Coordination of Beneﬁts (COB) Retiree Rider
An option for your clients’ out-of-area retirees • Outpatient brand-name and generic drug
coverage is included.
The Kaiser Permanente Insurance Company (KPIC)
COB Retiree Rider is a contract option for your retired • Retirees have access to KPIC’s contracted PHCS
employees. KPIC coordinates beneﬁts as a second Network, which offers approximately 450,000
payer to Medicare. The COB Retiree Rider may be providers nationwide.
issued with any of the KPIC PPO and Out-of-Area
Indemnity (OOA) plans, each with a broad range of Q: Is the KPIC COB Retiree Rider a Medicare Advan-
plan cost sharing, coinsurance, and deductibles. With tage or a Medicare Supplement (Medigap) plan?
this rider, you can offer retirees KPIC PPO and OOA A: It’s neither. The rider extends eligibility to retirees
plans that are available to active employees. To be who as a result of their retirement status would not
eligible, your retirees must be enrolled in Medicare be eligible to enroll in a PPO or an OOA Indemnity
Parts A and B and must reside outside the Kaiser plan. Through this option, KPIC coordinates beneﬁts
Permanente service area. with Medicare. Medicare is the primary payer, and
KPIC is the secondary payer. All beneﬁts and cover-
Q: Why should I offer this rider to my retirees? age are regulated by the California Department
A: The KPIC COB Retiree Rider can provide peace of of Insurance. The KPIC COB Retiree Rider has
mind for employees who are nearing retirement no afﬁliation with the Centers for Medicare and
and are concerned about ﬁnding coverage outside Medicaid Services.
the Kaiser Permanente service area.
Q: What advantage does the rider offer my business
and my retirees?
A: The advantages include the following:
• Employees can continue coverage under your
group’s health plan, even after retirement.
• You can manage retiree health care costs and
contribution levels through a variety of plan
coinsurance, copayments, and deductibles.
Q: How is the retiree coverage provided under the
KPIC COB Retiree Rider different from Medicare
Supplement (Medigap) plans?
A: Unlike Medigap plans, the KPIC COB Retiree Rider
doesn’t supplement coverage or waive deductibles
of Medicare Advantage plans. Medicare is billed ﬁrst
and pays for covered services. The KPIC COB Retiree
Rider pays the remaining costs, less any applicable
plan deductible, coinsurance, or copayment.
Q: Does the KPIC COB Retiree Rider entitle members
to access to Kaiser Permanente medical services
A: No. Because the rider is for retirees living outside
our service areas, this rider is available only to our
PPO and OOA plan members. Care is provided by
KPIC’s contracted PHCS Network or by any other
Q: Where can I ﬁnd more information?
A: To learn more about how the KPIC COB Retiree Rider
can meet the needs of your out-of-area retirees, con-
tact your broker or Kaiser Permanente representative.
Business Marketing Communications
0502-0480-01-r03 October 2006