Plan and Benefit Options

Chiropractic/acupuncture

For 2023 Plan Designs

Combined coverage for chiropractic/acupuncture care is included in the following ACA-compliant metal plans:

• Platinum 90 HMO 0/10 + Child Dental Alt

• Gold 80 HMO 0/30 + Child Dental Alt

• Gold 80 HMO 1000/40 + Child Dental Alt

• Silver 70 HMO 1900/65 + Child Dental Alt

• Silver 70 HMO 2300/65 + Child Dental Alt

• Silver 70 HMO 2800/65 + Child Dental Alt

• Bronze 60 HMO 5400/60 + Child Dental Alt

    Note, although the new Gold 80 HDHP HMO 1600/15% + Child Dental Alt is an “Alt” plan, it does not include chiropractic/acupuncture benefits. HDHP plans are not permitted to offer these benefits before to the deductible and therefore these extra benefits are not available with HDHP plans.

Chiropractic/acupuncture for grandfathered (nonmetal)

Optional chiropractic/acupuncture coverage is available for grandfathered (nonmetal) plans, except for HSA-qualified high deductible health plans (HDHP).

• If you offer chiropractic/acupuncture coverage, all subscribers and dependents must participate.

• You can add coverage only at renewal.

• You can discontinue coverage anytime up to 4 months before your renewal date or at renewal.

Infertility

The optional infertility benefit is available to groups with 20 or more eligible employees where Kaiser Permanente is the sole carrier.

• This benefit will be added to all HMO plans, when selected.

• All metal PPO plans include this infertility benefit.

      You can only add or cancel this benefit upon renewal if the benefit isn’t part of your original contract.  

Supplemental Family dental plans (optional)

• Supplemental family dental plans are available only to those enrolled in a Kaiser Permanente medical plan.

• If you choose a family dental plan, all subscribers and dependents must participate.

• The DeltaCare HMO family dental plan isn’t offered with PPO medical plans.

• Kaiser Permanente family dental plans cover the entire family, including adults and dependent children up to age 26 (if you offer dependent coverage). Supplemental family dental plans are not a substitute for ACA required child dental coverage of members under 18 years old.

Child dental

• All metal HMO and PPO plans cover the ACA-defined essential health benefits, which include child dental services.

• HMO members are enrolled in a separate child dental benefit underwritten by Delta Dental of California.

• PPO medical plan members receive child dental PPO benefits as part of their medical coverage and not as a separate plan.

• Child dental services apply to all members 19 years old. If a child turns 19 before the current contract renews, coverage is extended until the contract date. 

Child vision

• Child vision benefits are included on all ACA plans.

• High-level features include routine vision exam and eyewear (eye-glasses and contact lenses). See benefits for any exclusions and limitations.

Durable medical equipment

• Supplemental and base DME coverage is included on all ACA plans.