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Preferred provider organization (PPO) and point-of-service (POS) plans

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Provider choice + flexibility for your employees

With our PPO or 3-Tier POS plans, you can get a total health care solution that gives you and your employees choice, flexibility, and convenience.1

PPO or 3-Tier POS plans are available side by side with an HMO, a deductible HMO, or a high deductible health plan, offering your organization the convenience of one health plan for all your employee benefits.

Get the comprehensive coverage you want

PPO Plans

With our PPO plans, your employees can choose from a wide range of providers, helping them manage their health care costs. They can get care from participating providers or any licensed non-participating provider.

  • Having 2 tiers of providers to choose from gives your valued employees what they need to be healthier and more engaged every day.
  • With the participating provider network, your employees have the freedom to choose their doctor for each visit — no referral is needed.
  • In California, Colorado, Georgia, Maryland, Oregon, Virginia, Washington, and the District of Columbia, care is available from the PHCS Network, First Choice Health, or the First Health Network, depending on your group’s location.2,3 In Kaiser Permanente’s Northwest and Georgia regions, care is also available from Kaiser Permanente providers.
  • In other states, PPO members can visit Cigna HealthcareSM PPO Network providers.4
    • Exceptions: The Cigna Healthcare PPO Network isn’t available for Kaiser Permanente Washington and Kaiser Permanente Northwest employers based in Washington who have PPO plans. These members can access First Choice Health and the First Health Network.5
  • Non-participating provider tier: Access to any licensed provider.
  • Some services, such as outpatient surgery and complex imaging, require precertification.

POS plans

Our 3-Tier POS plans combine Kaiser Permanente HMO coverage with other in-network and out-of-network options, all in one convenient plan. Having 3 tiers of providers to choose from gives your valued employees what they need to be healthier and more productive every day.

  • It’s a “best of both worlds” solution for you and your employees.
  • Your employees have access to Kaiser Permanente providers while maintaining access to any provider of their choice.
    • HMO tier: In-network care from Kaiser Permanente provides the most coordinated care and lowest out-of-pocket costs.
    • Participating provider tier: Members can choose from a nationwide network of participating providers.
      • For 3-Tier POS plans in California, Colorado, Maryland, Oregon, Virginia, Washington, and the District of Columbia, care is available from the PHCS Network, First Choice Health, or the First Health Network, depending on your group’s location.2,3
      • In other states, members can visit Cigna HealthcareSM PPO Network providers.4
        • Exceptions: The Cigna Healthcare PPO Network isn’t available for Kaiser Permanente Washington and Kaiser Permanente Northwest employers based in Washington who have PPO plans. These members can access First Choice Health and the First Health Network.5
    • Non-participating provider tier: Access to any licensed provider.
  • Some services, such as outpatient surgery and complex imaging, require precertification.

For more information

Contact

Some plan options, products, and riders not available in all Kaiser Permanente areas.
 

  • 1

    California: Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc., underwrites the Out-of-Network coverage consisting of the Participating Provider and/or the Non-Participating Provider Tiers of the POS Plan. Colorado: Kaiser Foundation Health Plan of Colorado, underwrites the HMO Tier and Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc., underwrites the Participating Provider Tier and the Non-Participating Provider Tier of the 3-Tier POS Plan. The PPO Plan is fully underwritten by KPIC. Georgia: The Dual Choice and Out-of-Area PPO Plans are underwritten by Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc. Hawaii: 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 KFHP. Mid-Atlantic States: Kaiser Foundation Health Plan of the Mid-Atlantic States (KFHP-MAS) underwrites the In-Network HMO Tier of the POS Plan. Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP), underwrites the In-Network PPO Tier and Out-of-Network Tier of the POS and PPO plans. Northwest: All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest (KFHP).

  • 2

    KPIC has contracted with PHCS Network to provide access to hospitals and physicians with a commitment to keeping out-of-pocket costs low through contracted rates.

  • 3

    In Colorado: Kaiser Permanente Insurance Company is contracted with First Health. First Health is a brand name of First Health Group Corp.

  • 4

    The Cigna HealthcareSM PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.

  • 5

    Beginning January 1, 2024, Kaiser Foundation Health Plan of the Northwest members enrolled in 3-Tier Point-of-Service (POS) and PPO plans, and whose employers are based in Oregon, will have access to Cigna Healthcare PPO Network providers. The Cigna Healthcare PPO Network is not available to members whose employers are based in Washington and are enrolled in 3-Tier POS and PPO coverage issued by Kaiser Foundation Health Plan of the Northwest. The Cigna Healthcare PPO Network is not available to members enrolled in 3-Tier POS and PPO coverage issued by Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc.

 
Cigna Healthcare is an independent company and not affiliated with Kaiser Foundation Health Plan, Inc., and its subsidiary health plans. Access to the Cigna Healthcare PPO Network is available through Cigna Healthcare’s contractual relationship with the Kaiser Permanente health plans. The Cigna Healthcare PPO Network is provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Healthcare Intellectual Property, Inc.