Kaiser Permanente's microsite for County of Sonoma employees
The Deductible First HDHP plan provides a 21% savings compared to the current Kaiser Permanente $10 Copay Plan. This plan requires a member to meet the calendar year deductible FIRST before ANY plan benefits will be paid, except covered preventive services.
- Members will pay 100% of the doctor office visits, radiology services, lab tests, prescriptions, hospitalizations, etc., until the calendar year deductible is met. Once the deductible is met, covered medical, hospital, and prescription benefits will be provided for a copayment or coinsurance amount.
- While this plan does require a member to meet the deductible first, members who anticipate a hospital stay (such as a surgery or the birth of a child), may find this plan offers a lower total out-of-pocket cost than the new Hospital Services HDHP plan.
- The calendar year out-of-pocket maximum includes; calendar year deductibles, copayments, and coinsurance.
Note: If you (the employee) elect to enroll in this plan, which qualifies as a HSA-qualified high deductible health plan, and you have a Flexible Spending Account and/or a Health Reimbursement Arrangement (HRA), be advised that under IRS rules you are NOT allowed to contribute to a Health Savings Account (HSA). Because the County’s FSA and HRA accounts can be used to reimburse your out-of-pocket medical expenses, the IRS does not allow you to also contribute to a Health Savings Account at the same time as it is considered prohibited health coverage.