Kaiser Permanente Medical Plans Effective July 1, 2024
COMMERCIAL PLAN
Questions about your plan? Having trouble filling a prescription or need answers regarding a recent bill? Reach our designated Kaiser navigation team for speedy assistance by emailing D11@KP.org
Our Desk Reference Guide offers answers to most of your benefits questions, including side-by-side plan comparisons, plan overviews, and contact information.
2024_25NewEmployeeDeskReferenceGuide.pdf
Specialty Care Referral Update (Effective January 2025)
Customer Service/Billing Questions:
Mon-Fri 8am— 6pm MST
D11 Member Direct Line: (855) 211-0229 (TTY 711)
Patient Financial Services:(303)743-5900/1-800-632-9700
Behavioral Health: Call (303) 471-7700 or (866) 359-8299 (TTY 711). If you’re in the southern Colorado area, call
(866)-702-9026 (TTY (866)-835-2755)
Member Inquires: D11@KP.org
Provider List: www.KP.org/locations
As a nonprofit provider of health care and coverage together, Kaiser Permanente offers integrated care that’s nationally recognized for its quality and an experience that’s seamless and easy to navigate.
Integrated care means that your Kaiser Permanente doctors, pharmacists and care teams have instant access to your medical history, through a shared electronic medical record. This helps them coordinate your care – so you don’t have to.
Kaiser Permanente offers a choice of providers and convenient care options designed to fit any schedule.
CHOICE OF PROVIDERS:
• Choose to see Kaiser Permanente providers at one of their medical offices (there are 5 in southern Colorado, and a total of 30 across the Front Range).
• You can also choose to see affiliated providers near you (there are 12,300 across the Front Range).
• Visit kp.org/locations to find providers near you.
IN PERSON CARE:
• Care under one roof: At most of their medical offices, you can see a doctor, fill a prescription, and get X-rays and labs done at one location.
• And for in-patient needs, members can get care at many of Colorado’s top hospitals.
• Urgent and emergency care are covered anywhere in the world.
• Your dependents under the age of 26 who live outside a Kaiser Permanente service area are covered for certain routine, continuing, or follow-up care through their Out-of-Area Benefit.
CARE FROM VIRTUALLY ANYWHERE:
• An extensive suite of virtual care options, such as 24/7 on-demand video visits, and online chat with a clinician or mental health specialist, make it easy to get care at home, or on-the-go.
• Use their mobile app, or kp.org to manage both your care and coverage. You can connect with care, 24/7, choose or change Kaiser Permanente doctors (and schedule appointments, view your medical history, get reminders about screenings, prescription refills, and more!
IF YOU NEED HELP NAVIGATING YOUR CARE AND COVERAGE:
• When you transition to Kaiser Permanente, they’ll help you choose a doctor, transfer prescriptions, and book appointments. Call their New Member Connect team after you receive your ID card at 1-844-639-8657 (TTY 711).
• After your coverage begins, you’ll have access a dedicated member services line, just for D11 employees – to help you navigate every aspect of your care and coverage: 1-855-211-0229 (TTY 711).
VISIT KP.ORG/D11 TO LEARN MORE ABOUT KAISER PERMANENTE AND EXPLORE YOUR CARE OPTIONS.
MAKING ENROLLMENT CHANGES WITHIN THE YEAR
In most cases, your benefit elections will remain in effect for the entire plan year (July 1-June 30). During each open enrollment period, you will have the opportunity to review your benefit selections and make changes for the coming year.
Certain coverage allows limited changes to elections during the year. These benefits include the medical, dental and vision plans. Under these benefits, you may only make changes to your elections during the year if you have a change in family status. Family status changes include:
- Marriage, divorce, or legal separation
- Gain or loss of an eligible dependent for reasons such as birth, adoption, court order, disability, death, marriage, or reaching the dependent age limit
- Changes in your spouse's employment affecting benefit eligibility
- Changes in your spouse's benefit coverage with another employer that affects benefit eligibility
The change to your benefit elections must be consistent with the change in family status. For example, if you gain a new dependent due to birth, you may change your benefit selections to add that dependent.
You have 31 days from the date of a family status change to turn in a completed enrollment change form and supporting documentation to Employee Benefits; otherwise, you must wait until the next open enrollment period to make a change to your election changes. In most cases, your election will become effective on the date of your family status change.