California Medical Plans

2020 and 2021 Plan Year Information

California Medical Coverage Options

Kaiser Permanente HMOs provide in-network coverage only and are available to certain employees located in Northern and Southern California based on home ZIP code.

Kaiser Permanente Northern California (In-Network Only)Kaiser Permanente Southern California (In-Network Only)
Note

The figures in the chart below reflect what the Plan pays, with the exception of deductibles and out-of-pocket maximums.

Individual Deductible

$500

None

Family Annual Deductible

$1,000

None

Individual Out-of-Pocket Maximum

$3,000

$1,500

Family Out-of-Pocket Maximum

$6,000

$3,000

Most Preventive Care, Subject to Plan’s Frequency Limits

Covered at 100%

Covered at 100%

Office Visits (non-preventive)

100% after $20 copay

100% after $20 copay

Maternity

Inpatient: covered at 90% per admission then 100%
Outpatient: Pre-natal covered at 100%

Inpatient: $250 copay per admission then 100%
Outpatient: Pre-natal covered at 100%

Fertility Coverage (includes cryopreservation, artificial insemination, IVF, GIFT and ZIFT)

Contact the plan for details about this coverage

Contact the plan for details about this coverage

Medical Plan ID Cards

If you are enrolling for medical coverage for the first time or switching Plan administrators, you will receive a medical ID card by mail. If you require proof of coverage before receiving your ID card, you may print a temporary ID card from the Plan administrator’s website.