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 Kaiser Added Choice.

Contribution

Each year during the budgeting process, the college determines the amount it will contribute to the cost of employees' health insurance. Reed currently pays 100% of the cost of the Kaiser plan for employee-only coverage and 60% of the Kaiser cost for eligible dependents. Reed pays this same dollar amount towards the Kaiser Added Choice plan and employees pay the difference. Employees who 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, 2019

Plan Coverage Reed contribution per pay period Cost to employee per pay period
Kaiser HMO** Individual $292.35 $0
You plus child(ren) $432.68 $93.55
You plus spouse/partner $467.76 $116.94
Family $643.17 $233.88
Kaiser Added Choice Individual $292.35 $58.62
You plus child(ren) $432.68 $198.89
You plus spouse/partner $467.76 $233.98
Family $643.17 $409.44

Medical Plans Comparison

Reed College Medical Plan Comparison

Services Kaiser HMO/
Kaiser Provider Network HMO/
Specialist referral required
Kaiser Added Choice
Network In-network only Tier 1 Tier 2 Tier 3
Annual out of pocket limit $1,500/
member
$3,000/
family
$2,250/
member
$4,500/
family
$3,000/
member
$9,000/
family
$8,000/
member
$24,000/
family
Annual deductible $0 $750/
member
$2,250/
family
$1,000/
member
$3,000/
family
$3,000/
member
$9,000/
family
Preventive care 100% covered/
no co-pay
100% covered 100% covered 40% cost share after deductible
Primary & specialty care $20 $15 $25 co-pay $50 co-pay
Lab & x-ray $10 $15 20% cost share 40% cost share after deductible
Inpatient surgery 15% cost share subject to deductible subject to deductible subject to deductible
Outpatient surgery $20 per visit 20% cost share after deductible 20% cost share after deductible 20% cost share after deductible
Urgent care $20 $35 $50 40% cost share after deductible
Emergency room $150 $250 $250 $250
Ambulance services $75 20% cost share after deductible 20% cost share after deductible 20% cost share after deductible
Alternative care (chiropractic, acupuncture, massage, naturopath) $20 ($25 for massage) using network providers $20 ($25 for massage) using network providers $20 ($25 for massage) using network providers $20 ($25 for massage) using network providers
Osteopathic spinal manipulations Covered with $20 co-pay if done by a DO (doctor of osteopathy) at Kaiser $20 using network providers $20 using network providers $20 using network providers
Rx $15 generic/
$30 preferred brand/
$50 non-preferred brand
$15 generic/
$30 preferred brand/
$50 non-preferred brand
At MedImpact Pharmacy: $20 generic/
$40 preferred brand/
$60 non-preferred brand
At MedImpact Pharmacy: $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
$30 generic/
$60 preferred brand/
$100 non-preferred brand (up to 90 day supply)
At MedImpact Pharmacy: $60 generic/
$120 preferred brand/
$180 non-preferred brand (up to 90 day supply)
At MedImpact Pharmacy: $60 generic/
$120 preferred brand/
$180 non-preferred brand (up to 90 day supply)
Vision $20 co-pay for eye exams plus $150 hardware allowance per 24 months $15 co-pay for eye exam. Hardware not covered $25 co-pay for eye exam. Hardware not covered 40% cost share after deductible
Annual limit of what the plan pays No limit No limit No limit No limit

Kaiser self-referred alternative care benefit

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.

Kaiser Added Choice

Kaiser Added Choice members have access to all the services and facilities that Kaiser members have, plus the option to seek services from providers outside of Kaiser.

Added Choice website
Overview of Added Choice
List of contacts for Added Choice members
Transition of care to Added Choice
Added Choice summary of benefits

Kaiser has set up a dedicated concierge team to answer your questions and to help you make the transition to Added Choice:

Added Choice concierge team:
Ph: 503-813-1299 or 503-813-3613
kpconcierge-nw@kp.org

Websites

Kaiser
Kaiser Added Choice
Regence

Forms

Affidavit of marriage/domestic partnership
Medical, dental, FSA enrollment/change online form
Form for submission of claim to Kaiser for care outside of Kaiser

Plan documents

Kaiser Portland Clinic partnership
Kaiser HMO summary of benefits and coverage as of April 1, 2018
Kaiser HMO summary of benefits as of April 1, 2018
Kaiser HMO summary of benefits as of April 1, 2019
Kaiser HMO evidence of coverage
Kaiser Added Choice evidence of coverage
Kaiser Added Choice summary of benefits as of April 1, 2018
Kasier Added Choice summary of benefits as of April 1, 2019
Kaiser Added Choice summary of benefits and coverage as of April 1, 2018
PEHT Regence summary of benefits and coverage as of April 1, 2018
PEHT Regence summary plan description