Plan Options

IntroducingBlue and Green

We have two options, CDHP Blue with HSA and CDHP Green with HSA. That's two CDHP with HSA options giving you more choices and control over how you pay for health care.

Have other coverage outside of K-C?

If you’re enrolled in TRICARE or Medicare, or are participating in another plan outside of K-C that doesn’t qualify for a high-deductible health plan, the IRS specifies that you cannot contribute to or receive company contributions into an HSA. This restriction also applies if you receive Veterans Administration benefits for the three months prior to an HSA contribution. You’ll be given an opportunity to designate your TRICARE, Medicare, Veterans Benefits, or alternate plan eligibility during the enrollment process. You’ll then be offered a CDHP with a Health Reimbursement Account (HRA) that meets the IRS regulations.

Plan Options">

No matter which option you choose, both CDHP Blue and Green have:

  • Work the same way
  • Offer the same coverage
  • Operate under the same Anthem BlueCross BlueShield network of providers
  • Experience the same network discounts
  • Receive the same HSA contribution from K-C

Plan Comparison & Paycheck Costs

When comparing the plans, it's important to note that a separate deductible, out-of-pocket maximum, and coinsurance apply to out-of-network services. Print a PDF of this comparison for reference. Just remember, the paycheck costs doesn’t always tell the full story. For a better understanding of the full cost, try the Real-Life Examples tool.

Blue Green

How the options are different:

Your annual medical paycheck costs
(Before tobacco-free discount)
$444 Individual
$1,803 2-Party
$3,157 2-Party Plus
$300 Individual
$1,135 2-Party
$2,162 2-Party Plus
Your deductible In-network:
$1,500 Individual
$3,000 2-Party
$3,000 2-Party Plus

Out-of-network:
$3,000 Individual
$6,000 2-Party
$6,000 2-Party Plus
In-network:
$2,500 Individual
$5,000 2-Party
$5,000 2-Party Plus

Out-of-network:
$5,000 Individual
$10,000 2-Party
$10,000 2-Party Plus
Out-of-pocket maximum In-network:
$3,000 Individual
$6,000 2-Party
$6,000 2-Party Plus

Out-of-network:
$6,000 Individual
$12,000 2-Party
$12,000 2-Party Plus
In-network:
$5,000 Individual
$10,000 2-Party
$10,000 2-Party Plus

Out-of-network:
$10,000 Individual
$20,000 2-Party
$20,000 2-Party Plus

How the Options Are the Same:

K-C's HSA contribution $700 Individual
$1,400 2-Party
$1,400 2-Party Plus
$700 Individual
$1,400 2-Party
$1,400 2-Party Plus
Preventive care K-C pays 100%
Coinsurance In-network: You pay 100% until you reach the in-network deductible, then K-C pays 80%

Out-of-network: You pay 100% until you reach the out-of-network deductictle then K-C pays 60%
Office visits
Urgent care
Emergency room
Hospitalization
Lab, X-ray, imaging
Mental health inpatient
Mental health outpatient
Physical (includes chiropratic), speech, and occupational therapy You pay 100% until you meet the deductible, then K-C pays 80% (combined 60-visit annual max.)

How Both Options Cover Prescription Drugs:

Maintenance K-C pays 100% for certain maintenance prescriptions1
Generic You pay 100% until you meet the deductible, then K-C pays 80%
Preferred brand
Non-preferred brand
1To learn which maintenance prescriptions are included, log in at caremark.com or call CVS/caremark at 888-797-8911

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Which Plan Is Right For You?

Not sure if you’re Blue or Green? The plans are very similar, but here’s an easy way to start thinking through the differences.

Go BLUE if...

you prefer paying more out of your paycheck now, but having a lower deductible and out-of-pocket maximum to meet when you need care, you might prefer the CDHP Blue with HSA.

Go GREEN if...

you prefer paying less out of your paycheck now, but having a higher deductible and out-of-pocket maximum to meet when you need care, then the CDHP Green with HSA might be more your speed.

How a CDHP with HSA Works

A CDHP with HSA combines a Consumer Driven Health Plan (CDHP) with a Health Savings Account (HSA). That means:

 

Annual Checkups

Your annual checkups and other preventive care are 100% paid by the plan — as long as you see an in-network provider. If you go out of network for preventive care, you’ll pay the entire cost of that care. If you need any medical care beyond your annual checkup, you pay the full Anthem-negotiated cost out of your HSA or out of pocket until you reach your deductible.

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Deductible

If you reach your deductible, K-C pays 80% of the cost and you pay the remaining 20% when you use Anthem network providers.

 

 

Prescription Drugs

Certain prescription drugs are covered at 100% by the plan without having to meet the deductible; for all other drugs, you pay the full Caremark network cost until you meet your deductible — then K-C pays 80% and you pay 20%.

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Out-of-pocket Maximum

If you reach your out-of-pocket maximum, the plan pays 100% of your covered medical services and prescription drugs for the rest of the year, as long as you're enrolled in a CDHP with HSA.

 

Benefits Information Line 800-551-2333 (U.S. & Canada)

Copyright | Disclaimer

Disclaimer

This site is provided to help Kimberly-Clark (K-C) employees better understand their benefit plans. It does not guarantee coverage under a plan and does not provide complete descriptions of K-C benefit plans. K-C reserves the right to change these plans at any time. In all cases, the formal Plan Documents will govern.

If you are an organized hourly employee covered by these plans, see your HR representative or other person designated at your unit for information on how your plan(s) may differ from the information on this site. You may also call the Benefits Center at 800-551-2333 (U.S. & Canada) or 718-354-1340 (outside of U.S. & Canada) Monday through Friday, 9 a.m. to 5 p.m. Eastern time.