National Medical Plan Options
K-C offers national medical plans that give you more control of your health care spend and saving for your future. All of the plan options offer access to Anthem’s national network of doctors and CVS/caremark’s network of pharmacies. They also all provide free preventive care.
CDHP Blue or Green
With your two medical plan options, the Consumer Driven Health Plan (CDHP) Blue with Health Savings Account (HSA) and CDHP Green with HSA, K-C gives you more choices and control over how you pay for health care.
Plan Options
No matter which option you choose, both CDHP Blue and Green:
- 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
How Other Coverage Outside of K-C Impacts HSA Eligibility
If you’re enrolled in TRICARE, Medicare, or a non-high deductible health plan outside of K-C, the IRS specifies that you cannot contribute to or receive company contributions into an HSA. There are also special eligibility considerations for Veterans Administration benefits. If you're ineligible for an HSA, you'll be offered a CDHP with Health Reimbursement Account (HRA) that meet IRS restrictions. Click here to learn more about HSA eligibility.
Tobacco-Free Discount
Did you know that if you and your covered dependents are tobacco-free or enrolled in a tobacco cessation program for the last 12 months, you receive a $240 discount on your annual medical paycheck costs? During enrollment, you’ll be asked your tobacco-use status to determine if you’re eligible for the tobacco-free discount.
If you or your covered dependent (18 or older) need to kick the habit, getting the support you need is easy using LiveHealth Online. Whether you’re at work or on the go, you can visit one-on-one with a health coach through live video or over the phone. Coaches can work with you to create a personalized plan of action with strategies to cope with your cravings. They can also send you nicotine replacement directly to your home at no cost to you.
To learn more, register at LiveHealth Online and click the Tobacco-free tile.
Working Spouse/Partner Surcharge
K-C offers coverage to all spouses/partners, but for those who have employer-provided medical coverage available to them, there will be an additional cost starting in 2023. This means if your spouse/partner has access to medical coverage through their employer, K-C will apply a $100 monthly surcharge if you continue to cover them on a K-C Anthem medical plan option. The working spouse/partner surcharge will be applied to your paycheck medical deduction.
The surcharge will not apply if your spouse/partner is:
- not employed,
- a K-C employee,
- self-employed, or
- not offered or eligible for medical coverage through their employer’s plan.
During enrollment for your health & welfare benefits, you’ll be asked about your spouse/partner’s eligibility for coverage. All responses are subject to audit and K-C’s Code of Conduct. If you currently cover your spouse/partner and don’t complete your enrollment, the $100 monthly surcharge will be automatically applied in 2023. If your spouse/partner becomes eligible or loses eligibility for other employer medical coverage, you must notify K-C within 30 days of the change in eligibility. The change to apply or stop the surcharge on your paycheck will be made as soon as administratively possible after reporting the change in status and will apply going forward. K-C will not make retroactive adjustments to your paycheck.
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 2023 Medical Plan Comparison PDF or a 2022 Medical Plan Comparison PDF for reference. Just remember, the paycheck costs don’t always tell the full story.
Changes to Deductibles & Out-of-Pocket Maximums
The annual deductibles and out-of-pocket maximums are increasing for 2023. Review the 2023 Medical Plan Comparison Chart below to see the new limits.
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2022 Medical Plan Comparison Chart
CDHP Blue with HSA CDHP Green with HSA How the Options Are Different: Your 2022 annual medical paycheck costs
(Before tobacco-free discount)$564 Individual
$2,310 2-Party
$4,072 2-Party Plus
$300 Individual
$1,492 2-Party
$2,844 2-Party PlusDeductible 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 PlusIn-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 PlusOut-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 PlusIn-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 PlusHow 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 PlusPreventive care In-Network: K-C pays 100%.
Out-of-Network: You pay 100% until you reach the out-of-network deductible, then K-C pays 60%.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 deductible 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 In-Network: You pay 100% until you meet the in-network deductible, then K-C pays 80% (combined 60-visit annual max).
Out-of-Network: You pay 100% until you meet the out-of-network deductible, then K-C pays 60% (combined 60-visit annual max).How Both Options Cover Prescription Drugs Maintenance K-C pays 100% for certain maintenance prescriptions.1 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. -
2023 Medical Plan Comparison Chart
CDHP Blue with HSA CDHP Green with HSA How the Options Are Different: Your 2023 annual medical paycheck costs
(excludes tobacco-free discount and working spouse/partner surcharge)$582 Individual
$2,380 2-Party
$4,1942 2-Party Plus
$300 Individual
$1,561 2-Party
$2,966 2-Party PlusTobacco-Free Discount ($240) ($240) Working Spouse/Partner Surcharge (New for 2023) $1,200 $1,200 Deductible (Increased from 2022) In-Network:
$2,000 Individual
$4,000 2-Party
$4,000 2-Party Plus
Out-of-Network:
$4,000 Individual
$8,000 2-Party
$8,000 2-Party PlusIn-Network:
$3,500 Individual
$7,000 2-Party
$7,000 2-Party Plus
Out-of-Network:
$7,000 Individual
$14,000 2-Party
$14,000 2-Party PlusOut-of-pocket maximum (Increased from 2022) In-Network:
$4,000 Individual
$8,000 2-Party
$8,000 2-Party Plus
Out-of-Network:
$8,000 Individual
$16,000 2-Party
$16,000 2-Party PlusIn-Network:
$7,000 Individual
$14,000 2-Party
$14,000 2-Party Plus
Out-of-Network:
$14,000 Individual
$28,000 2-Party
$28,000 2-Party PlusHow 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 PlusPreventive care In-Network: K-C pays 100%.
Out-of-Network: You pay 100% until you reach the out-of-network deductible, then K-C pays 60%.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 deductible 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 In-Network: You pay 100% until you meet the in-network deductible, then K-C pays 80% (combined 60-visit annual max).
Out-of-Network: You pay 100% until you meet the out-of-network deductible, then K-C pays 60% (combined 60-visit annual max).How Both Options Cover Prescription Drugs Maintenance K-C pays 100% for certain maintenance prescriptions.1 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.
Note: If you’re covered by Collective Bargaining Agreement (CBA), some of these provisions and medical rates may not apply to you. Please refer to your CBA for full details.
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 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 you might prefer the CDHP Green with HSA.
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.
How a CDHP with HSA Works
The CDHP determines what and how your health care is covered and the HSA is where and how you save and pay for health care tax-free. That means for the CDHP:
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.
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% without having to meet the deductible; for all other drugs, you pay the full CVS network cost until you meet your deductible — then K-C pays 80% and you pay 20%.
Out-of-pocket Maximum
If you reach your out-of-pocket maximum, the plan pays 100% of your eligible medical expenses and prescription drugs for the rest of the year.