
$40 co-pay
30% coinsurance*
$30 co-pay
10% coinsurance**
30% coinsurance**
$30 co-pay
Urgent Care
$20 co-pay
30% coinsurance*
$20 co-pay
10% coinsurance**
30% coinsurance**
$15 co-pay
Emergency Room
$100/visit (waived if admitted)
$100/visit (waived if admitted)
$100/visit (waived if admitted)
10% coinsurance**
10% coinsurance**
$100/visit
Mental / Behavioral Health
No co-pay
30% coinsurance*
No co-pay
No co-pay**
30% coinsurance**
$15 co-pay
Inpatient Hospitalization
10% coinsurance
30% coinsurance*
$200 co-pay
10% coinsurance**
30% coinsurance**
$100 co-pay/admission
Outpatient Surgery
10% coinsurance
30% coinsurance*
No co-pay
10% coinsurance**
30% coinsurance**
$30/procedure
Infertility Services
10% coinsurance (managed by Maven)
30% coinsurance (managed by Maven)
No co-pay (managed by Maven)
10% coinsurance
(managed by Maven)**
30% coinsurance (managed by Maven)**
Please review the SPD for specific services and coverage.
Lab & X-Ray
10% coinsurance
30% coinsurance*
No co-pay
10% coinsurance**
30% coinsurance**
No co-pay

*30% coinsurance after out-of-network deductible is met.
**HDHP coinsurance percentage is after initial deductible is met

Have questions about your benefits?

Contact the UMG Benefits Service Center at (888) 526-2794 from Monday to Friday 8 am – 5 pm PT.