Federal Employee Health Benefits (FEHB) - 2020 FEHBP Open ... · Transition your care seamlessly...

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Federal employees and annuitants 2020 rates and benefits kp.org/feds Healthy together Care and coverage that fits your life Earn up to $500 in healthy rewards 1 Care at home and when you travel • Video visits at no cost GEORGIA

Transcript of Federal Employee Health Benefits (FEHB) - 2020 FEHBP Open ... · Transition your care seamlessly...

Page 1: Federal Employee Health Benefits (FEHB) - 2020 FEHBP Open ... · Transition your care seamlessly Easily move prescriptions so your treatment is uninterrupted. And find a location

Federal employees and annuitants 2020 rates and benefits

kp.org/feds

Healthy togetherCare and coverage that fits your life

• Earn up to $500 in healthy rewards1

• Care at home and when you travel• Video visits at no cost GEORGIA

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Kaiser Permanente

Welcome to care that fits your life

Your doctor, your choice

Choose your doctor based on what’s

important to you. Go to kp.org/searchdoctors for details about education,

specialties, languages spoken, and more. You

can also change doctors at any time.

Many services under one roof

Do more in less time. In most of our

facilities, you can see your doctor, get a

lab test, and pick up prescriptions — all in

a single trip.

Right care, right time

Get the care you need when you need it with

routine, specialty, urgent, and emergency care. If

you’re ever unsure where to go, call us for 24/7

care advice by phone.

More care optionsHow you get care

is up to you. Choose a phone appointment or video visit,2 email

your doctor’s office with nonurgent questions, or come see us in person.3

Convenient cost estimates

Get an idea of what you’ll pay before you

come in for care. For a personalized

estimate based on your plan details, visit "Tools

and Resources" on kp.org/feds.

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Care and coverage that fits your life

Experience the Kaiser Permanente difference

To be healthy, you need quality care that’s simple, personalized, and

hassle-free. At Kaiser Permanente, care and coverage come together —

so you get everything you need to stay on top of your health in one

easy-to-use package.

Let’s get started

A stress-free path to switch plans 3

Quality care with you at the center 4

Great care, great results 5

Healthy resources 6

Your care, your way 7

Care when and where you need it 8

Care when you travel 9

What you need to know for 2020

Featured benefits 10

Your 2020 benefits at a glance 17

Ready to enroll with Kaiser Permanente? 18

Vision and dental care services 20

Locations near you 21

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Kaiser Permanente

There’s a lot to do when changing health plans. That’s why we created a single destination that makes it easy to join Kaiser Permanente, and to get started once you do.

Feel the healthy change — every step of the way

Have questions about joining Kaiser Permanente? We're here to help. Call us at:

1-855-315-1006 (TTY 711), Monday through Friday: 10 a.m. to 8 p.m.

During open enrollment season: Monday through Friday: 9 a.m. to 10 p.m.

See just how easy it is to get started as a member at kp.org/easyswitch.

Let us help you find the right doctor

Finding a new doctor can feel stressful. But our online doctor profiles let you browse the many excellent doctors and convenient locations in your area, even before you enroll. So you can join knowing you’ve found a doctor who fits your needs. You’re also free to change at any time, for any reason.

Transition your care seamlessly

Easily move prescriptions so your treatment is uninterrupted. And 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, register for an online account at kp.org or get our mobile app. Then join the millions of members who easily manage their health online — whenever, wherever.

A stress-free path to switch plans

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Care and coverage that fits your life

Great care from great doctors

Our doctors come from top medical schools, and many of them teach at world-renowned universities. No matter which personal doctor you choose, you’ll be in highly skilled, experienced hands — and your health is their main concern.

As your biggest health advocate, your doctor will coordinate your care journey, and you’ll work closely together to make decisions about your health.

Better care with a connected team

Your doctor, nurses, and other specialists all work together to keep you healthy. They’re connected to each other, and to you, through your electronic health record. So they know important things about you and your health — like when you’re due for a screening and what medications you’re taking. That way, you get personalized care that’s right for you.

Personalized care for all members

Care at Kaiser Permanente isn’t one-size-fits-all. We believe your story, background, and values are as important as your health history. To help deliver care that’s sensitive to your culture, ethnicity, and lifestyle, we:

• Strive to hire doctors and staff who speak more than one language

• Offer telephone interpretation services in more than 150 languages

• Train our care teams on how to connect with and care for people of diverse backgrounds

Our physician-led care teams work together to keep you healthy by delivering high-quality, personalized care.

Through our culturally responsive care programs, we’ve improved health outcomes among diverse populations for conditions like high blood pressure, diabetes, and colon cancer.4

Quality care with you at the center

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Kaiser Permanente

Preventive care to keep you healthy

Preventive care is key to how we practice medicine. It can help you avoid some health issues and catch others before they become serious.

Your electronic health record plays a vital role. It tracks your preventive care services and sends reminders when you’re due for your next screening. We’ll let you know when to come in so you’re free to focus on living your life.

Specialty care when you need it

We’re also here for you if you get sick or need specialty care. With one of the largest multispecialty medical groups in the country, we can conveniently connect you with the right specialist. And you don’t need referrals for certain specialties, like obstetrics-gynecology, psychiatry, and drug dependency services.

From high-quality maternity care to treatment for cancer, heart problems, and more, you get great doctors, the latest technology, and evidence-based care — all combined to help you recover quickly.

Support for ongoing conditions

If you have a condition like diabetes or heart disease, you’re automatically enrolled in a disease management program for personal coaching and support. With a well-rounded approach backed by proven best practices and advanced technology, we’ll help you get the care you need to continue living life to the fullest.

A leader in clinical quality

In 2018, Kaiser Permanente led the nation as the top performer in 30 effectiveness-of-care measures — the most of any health plan.5 These measures include:

• Prevention and screening

• Cardiovascular care

• Comprehensive diabetes care

• Medication monitoring

Great care, great resultsFrom preventive screenings that keep you healthy to world-class care if you get sick, we’ve got you covered.

Hear care stories from real Kaiser Permanente members at kp.org/carestories.

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Care and coverage that fits your life

Get the most out of your health plan

Help to quit smoking

If you use cigarettes, e-cigarettes, or other tobacco products, let us help you quit. You pay nothing for classes, telephone coaching, online programs, and prescriptions, including prescribed over-the-counter tobacco-cessation drugs. For more information, ask your doctor or visit kp.org/quitsmoking.

Prescription costs at your fingertips

Use our prescription drug pricing tool to find out how much you‘ll pay for different medications as a Kaiser Permanente member. Learn more at kp.org/feds.

Healthy rewards

Take simple steps to improve your well-being Subscribers and their enrolled spouses (age 18 and over) are eligible to receive $200 (High and Standard Options) and $250 (Basic Option) for completing a confidential, online, Total Health Assessment (available in English or Spanish) and being up to date on certain biometric screenings. Visit kp.org/feds to learn more.

Online wellness toolsConnect to better health with online programs to help you lose weight, quit smoking, reduce stress, and more — all at no cost. Learn more at kp.org/healthylifestyles.

Health classesSign up for health classes and support groups at many of our facilities. See what’s available near you at kp.org/classes — some may require a fee.

Personal wellness coaching

Get help reaching your health goals. Work one-on-one with a wellness coach by phone at no cost. Find out more at kp.org/wellnesscoach.

Special rates for members

Enjoy reduced rates on services that can help you stay healthy — like gym memberships, massage therapy, and more. Explore your options at kp.org/choosehealthy.

Good health goes beyond the doctor’s office. Explore all the convenient resources available to members and choose the ones that fit your life.

Healthy resources

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Kaiser Permanente

Get care where, when, and how you want it. With more options to choose from, it’s easier to stay on top of your health.

Choose how you get care

In person

Most of our locations have many services under one roof, so you can see your doctor, get lab services or X-rays, and pick up a prescription—all in the same trip3. We also offer same-day and next-day appointments for many services at several of our locations.

Phone - $0 Copay

Have a condition that doesn’t require an in-person exam? You may be able to save a trip to the doctor’s office by having a phone appointment with a physician to discuss your progress, talk about a new concern, or ask a question about your care2, 3

Video - $0 Copay

For some conditions, you can meet virtually face-to-face with your doctor2, 3 on your computer, smartphone, or tablet. Video visits are available for primary care, as well as a growing number of specialties, for members who are registered on kp.org and have seen their doctor in the past year. For certain minor issues, same-day video appointments are also available.

24/7 Nurse Advice - $0 Copay

Have questions? Not sure what kind of care you need? You can call our local, specially trained Kaiser Permanente nurses anytime at 404-365-0966. If you receive care in our facilities, the nurses are connected to your doctor, can see your health record and help determine what type of care you may need.

Email - $0 Copay

Message your doctor’s office anytime with nonurgent health questions.3 You’ll get a response usually within 2 business days, if not sooner.

Online - $0 Copay

Manage your health, find nearby locations, and take advantage of health guides and other resources. You can also download the Kaiser Permanente app to keep up with your care on the go.6 Visit kp.org/newmember to see how it works. To learn more about the KP app, visit kp.org/mobile.

Your care, your way

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Care and coverage that fits your life

It’s easy for you and your family to get the care you need when you need it. There are many Kaiser Permanente facilities in your area, offering convenient hours and a wide range of care and services.

Convenient care near you

With multiple locations to choose from, it’s easy to find one near home or work. We offer same-day, next-day, after-hours, and weekend services at many of our locations, along with ob-gyn, pediatrics, and other specialty departments. You can also see different doctors at different locations — whatever works best for you.

Finding the right location

Choosing a convenient place to get care is simple — just hop online or grab your smartphone.

• Visit kp.org/facilities to search by ZIP code, keyword, or the type of service you need.

• Search on your smartphone with the location finder on the Kaiser Permanente mobile app.6

Getting care anytime, anywhere

Urgent/same-day careIf you need care quickly, we're here for you. For less serious symptoms, you can schedule a same-day telephone or video appointment, or visit one of our offices offering same-day appointments. Three of our Kaiser Permanente medical centers offer 24/7 Urgent Care, where you'll also find lab, X-ray, and pharmacy under the same roof. You also have access to our affiliated Urgent Care locations, found on page 32 - 35.7

Emergency careIf you ever need emergency care, you’re covered worldwide—anytime, anywhere.You can get care at any hospital emergency room, even if it's not affiliated with Kaiser Permanente.8

Care away from homeIf you get hurt or sick while traveling, we’ll help you get care. We can also help you before you leave town by checking to see if you need a vaccination, refilling prescriptions, and more. Just call our 24/7 Away from Home Travel Line9 at 951-268-3900 or visit kp.org/travel.

Care when and where you need it

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Kaiser Permanente

Enjoy peace of mind when you travel, knowing that you’re covered for emergency care anywhere in the world at emergency rooms and urgent care centers.8 And once you’re registered at kp.org and download our app, you can see your health information online.

In a different Kaiser Permanente service area

You’re covered for certain routine and specialty care, including care for an ongoing health condition, at any of our Kaiser Permanente or affiliated facilities in a different Kaiser Permanente service area.

Student coverage outside the service area

Students taking at least 12 credit hours per semester at an accredited institution outside of a Kaiser Permanente service area and within the United States are covered for routine, continuing, and follow-up medical care. You pay 20% of the usual and customary charges with an annual benefit limit of $1,200.

Outside a Kaiser Permanente service area

In addition to emergency care, you can also get certain follow-up care when Kaiser Permanente facilities aren’t near. When you’re temporarily outside your home service area by more than 100 miles and outside any other Kaiser Permanente service area, you're covered for the following:

• Outpatient follow-up care to complete a course of treatment after a covered emergency

• Outpatient continuing care for covered services related to conditions diagnosed and treated within the previous 12 months by a Kaiser Permanente practitioner or affiliated practitioner

You pay $25 for each follow-up or continuing care office visit. Kaiser Permanente pays up to $1,200 each calendar year for this follow-up or continuing care travel benefit.

Care when you travel

Just call our 24/7 Away from Home Travel

Line9 at 951-268-39005 or visit kp.org/travel.

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Care and coverage that fits your life

» Premiums as low as $45.39

» New Basic Option with low premiums, predictable costs, and high rewards

» Up to $500 in Healthy Rewardsdepending on the option and enrollment you choose

New for 2020

Need more information to make a decision?Call 855–315–1006 (TTY 711) Monday through Friday:10 a.m. to 8 p.m.

During open enrollment season:

Monday through Friday: 9 a.m. to 10 p.m.

Visit kp.org/feds anytime.

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Kaiser Permanente

Could our Basic Option be right for you?

• Among the lowest premium FEHB plans

• Deductible does not apply to routine office visits, labs, emergency care and prescription drugs

• No coinsurance for most services and relatively low copays; you will know what you pay for a service

• $250 deductible applies to services such as inpatient hospital care and outpatient surgery

• Up to $500 per family in Healthy Rewards

Consider this option if you

• Don't go to the doctor often

• Want a lower premium with copays for services and prescription drugs

• Want the convenience of having your doctor, lab, pharmacy, and x-ray in one location

• Want the highest amount in Healthy Rewards

Earn up to $500 in rewards with the Basic Option1

Take steps to improve your well-being to earn rewards to pay for qualified medical expenses. Standard Option subscribers and their enrolled spouses are eligible to earn $250 per person in rewards by completing the following activities:

• Taking our Total Health Assessment, an online questionnaire that gives you a wellness action plan

• Completing the following biometric screenings: Blood Glucose, Blood Pressure, Body Mass Index (BMI), Total Cholesterol

You must complete both activities during the 2020 calendar year to earn your rewards. Start by visiting kp.org/feds to learn more and get started.

What can you pay for with your rewards?

We’ll send you a Kaiser Permanente Health Payment Card upon completion of all activities. It can be used to pay for qualified medical expenses, including:

• Your deductible

• Cost-sharing, such as your copays

• Prescription eyeglasses or contact lenses

• Prescription medications in our Kaiser Permanente Medical Facility Pharmacies

• Other IRS-qualified medical expenses

Basic Option

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Care and coverage that fits your life

For a more complete benefits summary, see page 17 or visit kp.org/feds.

Outpatient services (per visit or procedure) You pay

Deductible does not apply

Preventive care $0

Primary care $20

Specialty care $40

Most lab tests and X-rays $0

Preferred Generic prescription drugs (up to a 30-day supply at plan medical center pharmacies)

$5

Emergency and Urgent Care

Emergency care $250

Urgent care $40

Your premium share Basic Option

Out-of-pocket maximum (2x per family maximum) $6,500

Deductible $250

Self Only Enrollment code: LA1

Biweekly Non-Postal $45.39

Biweekly Postal Category 1 $43.57

Biweekly Postal Category 2 $37.67

Monthly Non-Postal $98.34

Self Plus One Enrollment code: LA3

Biweekly Non-Postal $102.57

Biweekly Postal Category 1 $98.47

Biweekly Postal Category 2 $85.14

Monthly Non-Postal $222.24

Self and Family Enrollment code: LA2

Biweekly Non-Postal $102.57

Biweekly Postal Category 1 $98.47

Biweekly Postal Category 2 $85.14

Monthly Non-Postal $222.24

These rates do not apply to all enrollees. If you are in a special enrollment category, please contact the agency or tribal employer that maintains your health benefits enrollment.

2020 Basic Option Quick Look

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Kaiser Permanente

Could our Standard Option be right for you?

• Great balance of low premiums and affordable copays

• $0 copay for primary care for children through age 17

• Deductible does not apply to routine office visits, labs, emergency care and prescription drugs

• Low $100 deductible applied to services like inpatient hospital services and outpatient surgery

• Preventive dental services included

• Up to $400 in Healthy Rewards

Consider this option if you

• Are a family with young children

• Want the convenience of having your doctor, lab, pharmacy, and x-ray in one location

• Want a lower premium with reasonable copays

• Want preventive dental coverage without the added expense of a separate dental plan

Earn up to $400 in rewards with the Standard Option1

Take steps to improve your well-being to earn rewards to pay for qualified medical expenses. Standard Option subscribers and their enrolled spouses are eligible to earn $200 per person in rewards by completing the following activities:

• Taking our Total Health Assessment, an online questionnaire that gives you a wellness action plan

• Completing the following biometric screenings: Blood Glucose, Blood Pressure, Body Mass Index (BMI), Total Cholesterol

You must complete both activities during the 2020 calendar year to earn your rewards. Start by visiting kp.org/feds to learn more and get started.

What can you pay for with your rewards?

We’ll send you a Kaiser Permanente Health Payment Card upon completion of all activities. It can be used to pay for qualified medical expenses, including:

• Your deductible

• Cost-sharing, such as your copays

• Dental treatments

• Prescription eyeglasses or contact lenses

• Prescription medications in our Kaiser Permanente Medical Facility Pharmacies

• Other IRS-qualified medical expenses

Standard Option

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Care and coverage that fits your life

For a more complete benefits summary, see page 17 or visit kp.org/feds.

Outpatient services (per visit or procedure) You pay

Deductible does not apply

Preventive care $0

Primary care $20/$0 for children through age 17

Specialty care $40

Most lab tests and X-rays $0

Preferred Generic prescription drugs (up to a 30-day supply at plan medical center pharmacies)

$5

Emergency and Urgent Care

Emergency care $200

Urgent care $40

Your premium share Standard Option

Out-of-pocket maximum (2x per family maximum) $5,000

Deductible $100

Self Only Enrollment code: F84

Biweekly Non-Postal $63.73

Biweekly Postal Category 1 $61.18

Biweekly Postal Category 2 $52.90

Monthly Non-Postal $138.08

Self Plus One Enrollment code: F86

Biweekly Non-Postal $144.03

Biweekly Postal Category 1 $138.27

Biweekly Postal Category 2 $119.54

Monthly Non-Postal $312.06

Self and Family Enrollment code: F85

Biweekly Non-Postal $144.03

Biweekly Postal Category 1 $138.27

Biweekly Postal Category 2 $119.54

Monthly Non-Postal $312.06

These rates do not apply to all enrollees. If you are in a special enrollment category, please contact the agency or tribal employer that maintains your health benefits enrollment.

2020 Standard Option Quick Look

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Kaiser Permanente

Could our High Option be right for you?

• Lowest copays

• Only option with no deductible, but a higher premium

• $0 copay for inpatient maternity

• $0 copay for primary care for children through age 17

• Preventive dental services included

• Up to $400 per family in Healthy Rewards

Consider this option if you

• Are an expectant mother or are planning to have a baby

• Don't mind paying a higher premium knowing you have the lowest copays

• You may need significant medical care

• Want the convenience of having your doctor, lab, pharmacy, and x-ray in one location

• Want preventive dental coverage without the added expense of a separate dental plan

Earn up to $400 in rewards with the High Option1

Take steps to improve your well-being to earn rewards to pay for qualified medical expenses. High Option subscribers and their enrolled spouses are eligible to earn $200 per person in rewards by completing the following activities:

• Taking our Total Health Assessment, an online questionnaire that gives you a wellness action plan

• Completing the following biometric screenings: Blood Glucose, Blood Pressure, Body Mass Index (BMI), Total Cholesterol

You must complete both activities during the 2020 calendar year to earn your rewards. Start by visiting kp.org/feds to learn more and get started.

What can you pay for with your rewards?

We’ll send you a Kaiser Permanente Health Payment Card upon completion of all activities. It can be used to pay for qualified medical expenses, including:

• Cost-sharing, such as your copays

• Dental treatments

• Prescription eyeglasses or contact lenses

• Prescription medications in our Kaiser Permanente Medical Facility Pharmacies

• Other IRS-qualified medical expenses

High Option

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Care and coverage that fits your life

For a more complete benefits summary, see page 17 or visit kp.org/feds.

Outpatient services (per visit or procedure) You pay

Preventive care $0

Primary care $15/$0 for children through age 17

Specialty care $30

Most lab tests and X-rays $0

Preferred Generic prescription drugs (up to a 30-day supply at plan medical center pharmacies)

$5

Emergency and Urgent Care

Emergency care $200

Urgent care $30

Your premium share High Option

Out-of-pocket maximum (2x per family maximum) $4,000

Deductible None

Self Only Enrollment code: F81

Biweekly Non-Postal $101.17

Biweekly Postal Category 1 $97.89

Biweekly Postal Category 2 $88.07

Monthly Non-Postal $219.20

Self Plus One Enrollment code: F83

Biweekly Non-Postal $257.36

Biweekly Postal Category 1 $250.36

Biweekly Postal Category 2 $229.35

Monthly Non-Postal $557.61

Self and Family Enrollment code: F82

Biweekly Non-Postal $215.01

Biweekly Postal Category 1 $207.42

Biweekly Postal Category 2 $184.66

Monthly Non-Postal $465.85

These rates do not apply to all enrollees. If you are in a special enrollment category, please contact the agency or tribal employer that maintains your health benefits enrollment.

2020 High Option Quick Look

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Kaiser Permanente

Benefits and Services Basic Option Standard Option High Option

Deductible does not apply No Deductible

Outpatient services (per visit or procedure)

Preventive care $0 $0 $0

Primary care office visits$20 $20; $0 for children

through age 17$15; $0 for children

through age 17

Specialty Care office visits $40 $40 $30

Most X-rays and lab tests $0 $0 $0

Emergency Care $250 $200 $200

Urgent Care $40 $40 $30

Ambulance $150 $125 $100

Maternity

Routine prenatal care visit and first postpartum visit $0 $0 $0

Prescription drugs (up to a 30-day supply at plan medical center pharmacies, or up to a 100-day supply for 2 copays by mail order)†

Preferred Generic / Non-preferred Generic $5/$10 $5/$10 $5/$10

Preferred brand / Non-preferred brand $45/$65 $45/$55 $45/$45

Specialty $200 $150 $100

Out-of-pocket maximum (2x per family maximum) $6,500 per person $5,000 per person $4,000 per person

Deductible $250 $100 None

Hospital & facility Subject to the Deductible No Deductible

Outpatient surgery $250 $200 $150

Inpatient hospital care (per admission) $750 $750 $500

Maternity (delivery) $750 $250 $0

* This is a summary of the features of the Kaiser Permanente health plan. Before making a final decision, please read the Federal Employees Health Benefits (FEHB) brochure, 73-321. All benefits are subject to the definitions, limitations, and exclusions set forth in the FEHB brochure.

† Plan providers determine the drug that is medically necessary. If you request another drug, you pay prices charged to members for non-covered drugs.

Your 2020 benefits summary 10

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Care and coverage that fits your life

Ready to enroll with Kaiser Permanente and get healthier care?

1. Choose an option

• Basic Option

• Standard Option

• High Option

2. Select your enrollment type

• Self only covers you (the enrollee).

• Self Plus One covers you and one eligible family member.

• Self and Family covers you and all eligible family members.

3. With your enrollment code in hand, sign up online or call

• Visit opm.gov to enroll online.

• Contact your employing agency or retirement office for next steps.

Annuitants can contact the Retirement Information Center at 888-767-6738 or 855-887-4957 (TTY) or [email protected].

To sign up, find your enrollment code in the chart below. Then, visit opm.gov to enroll online, or contact your employing agency or retirement office for next steps and other information.

ENROLLMENT CODE BASIC OPTION STANDARD OPTION HIGH OPTION

Self Only LA1 F84 F81

Self Plus One LA3 F86 F83

Self and Family LA2 F85 F82

Important Note: Enrollees covering themselves and one other eligible family member may choose either the “Self Plus One” or ”Self and Family“ enrollment type. If you choose the High Option, you will save money if you enroll in the "Self and Family." Current "Self Plus One" subscribers must make an active enrollment election to move to Self and Family and get a lower member contribution.

These are highlights of the FEHB enrollment process. Please refer directly to opm.gov and your employing agency or retirement office for FEHB coverage effective dates, enrollment procedures and deadlines, and other information.

Need help?

Call us at 855-315-1006 (TTY 711) Monday through Friday, 10 a.m. to 8 p.m. During open enrollment season, Monday through Friday, 9 a.m. to 10 p.m.

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Kaiser Permanente

Coverage for vision services

With Kaiser Permanente, you have access to many of our plan optometrists or ophthalmologists practicing within one of our Glenlake, Gwinnett, Southwood, and TownPark Medical Facilities. You pay no deductible—just a copay. You can then take your prescription to one of our partners for a discount on your vision hardware. To find a vision hardware partner, visit avesis.com or call 404-365-0966 for the location nearest you.

Coverage for dental services

Kaiser Permanente and Delta Dental Insurance Company recognize that good oral care is an important part of your general health. Your enrollment in a Kaiser Permanente FEHB plan option gives you and your family two ways to maintain good oral health — a preventive dental benefit administered by Delta Dental (Delta Dental PPO™), which is included as part of your High Option or Standard Option benefits, and a separate optional plan (DeltaCare® USA), which you may be eligible to purchase for an additional premium in either plan option you choose.*

Delta Dental PPO Preventive dental coverage

With your FEHBP medical coverage in the High or Standard Option plans through Kaiser Permanente, you receive dental coverage for preventive services. Your only costs will be the patient’s share of the procedure at the time of treatment. With Delta Dental PPO, you may visit the dentist of your choice, but your out-of-pocket costs are usually less when you choose to visit a Delta Dental dentist. There's no need to sign up separately for Delta Dental PPO. To search for a dentist, visit

deltadentalins.com and select Delta Dental PPO under the Find a Dentist section. For Delta Dental PPO customer service, call 1-800-521-2651.

DeltaCare USA (optional plan*)

No matter the plan option you choose, you can get more inclusive coverage for you and your family by obtaining separate coverage through Delta Dental’s prepaid program for an additional monthly premium. The DeltaCare USA program has set copayments and no annual deductibles or maximums for covered benefits. You must select a dentist in the DeltaCare USA network from whom you receive treatment. To find a participating dentist or for more information about DeltaCare USA, go to deltadentalins.com and select DeltaCare USA under the Find a Dentist section. You can also request a copy of the DeltaCare USA enrollment brochure by calling DeltaCare USA customer service at 1-844-519-8693.

Coverage includes the following types of services (refer to your copayment schedule for a complete list of covered services):

Vision + Dental

* These services are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all enrollees and family members who become members of Kaiser Permanente.

• X-rays

• Extractions

• Root canals

• Dentures

• Fillings

• Crowns

• Orthodontics

• Periodontal scaling and root planing

Type Monthly Twice a year

Employee $10.96 $65.76

Employee and spouse $18.81 $112.86

Employee and child(ren) $18.93 $113.58

Employee and family $27.29 $163.74

The cost of coverage for DeltaCare USA (GAA11)

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20

Care and coverage that fits your life

When your care requires a trip to the hospital, we’re proud of our partnerships with some of Atlanta’s very best.

Kaiser Permanente doctors are on-site 24/7 at Emory Saint Joseph’s Hospital and Emory University Hospital Midtown. This exciting collaboration ensures our members benefit from one of the most effective and proven models of integrated care in the industry.

PARTNERS IN HEALTH

For a full list of our hospital partners, see page 31.

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21

Kaiser Permanente

MEDICAL OFFICES AND SPECIALTIESFull facility list and details inside

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Care and coverage that fits your lifeKaiser Permanente

Specialties and locations

?

CT/MRIGlenlakeGwinnett

SouthwoodStonecrest*

TownPark

DEXA ScanCascadeCrescentGwinnett

SouthwoodTownPark

MammographyAlpharettaCascadeCrescent

CumberlandHenry Towne

GlenlakeGwinnett

PanolaSouthwoodTownPark

UltrasoundCrescentGlenlakeGwinnett

SouthwoodTownPark

Audiology

GlenlakeGwinnett

SouthwoodSpecialty

Behavioral Health

Cardiology

CascadeGlenlakeGwinnett

SouthwoodTownPark

Child Psychiatry

Dermatology

CrescentCumberland

GwinnettSandy Springs

SouthwoodSouthwood

SpecialtyTownPark

Ear, Nose, and ThroatGlenlakeGwinnett

SouthwoodSpecialty

EndocrinologyCumberland

GwinnettSouthwood

Specialty

Gastroenterology

GlenlakeGwinnett

Southwood Specialty TownPark

General Surgery

GeriatricsCumberland

GwinnettSouthwoodSouthwood

Specialty

Gynecology

DecaturDouglasvilleHenry Towne

SnellvilleStonecrest

Sugar Hill-Buford

Hand SurgeryGwinnett

SouthwoodTownPark

Hematology/Oncology

Infectious Disease

AlpharettaBrookwood

CascadeCrescent

CumberlandGwinnett

Sandy SpringsSouthwoodStonecrestTownPark

AlpharettaCrescent

CumberlandGwinnett

Sandy Springs

GlenlakeGwinnett

Southwood

GwinnettSouthwoodTownPark

BrookwoodCumberland

GlenlakeGwinnett

Southwood

?

NephrologyCascadeCrescent

CumberlandGwinnett

PanolaSouthwood

Specialty

NeurologyGlenlakeGwinnett

SouthwoodTownPark

OB/GYN

AlpharettaCascadeCrescent

CumberlandGlenlakeGwinnett

PanolaSnellville

SouthwoodTownPark

Optometry/Opthalmology

GlenlakeGwinnett

SouthwoodTownPark

Orthopedic/Sports Medicine

GlenlakeGwinnett

SouthwoodTownPark

Pain Management

Palliative Care

PerinatologyBrookwood

Glenlake

Plastic Surgery

PodiatryCrescent

CumberlandGlenlakeGwinnett

Southwood

PsychiatryBrookwood

CascadeCrescent

CumberlandGwinnett

Sandy SpringsSouthwoodStonecrestTownPark

PsychologyCrescent

CumberlandGwinnett

Sandy SpringsSouthwoodStonecrestTownPark

PulmonologyGlenlakeGwinnett

SouthwoodTownPark

RheumatologyCumberland

GwinnettSouthwood

Specialty

Sleep Medicine

UrologyGlenlakeGwinnett

Southwood

Vascular Surgery

Weight Management

CumberlandGlenlakeGwinnett

Southwood

CumberlandGwinnett

Southwood

Brookwood Glenlake

CumberlandGlenlake

GlenlakeSouthwood

Cascade Gwinnett

Adult, Family, and Pediatric

Medicine

Lab

Pharmacy

Services available at most Kaiser Permanente

medical centers

X-Ray

Specialties and locations subject to change. Call Member Services at 888-865-5813 to find a service near you.

Primary Care Diagnostic Imaging Specialty Services

* MRI only

TEA

R O

UT H

ERE

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23

Kaiser Permanente

COMPREHENSIVE MEDICAL CENTERS24/7 Urgent Care • Specialty Services • Express Care Diagnostic Centers of Excellence • Gwinnett, Southwood, TownPark

CUMBERLAND DOWNTOWN DECATUR DOUGLASVILLECRESCENT

ALPHARETTA BROOKWOOD AT PEACHTREE CASCADE CONYERS

SUGAR HILL-BUFORD

SNELLVILLESANDY SPRINGS

STONECREST

HOLLY SPRINGS

LAWRENCEVILLE PANOLANEWNAN

HENRY TOWNE CENTERFORSYTH GLENLAKE

FAYETTE

GWINNETT

24/7 URGENT CARE

SOUTHWOOD

24/7 URGENT CARE

TOWNPARK

24/7 URGENT CARE

With your choice of great doctors and convenient locations throughout metro Atlanta, it’s easy to get the care you need. Most locations offer multiple services under one roof — so you can see your doctor, get a lab test or X-ray, and pick up your medications, all without leaving the building.

KP

KP

Kaiser Permanente Medical Facilities

Kaiser Permanente Comprehensive Medical Centers

COWETA

SPALDING

HENRY

FAYETTE

CLAYTON

FULTON

DOUGLAS

BUTTS

NEWTON

ROCKDALE

DEKALB

WALTON

BARROW

ATHENS-CLARKE

FULTON

CHEROKEEBARTOW

PAULDING

CARROLL

PICKENS

DAWSON

COBB

FORSYTH

GWINNETT

HARALSON

HEARD

MERIWETHERPIKE

LAMAR

75

75

985

575

285

285

285

20

20

67575

85

85

8578

78

316

400

400

166

75

10

316

78KP

KP

KP

KP

KP KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KPKP

KP

KP

KP

KP

KP

KP Kaiser Permanente Medical Facilities

Affiliated Community Urgent Care Centers

Affiliated Hospitals

Holly Springs

Southwood

Douglasville

Fayette

Henry Towne Centre

Conyers

SnellvilleGwinnett

Lawrenceville

Stonecrest

Panola

Sandy SpringsGlenlake

Alpharetta

Forsyth

Brookwood

Decatur

Cumberland

West Cobb

Newnan

COWETA

SPALDING

HENRY

FAYETTE

CLAYTON

FULTON

DOUGLAS

BUTTS

NEWTON

ROCKDALE

DEKALB

WALTON

BARROW

ATHENS-CLARKE

FULTON

CHEROKEEBARTOW

PAULDING

CARROLL

PICKENS

DAWSON

COBB

FORSYTH

GWINNETT

HARALSON

HEARD

MERIWETHERPIKE

LAMAR

75

75

985

575

285

285

285

20

20

67575

85

85

8578

78

316

400

400

166

75

10

316

78KP

KP

KP

KP

KP KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KP

KPKP

KP

KP

KP

KP

KP

KP Kaiser Permanente Medical Facilities

Affiliated Community Urgent Care Centers

Affiliated Hospitals

Athens

TownPark

Cascade

Sugar Hill-Buford

Crescent

Southwood Specialty

Skip the trip. Ask about a video visit.

Call 404-365-0966.

Care when and where you need itCare that's close by

ATHENS

SOUTHWOOD SPECIALTY

WEST COBB

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24

Care and coverage that fits your life

Locations near you With 26 Kaiser Permanente offices and more than 600 doctors throughout metro Atlanta — plus pharmacy, lab, and X-ray usually right in the same building —you’ll enjoy convenience you won’t find with other plans. Plus, you won't have to pay for parking.

Athens-Clarke County

ATHENS MEDICAL OFFICE 2142 West Broad Street, Building 200, Athens, GA 30606Phone: 706-583-5000

• Adult Medicine• Health Education• Lab Services

• Nutrition• Pediatrics/Adolescent

Medicine

• Pharmacy• X-ray

Cherokee County

HOLLY SPRINGS MEDICAL OFFICE684 Sixes Road, Suite 275, Holly Springs, GA 30115Phone: 770-852-2440

• Adult Medicine• Family Medicine

• Lab Services• Pediatrics/Adolescent

Medicine

• Pharmacy

Clayton County

SOUTHWOOD COMPREHENSIVE MEDICAL CENTER2400 Mt. Zion Parkway, Jonesboro, GA 30236Phone: 770-603-3649

• 24/7 Advanced Care• Adult Medicine• Behavioral Health• Cardiology• CT/MRI• DEXA Scan• Endocrinology• Express Care• General Surgery• Geriatrics• Hand Surgery• Health Education• Heart Failure Clinic• Infectious Diseases• Infusion Center

• Lab Services• Neurology• Nuclear Medicine• Nutrition • OB/GYN• Oncology• Ophthalmology• Optometry• Orthopedics• Orthopedic Surgery• Palliative Care• Pain Management• Pediatrics/Adolescent

Medicine• Pharmacy

• Podiatry• Psychiatry• Psychology• Pulmonology• Routine

Mammography• Ultrasound• Urgent Care• Urogynecology• Urology• Vascular Surgery• X-ray

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Kaiser Permanente

SOUTHWOOD SPECIALTY CENTER 2470 Mt. Zion Parkway, Jonesboro, GA 30236Phone: 770-603-3969

• Audiology• Dermatology• Ear, Nose, and Throat

• Endocrinology• Gastroenterology (GI)• Geriatrics

• Nephrology• Rheumatology

Cobb County

CUMBERLAND MEDICAL CENTER 2525 Cumberland Parkway, SE, Atlanta, GA 30339Phone: 770-431-4235• Adult Medicine• Behavioral Health• Child & Adolescent

Psychiatry• Dermatology• Endocrinology• Express Care• Geriatrics• Health Education• Infectious Diseases

• Lab Services• Nephrology• Nutrition• OB/GYN• Pain Management• Palliative Care• Pediatrics/Adolescent

Medicine• Pharmacy• Podiatry

• Psychiatry• Psychology• Rheumatology• Routine Mammography• Sleep Medicine• X-ray

TOWNPARK COMPREHENSIVE MEDICAL CENTER 750 TownPark Lane, NW, Kennesaw, GA 30144Phone: 770-514-5401

• 24/7 Advanced Care• Adult Medicine• Behavioral Health • Cardiology• CT/MRI• Dermatology• DEXA Scan• Express Care• Family Medicine• Gastroenterology• Hematology/Oncology

• Hand Surgery• Health Education• Lab Services• Neurology• Nuclear Medicine• Nutrition • OB/GYN• Ophthalmology• Optometry• Orthopedic Surgery• Pediatrics/Adolescent

Medicine

• Pharmacy• Psychiatry• Psychology• Pulmonology• Routine

Mammography• Sports Medicine• Ultrasound• Urgent Care• X-ray

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Care and coverage that fits your life

WEST COBB MEDICAL CENTER 3640 Tramore Pointe Parkway, Austell, GA 30106Phone: 770-439-4700• Adult Medicine• Lab Services

• Pediatrics/Adolescent Medicine

• Pharmacy• X-ray

Coweta County

NEWNAN MEDICAL OFFICE 203 Newnan Crossing Bypass, Newnan, GA 30265Phone: 770-304-4400

• Adult Medicine• Lab Services

• Pediatrics/Adolescent Medicine

• Pharmacy• X-ray

DeKalb County

CRESCENT MEDICAL CENTER 200 Crescent Centre Parkway, Tucker, GA 30084Phone: 770-496-3414

• Adult Medicine• Behavioral Health• Child & Adolescent

Psychiatry• Dermatology• DEXA Scan• Express Care• Family Medicine

• Health Education• Lab Services• Nephrology• Neuropsychology• Nutrition • OB/GYN• Podiatry• Psychiatry

• Psychology• Pediatrics/Adolescent

Medicine• Pharmacy• Routine

Mammography• Ultrasound• X-ray

DOWNTOWN DECATUR MEDICAL OFFICE 201 W. Ponce de Leon Avenue, Suite A, Decatur, GA 30030Phone: 404-687-7700

• Adult Medicine• Family medicine• Gynecology

• Lab Services• Pediatrics/Adolescent

Medicine

• Pharmacy

PANOLA MEDICAL CENTER 5440 Hillandale Drive, Lithonia, GA 30058Phone: 770-322-2777

• Adult Medicine• Health Education• Lab Services• Nephrology

• Nutrition • OB/GYN• Pediatrics/Adolescent

Medicine

• Pharmacy• Routine

Mammography• X-ray

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27

Kaiser Permanente

STONECREST MEDICAL CENTER 8011 Mall Parkway, Lithonia, GA 30038Phone: 678-323-7500

• Adult Medicine• Behavioral Health• Family Medicine• Gynecology

• Lab Services• MRI• Pediatrics/Adolescent

Medicine

• Pharmacy• Psychiatry• Psychology• X-ray

Douglas County

DOUGLASVILLE MEDICAL OFFICE 6875 Douglas Boulevard, Suite A, Douglasville, GA 30135Phone: 678-838-2225

• Adult Medicine• Family Medicine• Gynecology• Lab Services

• Maternal Child Health/Lactation

• Pediatrics/Adolescent Medicine

• Pharmacy• X-ray

Fayette County

FAYETTE MEDICAL OFFICE 101 Banks Station, Fayetteville, GA 30214Phone: 678-610-3700

• Adult Medicine• Lab Services

• Pediatrics/Adolescent Medicine

• Pharmacy

Forsyth County

FORSYTH MEDICAL OFFICE 1400 Northside Forsyth Drive, Suite 350, Cumming, GA 30041Phone: 678-455-1407

• Adult Medicine• Lab Services

• Pediatrics/Adolescent Medicine

• Pharmacy• X-ray

Fulton County

ALPHARETTA MEDICAL CENTER 3550 Preston Ridge Road, Alpharetta, GA 30005Phone: 770-663-3110

• Adult Medicine• Behavioral Health• Child & Adolescent

Psychiatry• Health Education

• Lab Services• Nutrition• OB/GYN• Pediatrics/Adolescent

Medicine

• Pharmacy• Routine

Mammography• X-ray

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Care and coverage that fits your life

BROOKWOOD AT PEACHTREE MEDICAL OFFICE 1745 Peachtree Road, Suite U, Atlanta, GA 30309Phone: 404-888-7688

• Adult Medicine• Behavioral Health• Cosmetic

Dermatology Services• Express Care

• Genetic Counseling• Infectious Disease• Lab Services• Maternal Fetal

Medicine (Perinatology)

• Pediatrics/Adolescent Medicine

• Pharmacy• Plastic Surgery• Psychiatry

CASCADE MEDICAL CENTER 1175 Cascade Parkway, Atlanta, GA 30311Phone: 404-505-4006

• Adult Medicine• Behavioral Health• Cardiology• DEXA Scan• Health Education• Lab Services

• Nephrology• Nutrition• OB/GYN• Pediatrics/Adolescent

Medicine• Pharmacy

• Psychiatry• Routine

Mammography• Weight Management• X-ray

GLENLAKE COMPREHENSIVE SPECIALTY CENTER 20 Glenlake Parkway, Sandy Springs, GA 30328Phone: 770-677-6075

• Audiology• Breast Care Center• Cardiology• CT/MRI• DEXA scan• Ear, Nose, and Throat• Gastroenterology• General Surgery• Health Education• Infectious Disease• Lab Services• Maternal Fetal

Medicine (Perinatology)

• Neurology• Nuclear Medicine• OB/GYN• Ophthalmology• Optometry• Orthopedics• Orthopedic Surgery• Pain Management• PET Scan• Pharmacy• Plastic Surgery• Podiatry• Pulmonology

• Routine Mammography

• Sleep medicine• Ultrasound• Urodynamics• Urology• Urogynecology• Vascular Surgery• Vascular Ultrasound• Wound Care• X-ray

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29

Kaiser Permanente

SANDY SPRINGS MEDICAL OFFICE 1100 Lake Hearn Drive, NE, Suites 250 and 500, Sandy Springs, GA 30342Phone: 404-845-4500

• Adult Medicine• Behavioral Health• Chemical Dependency• Child & Adolescent

Psychiatry

• Dermatology• Lab Services• Nutrition• Pediatrics/Adolescent

Medicine

• Pharmacy• Psychiatry• Psychology• X-ray

Gwinnett County

LAWRENCEVILLE MEDICAL OFFICE 455 Philip Boulevard, Suite 130, Lawrenceville, GA 30046Phone: 678-985-5000

• Adult Medicine• Lab Services

• Pharmacy• X-ray

GWINNETT COMPREHENSIVE MEDICAL CENTER 3650 Steve Reynolds Boulevard, Duluth, GA 30096Phone: 770-931-6012

• 24/7 Advanced Care• Audiology• Adult Medicine• Behavioral Health• Cardiology• Child & Adolescent

Psychiatry• CT/MRI• Dermatology• DEXA Scan• Ear, Nose, and Throat• Endocrinology• Express Care• Family Medicine• Gastroenterology• General Surgery• Geriatrics

• Hand Surgery• Health Education• Infectious Disease• Lab Services• Neurology• Nephrology• Nuclear Medicine• Nutrition• OB/GYN• Oncology• Ophthalmology• Optometry• Orthopedic Surgery• Pain Management• Palliative Care• Pediatric/Adolescent

Medicine

• Pharmacy• Podiatry• Psychiatry• Psychology• Pulmonology• Rheumatology• Routine

Mammography• Sports Medicine• Ultrasound• Urgent Care• Urology• Weight Management• X-ray

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Care and coverage that fits your life

SNELLVILLE MEDICAL OFFICE 2240 Fountain Drive, Snellville, GA 30078Phone: 770-978-5400

• Adult Medicine• Family Medicine• Gynecology• Lab Services

• Maternal Child Health/Lactation

• Pediatrics/Adolescent Medicine

• Pharmacy• X-ray

SUGAR HILL–BUFORD MEDICAL CENTER 1435 Broadmoor Boulevard, Sugar Hill, GA 30518Phone: 678-765-5700

• Adult Medicine• Family Medicine• Gynecology• Health Education

• Lab Services• Nutrition• Pediatrics/Adolescent

Medicine

• Pharmacy• X-ray

Henry County

HENRY TOWNE CENTRE MEDICAL CENTER 1125 Towne Centre Village Drive, McDonough, GA 30253Phone: 678-583-6600

• Adult Medicine• Gynecology• Health Education• Lab Services

• Nutrition• Pediatrics/Adolescent

Medicine• Pharmacy

• Routine Mammography

• X-ray

Rockdale County

CONYERS MEDICAL OFFICE1478 Dogwood Drive, Conyers, GA 30013Phone: 678-413-4320

• Adult Medicine• Family Medicine• Lab Services

• Pediatrics/ Adolescent Medicine

• Pharmacy

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31

Kaiser Permanente

More care options when you need themKaiser Permanente has partnered with several leading hospitals and many urgent care facilities. In fact, our own doctors practice at some of Atlanta’s top hospitals. For medical emergencies, you have access to any hospital emergency room, even if it’s not affiliated with Kaiser Permanente.8

Our hospital partners include:

Athens Piedmont Athens Regional Hospital 1199 Prince Avenue Athens, GA 30606

706-475-7000

Metro Atlanta Children’s Healthcare of Atlanta at Egleston 1405 Clifton Road, NE Atlanta, GA 30322 404-785-6000

Children’s Healthcare of Atlanta at Scottish Rite 1001 Johnson Ferry Road, NE Atlanta, GA 30342 404-785-5252

Emory Johns Creek Hospital 6325 Hospital Parkway Johns Creek, GA 30097 678-474-7000

Emory Saint Joseph's Hospital 5665 Peachtree Dunwoody Road Atlanta, GA 30342 678-843-7001

Emory University Hospital 1364 Clifton Road, NE Atlanta, GA 30322 404-712-2000

Emory University Hospital Midtown 550 Peachtree Street, NE Atlanta, GA 30308 404-686-4411

Northside Hospital - Duluth 3620 Howell Ferry Road Duluth, GA 30045 678-312-6800

Northside Hospital - Lawrenceville 1000 Medical Center Boulevard Lawrenceville, GA 30045 678-312-4321

Northside Hospital 1000 Johnson Ferry Road, NE Atlanta, GA 30342 404-851-8000

Northside Hospital Cherokee 450 Northside Cherokee Boulevard Canton, GA 30115 770-224-1000

Northside Hospital Forsyth 1200 Northside Drive Cumming, GA 30041 770-844-3200

Piedmont Hospital 1968 Peachtree Road, NW Atlanta, GA 30309 404-605-5000

Piedmont Fayette Hospital 1255 Highway 54 West Fayetteville, GA 30214 770-719-7000

Piedmont Henry Hospital 1133 Eagle's Landing Parkway Stockbridge, GA 30281 770-389-2200

Piedmont Mountainside Hospital 1266 Highway 515 South Jasper, GA 30143 706-692-2441

Piedmont Newnan Hospital 745 Poplar Road Newnan, GA 30265 770-400-1000

Locations are subject to change. Visit kp.org/locations for the most up-to-date listing.

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32

Care and coverage that fits your life

Kaiser Permanente Urgent Care

Gwinnett Comprehensive Medical Center 3650 Steve Reynolds Boulevard Duluth, GA 30096 24 hours a day, 7 days a week

Southwood Comprehensive Medical Center 2470 Mt. Zion Parkway Jonesboro, GA 30236 24 hours a day, 7 days a week

TownPark Comprehensive Medical Center 750 TownPark Lane Kennesaw, GA 30144 24 hours a day, 7 days a week

Barrow CountyRegional FirstCare 340 Exchange Boulevard Bethlehem, GA 30620 678-963-7171

Bartow CountyPeachtree Immediate Care 122 North Morningside Drive Cartersville, GA 30121 678-723-6721

Carroll CountyPeachtree Immediate Care 209 Cooley Drive, Suite 101 Villa Rica, GA 30180 770-456-0911

Cherokee CountyChildren's at Cherokee Urgent Care 1558 Riverstone Parkway Suite 100 Canton, GA 30114 404-785-5437

Northside Family Medicine & Urgent Care of Holly Springs 684 Sixes Road, Suite 25-A Holly Springs, GA 30115 678-426-5450

Peachtree Immediate Care 720 Transit Avenue, Suite 101 Canton, GA 30114 770-720-7000

Clarke CountyAthens Reddy Urgent Care 1061 Dowdy Road, Suite 100 Athens, GA 30606 706-621-7575

Broad Street Reddy Urgent Care 283 East Broad Street Athens, GA 30601 706-850-9855

East Side Reddy Urgent Care 4028 Lexington Road Athens, GA 30605 706-621-7575

Piedmont Athens Regional FirstCare 485 Highway 29 North Athens, GA 30606 706-353-6000

Clayton CountyConcentra Urgent Care 4223 Moreland Avenue Hwy. 42 Conley, GA 30288 404-366-2900

Concentra Urgent Care 1500 Mount Zion Road Morrow, GA 30260 678-422-8824

Plus additional affiliated community urgent care locations throughout metro Atlanta:

Affiliated Community Urgent Care Locations

Piedmont Newton Hospital 5126 Hospital Drive Covington, GA 30014 770-786-7053

Piedmont Rockdale Hospital 1412 Milstead Avenue, NE Conyers, GA 30012 770-918-3000

Piedmont Walton Hospital 2151 West Spring Street Monroe, GA 30655 770-267-8641

Hospitals continued

Locations are subject to change. Visit kp.org/locations for the most up-to-date listing.

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33

Kaiser Permanente

Cobb CountyChildren's at Town Center 625 Big Shanty Road, NW Kennesaw, GA 30144 404-785-8010

Concentra Urgent Care 220 N. Cobb Parkway, Suite 400 Marietta, GA 30062 770-424-7125

Northside Family Medicine & Urgent Care of East Cobb 4800 Old Towne Parkway Suite 150-A Marietta, GA 30068 770-509-1025

Peachtree Immediate Care 3540 North Cobb Parkway Acworth, GA 30101 770-974-3911

Peachtree Immediate Care 2481 George Busbee Parkway Kennesaw, GA 30144 770-423-0000

Peachtree Immediate Care 1025 Veterans Memorial Highway, Suite 720 Mableton, GA 30126 770-732-0720

Peachtree Immediate Care 3295 South Cobb Drive Smyrna, GA 30080 678-679-6471

Summit Urgent Care at Marietta 3120 Johnson Ferry Road Marietta, GA 30062 770-832-4147

Coweta County

Peachtree Immediate Care 371 Newnan Crossing Bypass Suite 103 Newnan, GA 30265 770-400-8410

Summit Urgent Care 1825 Highway 34 East Suite 1200 Newnan, GA 30265 770-502-2021

Dawson County

Northside Family Medicine & Urgent Care of Dawsonville 81 Northside Dawson Drive Suite 100-A Dawsonville, GA 30534 706-216-6000

DeKalb County

Children's at Chamblee Brookhaven 5080 Peachtree Boulevard Suite 100 Chamblee, GA 30341 404-785-5437

Urgent Care at Druid Hills 2882 North Druid Hills Road, NE Suite B Atlanta, GA 30329 678-805-7981

Peachtree Immediate Care 1829 Lawrenceville Highway Decatur, GA 30033 678-679-6471

Peachtree Immediate Care 1834 Clairmont Road Decatur, GA 30033 404-634-4443

Douglas County

Get Well Urgent Care 6842 Douglas Boulevard Suite K Douglasville, GA 30135 404-937-3508

Peachtree Immediate Care 9390 The Landings Drive Douglasville, GA 30135 770-947-1112

Fayette County

Peachtree City Urgent Care 8 Eastbrook Bend, Suite B Peachtree City, GA 30269 770-487-2273

Peachtree Immediate Care 1275 Highway 54 West Suite 201 Fayetteville, GA 30214 770-461-3776

Summit Urgent Care 749 West Lanier Avenue Suite 118 Fayetteville, GA 30214 770-835-4925

Summit Urgent Care 100 Line Creek Drive Peachtree City, GA 30269 770-847-8786

Forsyth County

Children's at Forsyth 410 Peachtree Parkway Suite 300 Cumming, GA 30041 404-785-8900

Northside Family Medicine & Urgent Care of Cumming 5610 Bethelview Road Suite 500 Cumming, GA 30040 770-205-2804Locations are subject to change. Visit kp.org/locations

for the most up-to-date listing.

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Care and coverage that fits your life

Peachtree Immediate Care 2575 Peachtree Parkway Cumming, GA 30041 770-888-8777

Fulton County

Children's at North Point 3795 Mansell Road Alpharetta, GA 30022 404-785-3020

Concentra Urgent Care 3580 Atlanta Avenue Hapeville, GA 30354 404-768-3351

Concentra Urgent Care 5670 Fulton Industrial Boulevard Atlanta, GA 30336 404-344-3930

Concentra Urgent Care 688 Spring Street, NW Atlanta, GA 30308 404-881-1155

Concentra Urgent Care 6330 Roswell Road, NE Suite C Sandy Springs, GA 30328 678-812-2277

Concentra Urgent Care 10820 Abbotts Bridge Road Suite 3000 Duluth, GA 30097 770-441-0444

North Atlanta Urgent Care II 2701 Holcomb Bridge Road Alpharetta, GA 30022 404-327-8744

Northside Family Medicine & Urgent Care of Midtown 1110 West Peachtree Street, NW Suite 200-A Atlanta, GA 30309 404-575-2000

Peachtree Immediate Care 10905 Haynes Bridge Road Alpharetta, GA 30022 770-343-9898

Northside Family Medicine & Urgent Care of Roswell 11685 Alpharetta Highway Suite 150-A Roswell, GA 30076 770-619-3860

Roswell Urgent Care 660 West Crossville Road Suite 110 Roswell, GA 30075 770-992-4700

Summit Urgent Care 3515 Camp Creek Parkway East Point, GA 30344 404-344-7337

Urgent Care at Peachtree 2140 Peachtree Road Suite 232 Atlanta, GA 30309 678-805-7425

Gwinnett CountyChildren's at Satellite Boulevard 2660 Satellite Boulevard Duluth, GA 30096 404-785-8330

Children's at Hamilton Creek 2240 Hamilton Creek Parkway Suite 600 Dacula, GA 30019 404-785-5437

ChoiceOne Urgent Care 2690 Hamilton Mill Road Suite 100 Buford, GA 30519 470-326-7300

ChoiceOne Urgent Care 5910 Suwanee Dam Road Suite 100 Sugar Hill, GA 30518 470-326-7600

Concentra Urgent Care 6475 Jimmy Carter Boulevard Suite 200 Norcross, GA 30071 770-242-7744

Concentra Urgent Care 755 Lawrenceville Suwanee Road, Suite 1600 Lawrenceville, GA 30043 770-995-1500

Gwinnett Urgent Care 1300 Peachtree Industrial Boulevard, Suite 4101 Suwanee, GA 30024 770-831-5525

Peachtree Immediate Care 3425 Buford Drive, Suite 200 Buford, GA 30519 678-546-0200

Peachtree Immediate Care 696 Grayson Highway Lawrenceville, GA 30046 770-936-0927

Peachtree Immediate Care 3991 Highway 78, Suite 100 Snellville, GA 30039 678-786-8677

Peachtree Immediate Care3720 Holcomb Bridge Road Norcross, GA 30092770-263-1000

Peachtree Immediate Care3551 Satellite Boulevard Duluth, GA 30096770-476-3000

Locations are subject to change. Visit kp.org/locations for the most up-to-date listing.

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35

Kaiser Permanente

Sugarloaf Urgent Care 4835 Sugarloaf ParkwaySuite 200Lawrenceville, GA 30044 470-375-5940

Henry CountyChildren's at Hudson Bridge 1510 Hudson Bridge Road Stockbridge, GA 30281 404-785-8660

Muscogee CountyConcentra Urgent Care 1051 Talbotton Road Columbus, GA 31904 706-322-2511

MedCare Urgent Care 5612 Whitesville Road Columbus, GA 31904 706-322-2223

Midtown Acute Care 3465 Macon Road Columbus, GA 31907 706-243-3051

MyCare Urgent Care 7301 Blackmon Road Columbus, GA 31909 706-321-3750

MyCare Urgent Care101 13th Street, Suite 200Columbus, GA 31901706-494-4949

Urgent Care & Occupational Medicine4328 Armour RoadColumbus, GA 31904706-507-1213

Oconee CountyRegional First Care 1010 Village Drive Watkinsville, GA 30677 706-769-0000

Paulding CountyNew Hope Urgent Care 49 Hosiery Mill Road Suite 124 Dallas, GA 30157 770-443-6111

Peachtree Immediate Care 3827 Jimmy Lee Smith Parkway Hiram, GA 30141 770-222-8900

Rockdale CountyConcentra Urgent Care 1680 GA Hwy. 138 Suites E and F Conyers, GA 30013 866-944-6046

Troup CountyPeachtree Immediate Care 1495 LaFayette Parkway LaGrange, GA 30241 706-884-7822

Walton CountyMonroe Reddy Urgent Care 500 Great Oaks Drive, Suite 9 Monroe, GA 30655 706-363-9228

Locations are subject to change. Visit kp.org/locations for the most up-to-date listing.

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Care and coverage that fits your life

1 As a Kaiser Permanente member, you and your enrolled spouse (age 18 and over) are eligible to earn up to $200 each in rewards in the Standard and High Option, and $250 each in the Basic Option. We will send you a Kaiser Permanente Health Payment Card 4 to 6 weeks after you complete your first activity, then load additional rewards when you complete your second activity. You must keep your card for use throughout the year and use rewards to pay qualified medical expenses by March 31 of the next calendar year. Go to kp.org/feds to learn more and get started.

2 When appropriate and available. 3 These features are available when you get care at Kaiser Permanente facilities.4 Kaiser Permanente improved blood pressure control in our black/African-American members wth hypertension, raised colorectal

cancer screening rates in our Hispanic/Latino members, and improved blood sugar control in our members with diabetes. Self-reported race and ethnicity data are captured in KP HealthConnect, and HEDIS® measures are updated quarterly in the interregional CORE Datamart.

5 Kaiser Permanente 2018 HEDIS® scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass® and represent all lines of business. Kaiser Permanente combined region scores were provided by the Kaiser Permanente Department of Care and Service Quality. The source for data contained in this publication is Quality Compass 2018 and is used with the permission of NCQA. Quality Compass 2018 includes certain CAHPS® data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass® and HEDIS® are registered trademarks of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality.

6 To use the Kaiser Permanente app, you must be a Kaiser Permanente member registered on kp.org.7 An 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.

8 If 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.

9 This number can be dialed 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 can’t 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.

10 This is a summary of the features of the Kaiser Permanente health plan. Before making a final decision, please read the plan’s Federal brochure (73-321). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. The services listed on page 6 (“Healthy resources,” except “Health classes”) and on page 19 (vision and dental coverage) are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all enrollees and family members who become members of Kaiser Permanente. This plan’s brochure is available on the internet at kp.org/feds. A paper copy is also available, at no charge, by calling 404-261-2590, Monday through Friday, 7 a.m. to 7 p.m. For TTY, call 711.

Notice of Summary of Benefits and Coverage (SBC): Availability of Summary Health Information The Federal Employees Health Benefits (FEHB) Program offers numerous health benefits plans and coverage options. Choosing a health plan and coverage option is an important decision. To help you make an informed choice, each FEHB plan makes available a Summary of Benefits and Coverage (SBC) about each of its health coverage options, online and in paper. The SBC summarizes important information in a standard format to help you compare plans and options. This plan’s SBC is available on the internet at kp.org/feds. A paper copy is also available, at no charge, by calling 404-261-2590, Monday through Friday, 7 a.m. to 7 p.m. For TTY, call 711. To find out more information about plans available under the FEHB Program, including SBCs for other FEHB plans, please visit opm.gov/insure.

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37

Kaiser Permanente

Care is just a click awayOnline tools designed to make your life easier

Once you join ...Visit kp.org/newmember to get started. It’s easy to register at kp.org, choose your doctor, transfer your prescriptions, and schedule your first routine appointment. And if you need help, just give us a call.

Already a member?Manage your care online anytime at kp.org. If you haven’t already, go to kp.org/registernow so you can start emailing your doctor’s office with nonurgent questions, schedule routine appointments, order most prescription refills, and more.

Nondiscrimination Notice

Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Health Plan) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also:

• Provide no cost aids and services to people with disabilities to communicate effectively with us, such as:

• Qualified sign language interpreters

• Written information in other formats, such as large print, audio, and accessible electronic formats

• Provide no cost language services to people whose primary language is not English, such as:

• Qualified interpreters

• Information written in other languages

If you need these services, call 1-888-865-5813 (TTY: 711)

If you believe that Kaiser Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail at: Member Relations Unit (MRU), Attn: Kaiser Civil Rights Coordinator, Nine Piedmont Center, 3495 Piedmont Road, NE, Atlanta, GA 30305-1736. Telephone Number: 1-888-865-5813.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

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Care and coverage that fits your life

60577109_ACA_1557_MarCom_GA_2017_Taglines

Français (French) ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-865-5813 (TTY: 711).

Deutsch (German) ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-865-5813 (TTY: 711).

ગજુરાતી (Gujarati) સચુના: જો તમે ગજુરાતી બોલતા હો, તો નન:શલુ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-888-865-5813 (TTY: 711).

Kreyòl Ayisyen (Haitian Creole) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-865-5813 (TTY: 711).

हिन्दी (Hindi) ध्यान दें: यहद आप हििंदी बोलते िैं तो आपके ललए मुफ्त में भाषा सिायता सेवाएिं उपलब्ध िैं। 1-888-865-5813 (TTY: 711) पर कॉल करें। 日本語 (Japanese) 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。1-888-865-5813(TTY: 711)まで、お電話にてご連絡ください。

한국어 (Korean) 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-888-865-5813 (TTY: 711) 번으로 전화해 주십시오.

Naabeehó (Navajo) Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dé̖é̖’, t’áá jiik’eh, éí ná hóló̖, koji̖’ hódíílnih 1-888-865-5813 (TTY: 711).

Português (Portuguese) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-888-865-5813 (TTY: 711).

Pусский (Russian) ВНИМАНИЕ: eсли вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-865-5813 (TTY: 711).

Español (Spanish) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-865-5813 (TTY: 711).

Tagalog (Tagalog) PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-865-5813 (TTY: 711).

Tiếng Việt (Vietnamese) CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-865-5813 (TTY: 711).

60577109_ACA_1557_MarCom_GA_2017_Taglines

NONDISCRIMINATION NOTICE Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Health Plan) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also: • Provide no cost aids and services to people with disabilities to communicate

effectively with us, such as: • Qualified sign language interpreters • Written information in other formats, such as large print, audio, and

accessible electronic formats

• Provide no cost language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages

If you need these services, call 1-888-865-5813 (TTY: 711) If you believe that Kaiser Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail at: Member Relations Unit (MRU), Attn: Kaiser Civil Rights Coordinator, Nine Piedmont Center, 3495 Piedmont Road, NE Atlanta, GA 30305-1736. Telephone Number: 1-888-865-5813. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

____________________________________________________________________

HELP IN YOUR LANGUAGE ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-865-5813 (TTY: 711).

አማርኛ (Amharic) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-888-865-5813 (TTY: 711).

.، فإن خدمات المساعدة اللغوية تتوافر لك بالمجانالعربيةإذا كنت تتحدث :ملحوظة (Arabic) العربية (.TTY :711) 5813-865-888-1 اتصل برقم

中文 (Chinese) 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電1-888-865-5813(TTY:711)。

اگر به زبان فارسی گفتگو می کنيد، تسهيالت زبانی بصورت رايگان برای توجه: (Farsi) فارسی تماس بگيريد.1-888-865-5813 (TTY: 711) شما فراهم می باشد. با

Help in your language

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-865-5813 (TTY: 711).

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The right choice for a healthier youHaving a good health plan is important. So is getting quality care. With Kaiser Permanente, you get both.

©2019 Kaiser Foundation Health Plan, Inc.

Not a member yet?For more information, visit kp.org/feds or call 1-855-315-1006 (TTY 711), Monday through Friday, 10 a.m. to 8 p.m.

Open Season hours: Monday through Friday, 9 a.m. to 10 p.m.

Please recycle. 381134424 October 2019

Kaiser Foundation Health Plan of Georgia, Inc.Nine Piedmont Center

3495 Piedmont Road, NE Atlanta, GA 30305

404-364-7000