Human Resources

Medical plans

Eligibility

All regular (non-temporary) full-time and part-time employees who work at least half time (.5 FTE) are eligible for coverage on the first of the month following date of hire. If hired on the first day of the month, benefits begin immediately. Coverage is available for spouses, domestic partners and dependent children of eligible employees.

Description

The college, at its sole discretion, may offer more than one plan. At this time there are two medical plans: Kaiser HMO and Regence/Blue Cross Blue Shield (offered through the Pioneer Educators Health Trust) PPO plan.

Contribution

Each year during the budgeting process, the college determines the amount it will contribute to the cost of employees' health insurance. Reed pays 100% of the cost of the Kaiser plan for employee-only coverage and 50% of the Kaiser cost for eligible dependents. Reed pays this same dollar amount towards the Regence plans and employees pay the difference. Employees who select two-party or family coverage with the Kaiser plan will not be expected to contribute more than 9.5% of the full-time equivalent of their base salary/wage on the first date of the benefit plan year. Any changes in salary/wages during the year will not affect Reed's contribution until the following benefit plan year.  

Employees pay their portion of the cost of their heath insurance by pre-tax paycheck deductions. Note that coverage for domestic partners is taxable i.e. cannot be paid pre-tax.

Cost

Medical cost per pay period as of April 1, 2017

Plan
Coverage
Reed contribution per pay period
Cost to employee per pay period
Kaiser**
Individual $294.48 $0
Two-party $441.72 $147.24
Family (3 or more) $559.52 $265.02
PEHT (Regence)
Individual $294.48 $53.84
Two-party $441.72 $255
Family $559.52 $415.90

Medical Plans Comparison

Reed College Medical Plan Comparison
 

Services
Kaiser HMO/Kaiser Provider Network HMO/Specialist referral required
Pioneer Educators Medical Trust Plan/Regence Blue Cross Blue Shield PPO/No specialist referral required
Network In-network only In-network Out-of-network
Annual out of pocket limit

$1,500/member
$3,000/family

$4,000/individual
$12,000/family

$8,000/individual
$24,000/family

Annual deductible
none

individual: $1,500
family: $4,500

individual: $3,000
family: $9,000

Preventive care
100% covered/no co-pay 100% covered/no co-pay 40% cost share
Primary & specialty care
$20 co-pay

primary: $25 co-pay

specialty: $50 co-pay

40% cost share
Lab & x-ray
$10 per department visit 20% cost share 40% cost share
Inpatient surgery

15% cost share

20% cost share 40% cost share
Outpatient surgery
$20 per visit 20% cost share 40% cost share
Urgent care
$20 per visit $25 co-pay $25 co-pay
Emergency room
$150 per visit 20% cost share after
a $250 co-pay
Ambulance services
$75 per trip 20% cost share
Rx

$15,generic

$30, preferred brand

$60, specialty

Kaiser pharmacy only

$20 generic

$40, preferred brand

$60, non-preferred brand

Rx mail order

generic
up to 90 day supply for $30

preferred brand
up to 90 day supply for $60

generic
$30 for a 90 day supply

preferred brand
$60 for a 90 day supply

Vision
$20 co-pay for eye exam.  $150 allowance for hardware every 24 months. For dependents age 18 and under: no charge for one pair standard frames and lenses or 6-month supply of contact lenses every 12 months not covered not covered
Vision (dependents 18 and under)
No charge for one pair standard frames and lenses or 6-month supply contact lenses every 12 months One routine exam per calendar year plus one pair of lenses and one frame per calendar year
Annual limit of what the plan pays
No limit No limit

No limit

 

Alternative care (chiropractic, acupuncture, massage, naturopath)
$20 - $25 co-pay per visit with annual maximum benefit of $1,500 for all services combined not covered with the exception of chiropractic, which is covered with a $50 co-pay if seen by an in-network doctor of otheopathy

 

Kaiser self-referred alternative care benefit

As of April 1, 2017 Reed Kaiser plan members have access to chiropractic, massage, acupuncture and naturopathic medicine.  To find a provider in their network, visit CHPGroup.com.  Read more about this benefit here or call Kaiser at 800-813-2000.

Websites

Kaiser
Regence

Forms

Affidavit of marriage/domestic partnership
Medical, dental, FSA enrollment/change online form
Regence OptumRx mail order form effective April 1, 2016
Regence transition of care form
Form for submission of claim to Kaiser for care outside of Kaiser

Plan documents

Kaiser Portland Clinic partnership
Kaiser summary of benefits and coverage as of April 1, 2017
Kaiser summary of benefits as of April 1, 2017
Kaiser evidence of coverage
PEHT Regence summary of benefits and coverage as of April 1, 2017
PEHT Regence summary plan description
PEHT member guide