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					Federal Employee Health
    Benefit Program
  Open Season 2009
The History of KPS Health Plans

   KPS Health Plans was established in 1946
   KPS began serving the Puget Sound Naval Shipyard
     even before the FEHBP was established
   Joined the FEHBP in 1967
   Today, in addition to our FEHBP plans, we offer health
     insurance products for:
     • Individuals and families
     • Large and small employer groups
     • Medicare beneficiaries
Whether you live
near Seattle,
                        The KPS Difference
Spokane,
                         Self-refer to specialists
Vancouver, Walla
Walla, or Bellingham,    Dental is included at no additional cost as part of your plan
rest assured that
                         Vision, VSP Discount Program
KPS is working for
you with our             World Access provides you worldwide coverage,
extensive offering of       including emergency hospital and multilingual services
providers within the     Online Wellness Program, we want you to remain with KPS for
KPS, First Choice                                              You!,
                            your lifetime. We provide Good For You!, an interactive online
Health, and                 health and wellness program that includes a Personal Health
MultiPlan networks.
                            Record.
In fact, there are
more than 47,000          MyKPS.We
                         MyKPS.We offer secure 24/7 online customer service options,
preferred providers          including claims and pharmacy access, you can even order a
in Washington State          new ID card.
alone.
2010 Plans & Benefits
High Option
    No deductible
    $30 office visit copay for physicians, chiropractors,
     acupuncturists, and naturopaths
    20% coinsurance for hospital care, lab & x-ray,
     physical therapy, and other services
    Maternity paid at 100%- New for 2010
    Preventive, basic, and major dental care included
    Annual Routine Mammogram beginning age 35- New for 2010
    Annual Routine Colorectal Cancer Screening- New for 2010
    Annual out-of-pocket maximum - $5,000 per Individual or Family
High Option
Prescription Drugs

Tier 1 (Generic) $5
Tier 2 (Preferred) $25 – New for 2010
Tier 3 (Non-Preferred) 50% or $100, whichever is less

90-day supply of any Tier 1 and Tier 2 drugs with two copays

New for 2010

Same benefit with Medicare Parts A & B – New for 2010

Mail-Order Program through Walgreens
High Option
Dental Benefits
    No additional premium

    Preventive Care

    Basic & Major Care - $25 ($50 Family) deductible

    All benefits paid according to fee schedule

    Covers up to $1,000 per person per year

    Any licensed dentist
 2010 High Option Rates

Decreased!   Bi-weekly
             Non Postal
             Self $80.25
             Self and Family $165.57
             Postal
             Self $56.97
             Self and Family $113.34

             Monthly
             Retiree
             Self $173.87
             Self and Family $358.74
Standard Option
$350 Annual Deductible
$15 copay (no deductible) per visit for the first 3 professional office visits
combined for any of the following:
           Primary care
           Chiropractic
           Acupuncture
           Naturopath
           Physical, speech, and occupational therapy
           Mental health/substance abuse
 Preventive care – paid at 100% (no deductible) – New for 2010
 Maternity paid at 100% after deductible – New for 2010
 Hospital, Lab/X-Ray, DME, etc – 20% coinsurance & no inpatient
 copayment- New for 2010

 Annual Mammograms available at age 35- New for 2010
 Colorectal Cancer Screenings available once per year- New for 2010
 Annual out of pocket maximum - $5,000 per Individual or Family when
 seeing a Participating Provider
Standard Option
Prescription Drugs
Tier 1 (Generic) $10
Tier 2 (Preferred) $35 – New for 2010
Tier 3 (Non-Preferred) 50% with $40 minimum/$100 maximum
90-day supply of any Tier 1 and Tier 2 drugs with two copays


New for 2010
Same benefit with Medicare Parts A & B
Mail-Order Program through Walgreens
Standard Option
Dental Benefits

 No additional premium

 No deductible

 Preventive Care only

 All benefits paid according to fee schedule

 No annual maximum – New for 2010

 Any licensed dentist
 2010 Standard Option Rates
             Bi-weekly
Decreased!   Non Postal
             Self $41.06
             Self and Family $88.64

             Postal
             Self $23.82
             Self and Family $51.41

             Monthly
             Retiree
             Self $88.97
             Self and Family $192.05
HDHP Benefits
  Annual Deductible (applies separately for services received from
  Plan providers and non-Plan providers)
   Self Only = $1,500    Self and Family = $3,000
  After your deductible, KPS pays 80% for in network benefits and 60%
  for out of network benefits
  Maximum annual out-of-pocket expenses (includes the annual
  deductible and applies separately for services received from Plan
  providers and non-Plan providers) New for 2010
             Self Only = $5,000    Self and Family = $10,000

HDHP Benefits Preventive Care
      100% coverage (not subject to deductible) – New for 2010
      Includes:
           Routine physical exams
           Routine eye exams
           Preventive dental care – any licensed dentist
Advantages of an HDHP
It allows you to set up a health savings account (HSA).

Your contributions to your HSA are tax free funds that can roll over
from year to year and collect interest. And KPS Health Plans will
contribute tax free funds on your behalf!
The HSA fund is portable – you own it.
Funding for HSA
  For 2010 KPS will deposit directly into your HSA each month:
      • $62.50 for Self Only
      • $125 for Self and Family
  You may also deposit funds into your HSA. The maximum
  allowable contribution you can make in 2010 is:
      •$2,300 for Self only
      •$4,650 for Self and Family
  Your contributions are tax deductible.


Eligible Expenses
 For a complete listing of eligible expenses please see IRS
 Publication 502. Over the counter drugs and Medicare premiums
 are also reimbursable.
Are you eligible for an HSA?
If you can answer “no” to the following
questions, then you are eligible for an HSA.

   Are you enrolled in Medicare?
   Can you be claimed as a dependent on someone else’s tax
    return?
   Do you have other health insurance?
    (Does not include another HDHP, specific injury, accident, disability,
    dental, vision, or long-term care coverage.)
   Have you received VA benefits within the last 3 months?
   Are you covered under your own or someone else’s
    Flexible Spending Account?
Health Reimbursement Arrangement (HRA)
        Provided when you are not eligible for an HSA
        Entire HRA credit is funded to your account at enrollment
        HRA credit is not taxable
        Unused credits roll over from year to year
        Account does not earn interest and is not portable
        You may not contribute to an HRA.

Funding and Accessing the HRA
  The entire annual credit is deposited to your account the first day of
  enrollment (pro-rated) if your effective date is the first of the month.
  Otherwise, it will be deposited the first of the following month.
  For 2010 the annual credit for 12 months enrollment is:

         Self Only = $750            Self and Family = $1,500
2010 HDHP Rates
(Non-postal premiums decreased by 4.7% )

           Bi-weekly
           Non Postal
           Self $35.10
           Self and Family $76.71
           Postal
           Self $20.36
           Self and Family $44.49

           Monthly
           Retiree
           Self $76.06
           Self and Family $166.20
Dedicated Customer Service
   KPS Customer Service
   Call toll-free 1-800-552-7114, Monday through Friday,
   8:00 a.m. to 5:00 p.m. (PST)

   World Wide Access
   Call toll-free 1-800-497-4029 in the United States, Puerto
   Rico, and Virgin Islands
   Call collect 1-804-281-5723 24 hours a day/365 days
   a year when overseas


   2809s
   Fax to 360-698-0982
   ATTN: Lil Kerlee

				
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Description: Federal Employee Health Plans document sample