Mid-Atlantic Large Business plans and products

(51+ full time and full-time equivalent employees)

Companies with 51+ employees ask for that perfect mix of high-quality care, advanced services, and cost effectiveness. Kaiser Permanente plans for large businesses include copayment plans, deductible plans, point-of-service plans, and dental plans to meet those needs.

Related links: Product marketing materials | Dental plans | Workforce Health | Apply for coverage | Get quotes | Tools for employees | Application and enrollment forms

HMO Portfolio

Traditional HMO Plans

HMO plans with fixed copayments offer your employees a balance of affordability and predictability. Members pay copays for most covered services; there are no medical deductibles, low out-of-pocket expenses and virtually no claims to file.

It’s easy to predict out-of-pocket costs. Preventive care services, such as routine physicals, well-child visits, and certain screening tests, are provided at $0 copay.

Available Networks: Signature or Select

Deductible HMO Plans

Deductible HMO plans allow you to offer the same comprehensive benefit coverage as traditional HMO plans with copayments or coinsurance, but usually at a lower premium. By adding deductible requirements, you reduce premium prices below those of similar traditional HMO plans.

You can choose the plans that best meet the needs of you and your employees. These plans may also be paired with a Kaiser Permanente administered health reimbursement arrangement (HRA) or flexible spending account (FSA).

Available Networks: Signature or Select

Virtual Complete Plans – New for 2022!

Virtual Complete plans provide employees with affordable, high-quality care when and where it works best for them – whether in person, on the job, or from the comfort of home. With Kaiser Permanente’s flexible no-cost telehealth options, and availability of in-person care when needed, employees are always covered for care no matter how they choose to access it.

Virtual Complete plans offer:

  • $0 unlimited virtual care, with access to in-person care when it’s needed
  • $0 in-person preventive care, such as routine physicals, screenings, and immunizations
  • Up to 3 in-person office visits per year at a copay without having to meet a deductible
  • Lab and generic prescriptions not subject to deductible
  • Full suite of telehealth capabilities, including phone appointments, video visits, e-visits, email, and online chat with a registered nurse
  • Same-day/next-day pharmacy deliveries for a fee

Available Networks: Signature

Resources
Learn more about our Virtual Complete plans
Virtual Complete Sales Flyer
Virtual Complete Plan Detail Flyer

Virtual Forward Plans

Virtual Forward plans offer affordable, high-quality, and customized care using convenient virtual options-video visits, e-visits, phone, and email-with in-person care available if needed.

Your employees can get care when and where it works best for them – at home, at the office, on the road - and still get in-person care at a medical center when needed for an additional cost-share.

Virtual Forward plans offer:

  • $0 unlimited virtual care
  • $0 for the first in-person primary care visit each year
  • $0 in-person preventive care, such as routine physicals, screenings, and immunizations

Available Networks: Signature

Resources
Learn more about our Virtual Forward portfolio.

Virtual Forward Sales Flyer
Virtual Forward Plan Detail Flyer

HSA-Qualified Deductible HMO Plans

The HSA-Qualified Deductible HMO Choice plans provide the same comprehensive benefit coverage of the traditional HMO plans, with options for managing out-of-pockets costs with varying copayments, coinsurance, and deductibles.

Because this type of plan meets U.S. Treasury guidelines, it can be paired with a Hhealth Ssavings Aaccount (HSA). An HSA allows the use of pretax dollars to pay for qualified medical expenses. Once an HSA is opened, money can be put into it. Keep in mind that the IRS sets a limit on how much money can be put into an HSA each year. You can contribute money to your employees’ accounts.

Available Networks: Signature or Select

HMO Plus Portfolio

HMO Plus Plans

Kaiser Permanente HMO Plus plans are a great solution to help please all employees, while giving you the convenience of working with a single carrier. With these affordable plans, your employees can have access to the best of Kaiser Permanente through the in-network benefits, plus access to see out-of-network providers for certain covered outpatient services (visit limits apply).

HMO Plus plans provide limited nationwide coverage with any licensed provider, balanced by quality* care innate to Kaiser Permanente’s integrated delivery system. Members receive quality care from Kaiser Permanente physicians and affiliated providers. In addition, they have coverage for up to 10 outpatient medical visits out-of-network, including physician office visits, lab and radiology, and 5 pharmacy refills a year from any provider outside of the Kaiser Permanente care delivery system, anywhere in the United States.

Available Networks: Signature and limited Out-of-Network visits

Deductible HMO (DHMO) Plus Plans

Kaiser Permanente DHMO Plus plans also help please all employees while giving you the convenience of working with a single carrier. By adding deductible requirements, you reduce premium prices below those of similar HMO Plus plans. With even greater affordability, your employees can have access to the best of Kaiser Permanente through the in-network benefits, plus access to see out-of-network providers for certain covered outpatient services (visit limits apply).

DHMO Plus plans provide limited nationwide coverage with any licensed provider, balanced by the high-quality care innate to Kaiser Permanente’s integrated delivery system. Members receive quality care from Kaiser Permanente physicians and affiliated providers. In addition, they have coverage for up to 10 outpatient medical visits out-of-network, including physician office visits, lab and radiology, and 5 pharmacy refills a year from any provider outside of the Kaiser Permanente care delivery system, anywhere in the United States.

Available Networks: Signature and limited Out-of-Network visits

Resources
Learn more about our HMO Plus portfolio.

HMO Plus Sales Flyer

HMO Plus FAQs for Brokers

Flexible Choice Portfolio

Flexible Choice Plans

The Flexible Choice suite of three-tier point-of-service plans is the best of all worlds. It gives employees full choice of providers whenever they receive care, and allows them to determine and manage their health care costs. Employers may offer it side-by-side with HMO, Deductible HMO, HMO Plus, Deductible HMO Plus, or HSA-Qualified Deductible plans to decrease a company’s overall health care costs, and still offer employees plan choice.

Flexible Choice combines Kaiser Permanente HMO with Preferred Provider Organization (PPO) and non-preferred indemnity options. Multiple choices for managing out-of-pocket costs area available, with varying copayments, coinsurance, and deductibles from option to option.

Available Networks: Signature (Option 1), PHCS/Multiplan (Option 2), and Out-of-Network (any licensed provider) (Option 3)

Deductible Flexible Choice Plans

The Deductible Flexible Choice suite of three-tier point-of-service plans adds increased affordability to advantages of Flexible Choice. With a deductible in each tier, premium prices can be reduced below those of similar Flexible Choice plans. Employees still have a full choice of providers whenever they receive care, and can determine and manage their health care costs. Employers may offer Deductible Flexible Choice alongside HMO, Deductible HMO, HMO Plus, Deductible HMO Plus, or HSA-Qualified Deductible plans to decrease a company’s overall health care costs even further.

Deductible Flexible Choice combines Kaiser Permanente HMO with Preferred Provider Organization (PPO) and non-preferred indemnity options. Multiple choices for managing out-of-pocket costs area available, with varying copayments, coinsurance, and deductibles from option to option.

Available Networks: Signature (Option 1), PHCS/Multiplan (Option 2), and Out-of-Network (any licensed provider) (Option 3)

HSA-Qualified Deductible Flexible Choice Plans

The HSA-Qualified Flexible Choice three-tier point-of-service plan generally offers lower premiums than traditional and Deductible Flexible Choice plans, and can provide tax saving benefits. Employees continue to enjoy a full choice of providers whenever they receive care, and determine and manage their health care costs. Pairing HSA-Qualified Flexible Choice with our competitively priced HSA-Qualified Deductible HMO plan creates the most cost-effective Flexible Choice solution. It can also be offered beside HMO, Deductible HMO, HMO Plus, and Deductible HMO Plus plans.

Because the HSA-Qualified Deductible Flexible Choice plan meets U.S. Treasury guidelines, it can be paired with a health savings account (HSA). An HSA allows the use of pretax dollars to pay for qualified medical expenses. Once an HSA is opened, money can be put into it. Keep in mind that the IRS sets a limit on how much money can be put in an HSA each year. Both you and your employees can contribute money to the employees' HSA account.

Available Networks: Signature (Option 1), PHCS/Multiplan (Option 2), and Out-of-Network (any licensed provider) (Option 3)

Resources
Learn more about our Flexible Choice portfolio.

PPO Portfolio

Out-of-Area (OOA) PPO Plans

The OOA PPO plan provides covered services received from participating providers (PPO) as well as non-participating providers. OOA-PPO provides services outside of the Kaiser Permanente coverage area—making it the perfect solution for employers who have employees who live and work outside of the Kaiser Permanente HMO service area.

Out-of-pocket costs are generally lowest when using in-network providers. All inpatient services and certain outpatient services provided by PPO or out-of-network providers require precertification. Care can be received in the following ways:

In-Network:*
There are more than 240,000 primary care physicians, 718,000 specialists, and 4,500 hospitals in the Kaiser Permanente Insurance Company’s (KPIC’s) national PHCS and MultiPlan networks.Finding a physician, facility, or health care practitioner who participates in these networks is as easy as visiting multiplan.com/kpmas.

Out-Of-Network:*
Care from any licensed provider that is not considered in-network.

*Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP), underwrites the OOA-PPO Insurance Plan.
Provider numbers as of August 2020. The PHCS™ and MultiPlan™ networks include physicians and health care practitioners and facilities that are available to Kaiser Permanente Insurance Company members via a network access agreement. Not all PHCS and MultiPlan network providers are included. For a list of network participants, go to multiplan.com/kpmas.

Available Networks: PHCS/Multiplan (In-Network) and Out-of-Network (any licensed provider)

Resources
Learn more about our Out-of-Area PPO
Out-of-Area PPO Brochure

Added Choice Portfolio

The Added Choice and Deductible Added Choice two-tier point-of-service plans are a great all-in-one solution. Each offers employees the flexibility to determine how and where to get covered care - and to manage health care costs - on each occasion. They combine an in-network provider option (Option 1) with an out-of-network provider option (Option 2) all in one plan. With a deductible in the first tier, Deductible Added Choice premium prices can be reduced below those of similar Added Choice plans.Members are not limited to one provider option; Added Choice allows them to choose between two provider options at any time. When purchasing an Added Choice plan, you can choose from plans featuring various levels of copayments, coinsurance, deductibles, and out-of-pocket maximum limits.

Available Networks: Signature or Select (Option 1), and Out-of-Network (any licensed provider) (Option 2)

Resources
Learn more about our Added Choice portfolio.

Added Choice Brochure

Consumer-Directed Health Care

By pairing a Kaiser Permanente plan with a health payment account to create a consumer-directed health care (CDHC) offering, you are connecting your employees to high-quality care from providers who work as a team to keep members healthy.

You can choose from three types of health payment accounts to create an approach that works for your business:

  • Health Reimbursement Arrangements (HRA),
  • Health Savings Accounts (HSA), or
  • Flexible Spending Accounts (FSA)

Resources
Learn more about our Health Payment Accounts.

Videos
Obtain an in-depth look at why clients have more control and convenience with CDHC plans and health payment accounts supported by our integrated delivery system.

Short version (1:46)
Long version (3:32)

Health Payment Account Information for Large and Small Employers

Account summaries present comprehensive details on all our health payment account options to help you consult and educate Large and Small Group clients on the best solution for their financial bottom line.

Health Payment Account information with the Pay to Provider Option for Large Employers

Large Group employees have a simpler and more convenient way to pay for care by combining our Pay to Provider option with a health payment account. When they visit a Kaiser Permanente facility, employees won't have to worry about out-of-pocket expenses for most medical services. Instead, their payments will be automatically made from their Kaiser Permanente health payment account. For more information, review the account types below and contact your Kaiser Permanente representative.

Provider Options

Available Networks

Signature
With the Kaiser Permanente Signature provider network, members receive quality care from the over 1,600 award-winning physicians of the Mid-Atlantic Permanente Medical Group, P.C.,* These care teams practice exclusively in our medical centers, which are conveniently located throughout Kaiser Permanente’s coverage area in Maryland, Virginia, and Washington, DC.

Select
Building on our Signature provider network, Select adds access to contracted community physicians in private practice. Members may choose a physician in the Mid-Atlantic Permanente Medical Group, P.C., or one of many community physicians.

To find a provider in the Signature or Select networks, please visit: https://legacy.providerlookuponline.com/kaiser/po/KaiserIntro.asp

PHCS / Multiplan
For employer groups requiring wider network options, Kaiser Permanente offers particular products that incorporate a broad PPO network of medical providers and acute care facilities nationwide, contracted from PHCS/Multiplan.

Within KP’s three-tier Flexible Choice point-of-service plans, the PHCS/Multiplan network comprises the second tier (with the first being a Signature or Select HMO option, and the third being any licensed provider in the United States).

This network also forms the core of Kaiser Permanente Out-Of-Area PPO (OOA PPO) plans, available to Large Employers. Contracted providers in the national PHCS/Multiplan network are considered in-network, generally resulting in the lowest out-of-pocket costs. Employees may also seek care from any licensed provider in the United States, on an out-of-network basis. No referrals are required to visit providers in either tier.

The PHCS/Multiplan network has over 4,500 hospitals, more than 91,000 ancillary facilities, and almost 886,000 health care professionals.** To find a contracted provider visit www.multiplan/com/kpmas

Premier Hospitals

Kaiser Permanente carefully selects Premier hospitals to partner with in taking care of our members. Only the Premier hospitals can offer all of these advantages together:

  • Permanente physicians and hospitalists available 24/7, often in facilities dedicated to KP members.
  • Coordination of care with a member’s primary care and specialist physicians
  • Kaiser Permanente electronic medical records that are always up to date and available to a member’s care team
  • Speedy video consults with specialists if required
  • Quality of care that is always carefully evaluated and monitored
  • Level of comfort and services that are physician-reviewed and approved
  • Seamless transitions to care at home or a skilled nursing facility

Kaiser Permanente Premier hospitals include:

District of Columbia

  • Children's National Health System
  • MedStar Washington Hospital Center

Maryland

  • Anne Arundel Medical Center, Annapolis (maternity effective Jan 2021)
  • Baltimore - Washington Medical Center, Glen Burnie
  • Doctors Community Hospital, Lanham
  • Greater Baltimore Medical Center, Baltimore
  • Holy Cross Germantown Hospital, Germantown
  • Holy Cross Hospital, Silver Spring
  • Suburban Hospital, Bethesda

Virginia

  • Reston Hospital Center, Reston
  • Stafford Hospital, Stafford
  • Virginia Hospital Center, Arlington

*Permanente doctors are recognized as Top Doctors in Northern Virginia Magazine (2021), Washingtonian magazine (2020), and Baltimore magazine (2020).

**Provider numbers as of August 2020. The PHCS™ and MultiPlan™ networks include physicians and health care practitioners and facilities that are available to Kaiser Permanente Insurance Company members via a network access agreement. Not all PHCS and MultiPlan network providers are included.