NEED TO PURCHASE: EVA0514-0837 11.06.51 AM.JPGHawaii Employer-Union Health Benefits Trust Fund2020 EUTF Retiree Benefits

kp.org/eutf

Not a member yet?

For more information, visit kp.org/eutf or call 808-432-5250 (Oahu) or 1-844-276-6628 (toll free from the neighbor islands).

Monday through Friday, 7 a.m. to 7 p.m., except holidaysSaturday, 9 a.m. to 1 p.m.

Healthy togetherwith Kaiser Permanente

Kaiser Permanente Get more for your health

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Great reasons to choose Kaiser PermanenteAt Kaiser Permanente, you're at the center of everything we do — from being able to keep

your personal doctor when you enroll in Medicare to industry-leading digital tools that make

it easier to stay on top of your health. Check out what's included and see how your health

care dollar goes further with Kaiser Permanente.

Affordable, simple, and predictable

Make the right choice for a healthier you. You have peace of mind knowing that our

plans offer great value for your health care investment. You also have low caps for

out-of-pocket medical and prescription drug costs, and there's no deductible.

Quality care starts with over 600 of Hawaii's top providers

No matter which personal doctor you choose, you'll be in highly skilled hands.

You have exclusive access to physicians in our medical group, most of whom are

accepting new patients, so it's easy to choose or change doctors at anytime.

And when you enroll in Medicare, you can continue seeing the same personal

doctor you've come to know and trust. Learn more about our doctors

at kp.org/searchdoctors.

Convenient and hassle-free care anywhere, anytime

Care with Kaiser Permanente is care that fits your life. We make managing your

health easy with most services under one roof, an electronic medical record and

mobile app1 that travel with you, 24/7 nurse advice, same-day and phone

appointments, after-hours care, emails to your doctor's office with nonurgent

questions, worldwide urgent and emergency care, and more.

Specialty care available 24/7

You have access to specialty care 24 hours a day, 7 days a week at our Moanalua

Medical Center on Oahu. If a specialist isn't available on the neighbor islands, we

provide a complimentary neighbor island concierge service that can assist with air

and ground transportation to and from Moanalua Medical Center. This allows us to

provide the highest quality care in the highest quality environment.

2020 EUTF Retiree Benefits

EUTFNon-Medicare

EUTF MedicareSenior Advantage*

Annual deductible None None

Maximum out-of-pocket(Individual/Family) $2,000 / $6,000 $2,000 / $6,000

NEW! Diabetes Prevention Program No charge No charge

Hospital Inpatient

Services while hospitalized No charge No charge

Outpatient

Primary & specialty care $15 per visit $15 per visit

Preventive care and immunizations No charge No charge

Outpatient surgery $15 per visit $15 per visit

Lab, imaging, and testing $15 per visit No charge

Ambulance services 20% of charges 20% of charges

Emergency room visits for initial treatment only (Waived if admitted)

$50 per visit at a facility within the Hawaii service area;

20% of charges at a facility outside the Hawaii service area

$50 per visit worldwide

Mental Health and Chemical Dependency Services

Inpatient care No charge No charge

Outpatient visits $15 per visit $15 per visit

Outpatient Prescription Drugs

Pharmacy (30-day supply) $15 per prescription $15 per prescription

Mail order (90-day supply) $30 per prescription $30 per prescription

Additional Benefits

Home health care No charge No charge

Hospice care No charge for home and residential hospice

No charge for home and residential hospice

Durable medical equipment 20% of charges 20% of charges

Skilled nursing care No charge, up to 100 days per benefit period

No charge, up to 100 days per benefit period

*Retirees 65 and older residing in the Kaiser Permanente Senior Advantage plan service area are required to enroll in EUTF’s Kaiser Permanente Senior Advantage plan. Please refer to the non-Medicare benefits for Medicare members who reside outside the Kaiser Permanente Senior Advantage plan service area.

This is a summary of some benefits and their copayments and coinsurance.

This chart does not describe benefits in detail. Please see your detailed benefit summary on kp.org/eutf for information about coverage, limitations, and exclusions for all benefits, including those not listed in this summary.

Kaiser Permanente Get more for your health

Use the new and improved kp.org features from your smartphone or other

mobile device. Get started at kp.org/register or download the mobile app.1

Good health is in your hands

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New member transition

• Register on kp.org

• Choose a doctor

• Schedule an appointment

• Transfer your prescriptions

• Act for a family member

Online access 24/7

• Make and cancel appointments

• Access your digital membership ID card

• Refill most prescriptions

• View office visit information

• See biometric information

• Check immunizations

• View most test results

• See care gap reminders

• Get updated medical condition information

Convenience and wellness

• Schedule a phone appointment

• Email your doctor's office

• Speak to an advice nurse 24/7

• Get personal wellness coaching

• Join group health classes

• Take online healthy living programs

• Access videos, podcasts, recipes, and more

• Check health and drug encyclopedias

• View interactive symptom checker

Take charge of your costs

• View claims history

• Check your medical and prescription coverage

• Use our personalized cost estimator tool

• Pay your medical bills

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These features are available when you get care at Kaiser Permanente facilities.

Kaiser Permanente Get more for your health

You don't have to be a lifelong athlete to be active. The Silver&Fit Exercise and Healthy Aging

Program for our Kaiser Permanente Senior Advantage members makes it easier for you to

get fit and stay motivated — at no extra cost. After you enroll in Medicare, choose the fitness

center membership option or the home fitness program, then register at Silver&Fit.com or

call 1-877-750-2746 (TTY 711), Monday through Friday, 5 a.m. to 6 p.m. Pacific time.

The Silver&Fit® Program

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The Fit Rewards Program for non-Medicare members now includes all fitness centers

statewide.2 You can still earn a free gym membership at certain participating gyms or enjoy

discounted rates at other fitness centers. Choose from 5 tiers of fitness centers at different

price points. So whether you’re into group fitness, yoga, or pumping iron, we’ve got you

covered statewide. Whatever tier you choose, you can earn a $200 reward.3 Simply work out

at your chosen fitness center at least 45 days for at least 30 minutes a visit by the end of each

calendar year.

Get fit and get rewarded

Prefer to work out at home? Take advantage of the Home Fitness Kit program and receive

2 kits per year for just $10.

Go to kp.org/fitrewards for details or to find your favorite fitness center.

FIND THE BEST FIT FOR THE WAY YOU WANT TO WORK OUT!

CHOOSE ONE ANNUAL FEEADDITIONAL

MONTHLY FEEYOUR REWARD

TIER 1 $200 $0 $200

TIER 2 $200 $35 $200

TIER 3 $200 $55 $200

TIER 4 $200 $85 $200

TIER 5(OUTSIDE TIER

NETWORK)

YOU PAY STANDARD RETAIL FEES DIRECTLY TO FITNESS CENTER

N/A $200

You are responsible for any taxes that may be due on the amounts received. Please talk to your personal tax adviser for specific tax information about this reward.

Kaiser Permanente

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Care while traveling

Urgent and emergency care worldwide

Enjoy peace of mind when you’re away from

home, knowing that you’re covered for initial

emergency and urgent care anywhere in the

world. Visit kp.org/travel to learn how to get

care, what kind of care is covered, and what

to do if you’re admitted to a non–Kaiser

Permanente facility.4, 5

Care in another Kaiser Permanente service area

You’re covered for certain routine and

specialty care, including care for ongoing

health conditions, at any of our Kaiser

Permanente facilities. Outside of Hawaii,

you’ll find us in California, Colorado,

Georgia, Maryland, Oregon, Virginia,

Washington state, and Washington, D.C.

If you need urgent care in a Kaiser

Permanente service area/region, visit the

nearest Kaiser Permanente urgent

care clinic.6

Urgent care in states without Kaiser Permanente

If you need urgent care in a state without Kaiser Permanente, go to the nearest

MinuteClinic® or urgent care facility.7

If you need urgent care in Las Vegas, we

contract with Concentra Urgent Care and

Walgreens Healthcare Clinics.

If you need urgent care while traveling internationally, go to the nearest urgent

care facility or hospital.

For more tips to help you stay well while

you’re away from home, questions about

your benefits and out-of-pocket costs, how

to get care outside Hawaii, or for medical

advice at anytime, visit us at kp.org/travel or call 951-268-3900, 24 hours a day,

7 days a week.8

It’s easy for you and your family to get the care you need when traveling.

Peace of mind wherever you go

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Kaiser Permanente

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Switching made easyWe created a single destination that makes it easy for you to switch to Kaiser Permanente.

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It starts at kp.org/easyswitch

Let us help you find the right doctor

Our online doctor profiles let you browse our many excellent doctors, even before you enroll. So you can join knowing you’ve found doctors who fit the individual needs of everyone in your family. You’re also free to change your doctor at any time, for any reason.

Transition your care seamlessly

Easily transition your care and prescriptions so your treatment is uninterrupted. Find a location that’s close to your home, work, or school. Many services are often under one roof, making it easy to see your doctor, fill prescriptions, and get the care you need — all in one trip.

Get care on your schedule

Need to schedule an appointment? Have a nonurgent question you’d like to email to your doctor’s office? After you enroll, download our mobile app or register for an online account at kp.org/register. Then join the millions of members across our regions who easily manage their health online — whenever, wherever.

We're here to help — every step of the way

Our Care Transition Team can help you choose a personal doctor, make an appointment, and transition your prescriptions and care to Kaiser Permanente.

808-643-5744 or 711 (TTY), Monday through Friday, 9 a.m. to 5 p.m., except holidays

With you every step of the way

Kaiser Permanente

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With medical offices and hospitals close to where you work and live, you have options when it comes to getting care. To find a location near you, visit kp.org/facilities or download our free Kaiser Permanente app for your smartphone or mobile device. Then use our location finder to search by ZIP code or keyword.

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Medical Centers / Plan Hospitals

Neighborhood ClinicsOther Specialty Services

Medical Offices

Map not to scale

Lanai

Molokai

Hawaii Island

Maui

Kauai

Oahu

Behavioral Health

WailukuMaui Lani Elua

Sleep Center

Lanai Community Hospital

Molokai General Hospital

Moanalua

Samuel MahelonaMemorial Hospital

West KauaiMedical Center

Wilcox Memorial Hospital

Kula Hospital

Maui Memorial Medical Center

Hilo Medical Center

Kona Community Hospital

North Hawaii Community Hospital

Koolau

Mapunapuna

Honolulu

Waipio

Maui Lani

Kona Hilo

Waimea

Kihei

Lahaina

Nanaikeola

Kapolei

Kailua

Hawaii Kai

Kahuku

Lihue

Growing to Meet the Needs of West OahuWe’ve served West Oahu for more than 36 years. Now we’re bringing more services and personalized care to your growing community. Our new state-of-the-art, 40,000 square-foot facility will link our doctors and members to the latest technology in a spacious, soothing environment designed for healing.

• Family, Adult and Keiki Care• Prevention & Wellness Programs• Mental Health Services• Laboratory• Pharmacy

Featured Services

• 40,000 sq. ft. - three times larger than current facility• 40+ exam rooms• 28 provider offices• Est. cost $60M• Easy-access parking• Thrive Path and garden

with Hawaiian healing plants • 401 Kamokila Blvd., Kapolei, HI• 5.4 acres of land • Close proximity to H-1, and rail

Expanded Facility Size

NextGen Health HubThe Health Hub care model will better integrate care into our members’ lives. The technology maximizes members’ visits, evolves in response to their changing health care needs, supports care team collaboration, and contributes to improving quality of care.

WEST OAHU MEDICAL OFFICE ATKAPOLEI

OPENING EARLY 2021

• Women’s Health Services• General Radiology, Mammography and Ultrasound Imaging• Urgent Care with Extended Hours

New and Enhanced Services

Footnotes1To use the Kaiser Permanente app, you must be a Kaiser Permanente member registered on kp.org. 2Fitness centers must be qualified fitness organizations operating for the general public; must offer regular cardiovascular, flexibility, and/or resistance training exercise programs; established physical facility must offer a membership agreement and must be overseen by staff. Fitness centers outside the United States and the District of Columbia do not qualify.

3Earn your annual program fee back by exercising 45 days a year for at least 30 minutes per session at a qualifying fitness center. Reimbursement is limited to your annual program fee, up to $200 each calendar year.

Higher rates (for tiers 2, 3 and 4), taxes, and additional fees you pay your gym for classes, services, or amenities aren’t included in the program and are not eligible for the reward. Please consult with your tax adviser about the taxability of the reward. Except for earning your reward by exercising 45 days a year for at least 30 minutes per session at a participating fitness center, your annual program fee is not refundable and will not be prorated.

Fitness center visits completed before your annual member fee is paid do not count toward the Fit Rewards requirement. Medicare and Medicaid (QUEST Integration) members excluded. For details, visit kp.org/fitrewards.

Kaiser Permanente Fit Rewards is a value-added service and not part of your medical benefits. Your annual program fee does not count toward your health plan’s annual out-of-pocket maximum. This information is not a complete description of benefits. For details, including limitations and exclusions, see your Evidence of Coverage (EOC) or kp.org/fitrewards.

Kaiser Permanente Fit Rewards is administered by American Specialty Health Fitness, Inc. through its Active&Fit® program. American Specialty Health Fitness, Inc. (ASH Fitness) is a subsidiary of American Specialty Health Incorporated (ASH). All programs and services are not available in all areas. The people in this piece are not Active&Fit members. Active&Fit and the Active&Fit logo are trademarks of ASH and used with permission herein.

4An urgent care need is one that requires prompt medical attention, usually within 24 or 48 hours, but is not an emergency medical condition. This can include minor injuries, backaches, earaches, sore throats, coughs, upper-respiratory symptoms, and frequent urination or a burning sensation when urinating.

5If you reasonably believe you have an emergency medical condition, call 911 or go to the nearest emergency department. An emergency medical condition is a medical or psychiatric condition that requires immediate medical attention to prevent serious jeopardy to your health. For the complete definition of an emergency medical condition, please refer to your Evidence of Coverage or other coverage documents.

6If you get care at a MinuteClinic or any other urgent care facility within a state with Kaiser Permanente providers, you’ll be asked to pay upfront for services you receive and will need to file a claim for reimbursement.

7If you get care at a MinuteClinic, you’ll be charged your standard copay or coinsurance. Medicaid members and patients are not eligible.

8This number can be dialed from inside and outside the United States. Before the phone number, dial “001” for landlines and “+1” for mobile lines if you’re outside the country. Long-distance charges may apply, and we cannot accept collect calls. The phone line is closed on major holidays (New Year’s Day, Easter, Memorial Day, July Fourth, Labor Day, Thanksgiving, and Christmas). It closes early the day before a holiday at 10 p.m. Pacific Time (PT), and it reopens the day after a holiday at 4 a.m. PT.

Kaiser Permanente Medicare (HMO)Informational sessions for Oahu EUTF members

Seating is limited, don’t miss your opportunity to join the conversation and learn more!

Please reserve your space by calling 808-432-5915 (TTY 711 for the hearing/speech impaired).

A sales person will be present with information and applications. For accommodation of persons with special needs at sales events, call toll free 808-432-5915 (TTY 711 for the hearing/speech impaired), Monday through Friday, 8 a.m. to 4 p.m.

For more information about Kaiser Permanente’s Medicare program, call Member Services at 1-800-805-2739 (TTY 711 for the hearing/speech impaired), 7 days a week, 8 a.m. to 8 p.m. Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. You must reside in the Kaiser Permanente Medicare service area in which you enroll.

Join us for an informational meeting and get advice and answers to all your Medicare questions. Meetings will be held at the following Oahu Kaiser Permanente locations:

Kapolei Clinic599 Farrington HighwayKapolei, HI 96707

Waipio Medical Office94-1480 Moaniani St.Waipahu, HI 96797

Honolulu Medical Office1010 Pensacola StreetHonolulu, HI 96814

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Kaiser Foundation Health Plan, Inc.711 Kapiolani Blvd., Suite 400Honolulu, HI 96813

KAH3438 | 384136970ST-19 | August 2019 ©2019 Kaiser Foundation Health Plan, Inc.

Want to learn more?Visit kp.org/eutf or call our Member Services, Monday through Friday, 7 a.m. to 7 p.m. and Saturday, 9 a.m. to 1 p.m. (closed holidays)

• 808-432-5250 (Oahu) • 1-844-276-6628 (toll free from the neighbor islands) • 711 (TTY)

A website just for you: kp.org/eutfAt kp.org/eutf, you’ll find your Kaiser Permanente 2020 plan materials. You can also connect to our facility and physician directories and learn more about our services.