The 3 Tier Point-of-Service (POS) plan empowers your employees to make decisions about how they receive care and who they receive it from. Employees can receive care from 1) Kaiser Permanent’s full-service care delivery system 2) Contracted Providers and 3) Any licensed non-Contracted Provider. *
Your employees are free to choose whatever provider they prefer, whenever they receive care.
What does each option offer?
Kaiser Permanente provider option:
Kaiser Permanente Care: Fully coordinated, high-quality care, lowest cost of the three options.
- Choose from Kaiser Permanente Hawaii physicians from our more than 20+ locations on Oahu, Maui, and Hawaii Island, and Kauai, and Kaiser Permanente contracted physicians on Kauai, Lanai, and Molokai.
- A primary care physician coordinates care. When specialty care is needed, they will find the specialist right for the member and coordinate the referral.
- Kaiser Permanente Plan Providers are connected to an electronic health record, so they’re up-to-date on members care.
- Lowest out-of-pocket costs compared to contracted and non-contracted provider options.
- Most facilities offer many services conveniently under one roof, including pharmacy, imaging, lab, primary care physicians, and specialists.
- No claims paperwork is required.
Contracted provider option*:
Contracted providers in the community:
- Within Hawaii, choose from our Contracted provider option that has an extensive network of more than 3,000 Kaiser Permanente Insurance Company (KPIC) contracted providers and 160 contracted hospitals and care facilities in Hawaii. **
- In Non-Kaiser Permanente states, the Cigna PPO Network option is available outside of CA, CO, GA, MD, OR, VA, WA and DC for medical care. The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.
- We’ve contracted with providers directly to manager provider costs.
- Out-of-pocket costs will generally be higher than with Kaiser Permanente providers and usually less than non-contracted providers.
- A referral is not needed to see most specialists.
- Some kinds of care require precertification, such as inpatient care and some outpatient procedures. This includes using contracted providers in Hawaii for some services and procedures. If using the Cigna PPO Network for care in non-Kaiser Permanente states (outside of CA, CO, GA, HI, MD, OR, VA, WA and DC), the Cigna PPO providers are responsible for obtaining precertification on your behalf when precertification is required. You won’t be financially responsible if a Cigna PPO provider fails to obtain precertification for covered services.
Non-contracted provider option:
Any licensed non-contracted provider: Care from any licensed provider, highest out-of-pocket costs.
- Receive care from any licensed care provider including physicians, specialists, hospital or laboratory (who are not Kaiser Permanente providers or contacted providers).
- Out-of-pocket costs will usually be the highest with this option.
- Payment may be required to the provider directly at the point-of-service.
- A claim form will have to be completed, just as with most traditional health plans. If payment is required at the point-of-service, a medical claim will need to be submitted.
- A referral is not needed to see specialists.
- Certain services require precertification.
*Kaiser Foundation Health Plan, Inc. (KFHP) underwrites the Kaiser Permanente provider option. The contracted and non-contracted provider options of this plan are underwritten by Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc.
**Contracted providers, hospitals and care facilities in Hawaii as of 2022
- Get the care needed: Choose how and where to get covered care.
- Manage care and costs: Choose the provider. Determine how to manage out-of-pocket costs. Decide which provider network option to use any time to access care.
- Preventive care: It’s covered at no cost or copay with a Kaiser Permanente provider or contracted provider.
- Pharmacy services: Most Kaiser Permanente medical centers have on-site pharmacies. Prescriptions can be filled at retail pharmacies across the country.
Check here for more about pharmacy services, finding doctors and facilities and the benefits of Added Choice.
Is Added Choice right for you?
Here’s are some examples of how people use Added Choice to get the care they want:
For employers and brokers, Added Choice is a great all-in-one solution:
- Give your valuable employees full choice in their providers and allow them to determine and manage their health care costs.
- Having three options of providers to choose from gives your valued employees what they need to be healthier and more productive every day.
- The versatility and benefits of POS plans can help attract and retain employees.
- Your company has the convenience of one health plan for all your employee benefits administration.
- Offer it side-by-side with HMO plans to decrease your company’s overall health care costs, and still offer your employees plan choice.
How the Added Choice plan works for your company and employees.
With Added Choice, you can offer your participating employees three options when they receive care:
- Kaiser Permanente provider option:Members can receive in-network care from Kaiser Permanente Hawaii physicians at any one of our 22 facilities on Oahu, Maui, and Hawaii Island, and Kauai, and Kaiser Permanente contracted physicians on Kauai, Lanai, and Molokai through Kaiser Permanente’s high quality integrated healthcare delivery system. This option provides the most coordinated care with the lowest out-of-pocket costs. Preventive care is at no cost when you see a Kaiser Permanente provider.
- Contracted provider option: There is a deductible to be met, with copay or coinsurance for certain covered services after the deductible has been met. Depending on the plan selected, some services may be offered before the deductible at a copay. Preventive care is covered at no cost, before the deductible. Contracted Providers are available based on service location:
In Hawaii: Contracted Providers provide access to care. You have access to more than 3,000 Kaiser Permanente Insurance company (KPIC) contracted providers and more than 160 contracted hospitals and care facilities in Hawaii. ** Be sure to check if your provider is a contracted provider prior to receiving services.
Non-Kaiser Permanente States outside of CA, CO, GA, HI, MD, OR, VA, WA and DC the CignaPPONetwork* provides access to care.
*Disclaimer: The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as of the Cigna PPO for Shared Administration.
With the contracted provider option, members can work directly with more than 3,000 Kaiser Permanente Insurance Company (KPIC ) contracted providers and 160 contracted hospitals and care facilities in Hawaii**. There is a deductible to be met, with copay or coinsurance for certain covered services after the deductible has been met. Depending on the plan selected, some services may be offered before the deductible at a copay. Preventive care is covered at no cost, before the deductible.
- Non-contracted provider option: Members can receive services from any licensed provider or facility they choose outside those included in the Kaiser Permanente provider option or contracted provider option. Members pay deductibles, coinsurance, and may be balance billed. Out-of-pocket costs are generally the highest with this option.
Learn more about what’s included in the Kaiser Permanente provider option, contracted provider option, and CignaPPONetwork option, and non-contracted provider option and how they work.
*Contracted providers, hospitals and care facilities in Hawaii as of 2022
Employers’ frequently asked questions
What are the pharmacy choices under Added Choice?
Members have several choices for having their prescriptions filled.
- Most Kaiser Permanente medical centers have onsite pharmacies. Members can fill prescriptions written by Kaiser Permanente providers, contracted providers, and non-contracted providers at pharmacies located in Kaiser Permanente medical offices, at the lowest out-of-pocket costs among the three options. Members can also choose to receive their prescriptions by mail only if filled at a Kaiser Permanente pharmacy.*
- Members can register at to order most refills online and have the medicine mailed to them or they can pick it up at a medical center pharmacy.*
- Members can call the refill line at 808-643-RxRx (808-643-7979), 24 hours a day, and have the medicine mailed to them or it can be picked up at any medical center pharmacy.*
- Kaiser Permanente Insurance Company contracts with designated pharmacies to fill outpatient prescription drugs at retail pharmacies.
Learn more about pharmacy services.
What are the guidelines regarding precertification?
- Members using the Contracted Provider option and the non-Contracted Provider option need precertification for all inpatient services and certain outpatient surgeries, services and procedures. If using the Cigna PPO Network for care in non-Kaiser Permanente states (outside of CA, CO, GA, MD, OR, VA, WA and DC), the Cigna PPO providers are responsible for obtaining precertification on your behalf when precertification is required. You won’t be financially responsible if a Cigna PPO provider fails to obtain precertification for covered services.
- Our Permanente Advantage office with its extended hours is the administrator for precertification.
Learn more about precertification.
How are new members on-boarded?
- Onboarding includes: Comprehensive New Member Welcome handbooks, an onboarding call from Customer Service agents, and a help line with extended hours for any questions, from accessing care to transferring prescriptions.
Who processes claims?
The plans that underwrite the Kaiser Permanente provider option, contracted provider option, and non-contracted provider option, process the claims.
- Kaiser Foundation Health Plan, Inc. (KFHP) underwrites the Kaiser Permanente provider option.
- Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP), underwrites the contracted provider option and the non-contracted provider option.
Who do we contact for product pricing or to purchase Added Choice?
- Contact Kaiser Permanente at any time through our Business Plans contact page.
*Mail-order service is only available for prescriptions filled at a Kaiser Permanente pharmacy. We are not licensed to mail medications out of state. There are restrictions for delivery of certain medications and supplies, including but not limited to controlled medications, injections, medications affected by temperature, and medications excluded by Kaiser Permanente’s Pharmacy & Therapeutics Committee.