2018 Kaiser Permanente Washington September 2017 About Kaiser

2018 Kaiser Permanente Washington September 2017

About Kaiser Permanente Including Kaiser Foundation Health Plan of Washington § More than 11. 3 million members § 19, 000+ physicians § 38 hospitals and medical centers § 651 medical offices 2 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Group Health officially joins KP - Feb. 1, 2017 Group Health Cooperative clinic in late 40 s § Founded in the 1940 s § Both non-profit § Driven by a belief in affordable health care as a fundamental right § Committed to coordinated care and coverage § Leaders in prevention, evidencebased medicine, research, and innovative health care design and practice Kaiser Permanente early “baby in a drawer” innovation 3 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

KPWA Strengths § Great doctors – Our doctors went to some of the best medical schools in the country, and chose to work at Kaiser Permanente – One of the largest multispecialty groups in the region § Access to a broad network of contracted doctors – Including Family Care Network, Peace. Health Medical Group, Skagit Regional Clinics, Island Family Physicians, Columbia Medical Associates, Physicians Clinic of Spokane, Providence Medical Group, Rockwood Clinic, Kadlec Clinics, Apple Valley Family Medicine, KVH Family Medicine § Convenient, coordinated care – Led by the member’s personal physician, our health care professionals and support staff work together to meet each member’s individual health needs – Kaiser Permanente doctors, specialists, and care team members are all connected to the member’s electronic health record* – We help our members be well and stay well by screening for issues early, which prevents more serious problems and expensive care later – By using scientific evidence we can provide treatment that’s proven to be effective and efficient * Available when members receive care at Kaiser Permanente medical offices. 4 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

KPWA Quality Washington Health Alliance 2016 Community Checkup. Based on more than 50 clinical measures of quality. Also ranked by WHA as top performing commercial plan in the state. * Kaiser Permanente Washington (formerly Group Health Cooperative) Medicare HMO rated 4. 5 out of 5 based on quality of care and member experience in the National Committee for Quality Assurance Medicare Health Insurance Rankings 2015 -2016** All 25 Kaiser Permanente Washington medical centers have achieved the highest recognition status in 2017 by the National Committee for Quality Assurance for their Patient-Centered Medical Home Program** Top performing commercial HMO health plan in the country, based on the National Business Coalition on Health’s 2016 survey, a comprehensive review of health plan quality and efficiency*** *Washington Health Alliance, 2016 Community Checkup http: //wahealthalliance. org / Ranking applies to then Group Health Cooperative's medical group, formerly named Group Health Permanente, P. C. and now named Washington Permanente Medical Group, P. C. ** Kaiser Foundation Health Plan of Washington, formerly Group Health Cooperative. The National Committee for Quality Assurance (NCQA) is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. It issues health insurance plan ratings and Quality Compass Health Plan Quality Measures for Commercial and Medicare plans each year. Rating was not issued or endorsed by Medicare. Official CMS Star Rating can be found at www. medicare. gov. *** Kaiser Foundation Health Plan of Washington's (formerly named Group Health Cooperative) commercial HMO rated the top health plan in the United States in the 2016 e. Value 8™ survey. e. Value 8™ is managed by the National Alliance of Healthcare Purchaser Coalitions (formerly the National Business Coalition on Health). 5 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Kaiser Permanente Washington region § 677, 050 members (August 2017) § 78, 621 individual & family members (August 2017) § 1, 000+ physicians* § 25 medical offices, * all with pharmacy onsite; most with lab and X-ray § 9, 000 contracted providers, including 49 hospitals* (we do not own any hospitals) *OIC Provider Network Form A 6 07 October 2020 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Service area § Kaiser Permanente Washington service area is in the Washington counties shown here § Note: Kaiser Permanente Northwest service area extends into Southwest Washington counties: Clark (all zip codes), Cowlitz (all zip codes) 7 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

2018 ID cards for Washington region 8 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Regional highlights § Western WA – North Puget Sound – Island § Islands: Camano Island Whidbey Island – Whidbey Island: Clinton, Langley, Freeland, Coupeville, and Oak Harbor § Key contracted medical groups: Peace. Health, Family Care Network § Kaiser Permanente medical offices: Everett § Key hospitals: St Joseph Hospital, Island Hospital, Whidbey. Health Medical Center – San Juan § Islands: San Juan, Orcas, Shaw, and Lopez § Key cities: Friday Harbor, Roche Harbor, Westsound, Deer Harbor § Key contracted medical groups: Peace. Health, Family Care Network, Association in Family Medicine, Inter-Faith § Key hospitals: St Joseph Hospital, Island Hospital, Peace. Health Peace Island Medical Center See kp. org/wa/provider-directory for more providers 9 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Regional highlights § Western WA – North Puget Sound – Skagit § Key cities: Anacortes, Mount Vernon, Burlington, Sedro Woolley, La Conner § Key contracted medical groups: Peace. Health, Skagit Regional, Family Care Network § Hospitals: Island Hospital, Skagit Valley Hospital, Peace. Health United General Medical Center – Snohomish § Key cities: Arlington, Lake Stevens, Everett, Lynnwood § Kaiser Permanente medical offices: Everett, Lynnwood § Key contracted medical groups: Skagit Regional, The Everett Clinic § Hospitals: Cascade Valley Hospital, Providence Regional Medical Center – Whatcom § Key cities: Bellingham, Lynden, Blaine, Ferndale, Fairhaven § Key contracted medical groups: Peace. Health, Family Care Network, Association in Family Medicine, Inter-Faith § Hospitals: Peace. Health St Joseph Medical Center See kp. org/wa/provider-directory for more providers 10 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Regional highlights § Western WA – Central Puget Sound – King § Key cities: Bellevue, Burien, Federal Way, Redmond, Renton, Seattle § Kaiser Permanente medical offices: 12 medical offices (see map slide 19) § Hospitals: Swedish Hospital (Capital Hill and Cherry Hill), Seattle Children’s, Overlake Hospital Medical Center, St Francis Hospital – Kitsap, Lewis & Mason § Key cities: Port Orchard, Bremerton, Silverdale, Centralia, Chehalis, Shelton § Kaiser Permanente medical offices: Port Orchard, Silverdale, and Poulsbo (all in Kitsap county) § Key contracted medical groups: Cascade Family Medicine and Steck Medical See kp. org/wa/provider-directory for more providers § Hospitals: Harrison Hospital, Providence St Peter Hospital 11 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Regional highlights § Western WA – Central Puget Sound – Pierce § Key cities: Tacoma, Puyallup § Kaiser Permanente medical offices: Tacoma, Tacoma South, and Puyallup § Hospitals: St Anthony Hospital, St Clare Hospital, Mary Bridge Children’s Hospital and Health Center, St Joseph Hospital – Thurston § Key cities: Olympia § Kaiser Permanente medical offices: Olympia § Hospitals: Providence St Peter Hospital See kp. org/wa/provider-directory for more providers 12 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Regional highlights § Central WA counties – Kittitas § Key cities: Ellensburg and Cle Elum § Key contracted medical groups: Family Healthcare of Ellensburg and KVH Family Medicine § Hospitals: KVH Hospital – Yakima § Key cities: Yakima § Key contracted medical groups: Apple Valley Family Medicine, Family Medicine of Yakima, Memorial Cornerstone Medicine § Hospitals: Yakima Valley Memorial Hospital – Benton § Key cities: Richland Kennewick § Key contracted medical groups: Kadlec Clinics, TRIOS Care Centers (outpatient, doctors offices only) § Hospitals: Kadlec Regional Medical Center and Lourdes Medical Center 13 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only. See kp. org/wa/provider-directory for more providers

Regional highlights § Central WA Counties continued – Franklin § Key cities: Pasco § Key contracted medical groups: Kadlec Clinics and TRIOS Care Centers (outpatient, doctors offices only) § Hospitals: Kadlec Regional Medical Center and Lourdes Medical Center – Walla and Columbia § Key cities: Walla and Dayton § Key contracted medical groups: Walla Clinic and Family Medical Center § Hospitals: Providence St Mary Medical Center See kp. org/wa/provider-directory for more providers 14 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Regional highlights § Eastern WA Counties – Spokane § Key cities: Spokane § Kaiser Permanente medical offices: Riverfront, South Hill, Lidgerwood, and Veradale § Key contracted medical groups: Columbia Medical Associates (CMA)*, Rockwood Clinics, Providence Physicians Clinic of Spokane § Hospitals: Providence Sacred Heart, Providence Holy Family, Valley Hospital – Whitman § Key cities: Pullman § Key contracted medical groups: Pullman Family Medicine and Palouse Medical Pullman § Hospitals: Pullman Regional Hospital *Owned by Kaiser Foundation Health Plan of Washington See kp. org/wa/provider-directory for more providers 15 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Kaiser Permanente Washington and Affiliated Medical Facilities

Kaiser Permanente Washington locations 25 medical offices in the Puget Sound area of Western Washington and in Spokane 60 specialties and sub-specialties, including 20 surgical specialties 4 outpatient surgical centers 13 eye care centers 5 urgent care centers 11 locations with occupational health services kp. org/wa/provider-directory 17 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

KPWA affiliated providers and hospitals 18 07 October 2020 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only. | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

KPWA affiliate providers and hospitals | © 2017 Kaiser Foundation Health Plan 19 07 October 2020 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only. of Washington. For internal use only.

Easy ways to access care In additional to face office visits, members have other options to get the care they need. § Consulting Nurse Services – Talk with a nurse for care advice, or find out if you need immediate medical attention. Get help 24 hours a day, 365 days a year. No cost shares for members. § Online Visit – Members can receive diagnoses and even prescriptions for several common conditions, all online and typically within an hour. § Walk-in Care. Clinics - Get care for minor injuries and illnesses at walk-in Care. Clinics inside several Bartell Drugs locations in the Puget Sound area. You'll see a Kaiser Permanente board-certified physician assistant or nurse practitioner. § Urgent Care - Urgent care is for conditions that require prompt attention but do not pose an immediate, serious threat to your health or life. § Email Health Care Team - Exchange secure email with Kaiser Permanente doctors, other members of your health care team, or the Consulting Nurse Service. * § Online services and mobile app – Refill prescriptions, make appointments, check lab results, and more, from a computer or smartphone. * *Available when members receive care at Kaiser Permanente medical offices in Washington outside the 20 Vancouver/Longview area 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Kaiser Permanente Care. Clinics at Bartell Drugs Walk-in care for minor medical needs for ages two and up No appointment is necessary Providers are connected to KP electronic medical record system Locations at: Alderwood, Ballard, Bellevue Village, Crossroads, Des Moines, Gig Harbor, Greenwood, Rainier Avenue, Redmond Town Center, Renton, Sammamish, Silver Lake, Snoqualmie, University Village, West Seattle. 21 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Walk-in Care. Clinics at Bartell Drugs § Care. Clinics are staffed with Kaiser Permanente board-certified physician assistants and nurse practitioners. § Care. Clinics are open to Kaiser Permanente members and the general public. Non-Kaiser Permanente members should check with their insurance provider prior to their visit. § Care. Clinics are open daily 9 a. m. to 7 p. m. , including all holidays except Thanksgiving and Christmas. (Only Ballard Care. Clinic and Crossroads Care. Clinic are open on Thanksgiving and Christmas. ) § Kaiser Permanente member copay is the same as a medical office visit ($75 for non-members without insurance). § https: //www. bartelldrugs. com/careclinic/ 22 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Kaiser Permanente Washington 2018 Product Portfolio Overview – On Marketplace

Highlights All our plans provide high-quality, cost-effective care and coverage. Many offer upfront office visits before the deductible kicks in. Some are HSA (health savings account) compatible. Renewing for 2018 • The majority of the Kaiser Foundation Health Plan of Washington HMO plans on and off exchange (Marketplace) are renewing for 2018. • Only two Silver metal level plans will be offered on the exchange and one will be offered off the exchange. • Flex Silver and Visits. Plus Silver HD will be on the exchange only • Core Silver HSA will be off the exchange only 24 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

2018 benefit changes Emergency Department visits: • Removed $200 copay on the Standard and CSR Flex Silver plans and Flex Gold plan • Services now just subject to annual deductible and plan coinsurance Out of Pocket Maximums: • • Increased OOPM on Core Basics Plus Catastrophic plan Decreased OOPM on Visits. Plus Silver 87 HD and Visits. Plus Silver 94 HD CSR plans Medical Deductibles: • Increased the deductible Core Basics Plus Catastrophic plan • Decreased the deductible on Visits. Plus Silver 87 HD and Visits. Plus Silver 94 HD CSR plans 25 Prescription Drugs: 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only. • Moving from a closed to an open formulary

2018 Washington region portfolio Off-Marketplace Not Available 26 Health Plans On-Marketplace Core Basics Plus Catastrophic Available Core Bronze HSA Available Bronze Available Flex Bronze Available Core Silver HSA Not Available Visits. Plus Silver HD Available Not Available Flex Silver Available Flex Gold Available 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Kaiser Permanente Washington Region Whole Health Benefits — Name, Title (20 pt Arial Narrow) 27 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Whole health benefits § Chiropractic visits: Covered on all plans, subject to applicable cost shares with a yearly limit of 10 visits § Acupuncture visits: Covered on all plans, subject to applicable cost shares with a yearly limit of 12 visits § Network providers are contracted throughout the communities – kp. org/wa/provider-directory 28 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Extras to be your healthiest § Complementary Choices: 20 percent discount on acupuncture, naturopathy, chiropractic care, massage, yoga, tai chi, Pilates, and personal trainers § Fitness program discounts: Available at 10, 000 fitness facilities, plus exercise videos and home workout equipment. More at globalfit. com/kpwa. § Tobacco cessation program: The Quit for Life Program to help members stop using tobacco at no additional cost. Individual phone counseling is offered, along with Web tools and other support strategies. Visit quitnow. net/kpwa. 29 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

2018 Pharmacy Options and Formulary 30 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Getting prescriptions § Pharmacies at Kaiser Permanente medical offices § Large network of contracted pharmacies § Convenient mail order delivery § Medication history is part of your online record 31 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Mail order pharmacy § Locally owned mailed order facility in Renton, Washington § Order online, with the Kaiser Permanente app, or by calling § Standard mail delivery is free and typically takes 3 to 5 days § Do not use the Optum. Rx (our pharmacy benefits manager) mail order service 32 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

Formulary for Kaiser Permanente Washington Pharmacy Drug Tiers Complete formulary and any change notices at kp. org/wa/pharmacy/drug-formulary 33 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

2018 Effective Dates

Effective dates Open enrollment period: Nov. 1, 2017 to Dec. 15, 2017 Special enrollment period: Dec. 16, 2017 to Jan. 15, 2017* § Effective date is the date a member’s health coverage is scheduled to start § Typically, the effective date is the first of the following month once a completed application — and for those enrolled through the Marketplace first month’s premium has also been received § Effective dates during Special Enrollment Period (SEP) may be different based on the triggering event and receipt of application. Refer to SEP Enrollment Guide To start coverage on: Completed application must be received by: January 1, 2018 December 15, 2017 February 1, 2018 January 15, 2018 *This SEP is open to everyone and NO SEP documentation is required 35 07 October 2020 | © 2017 Kaiser Foundation Health Plan of Washington. For internal use only.

kp. org/wa/if All plans offered and underwritten by Kaiser Foundation Health Plan of Washington.