New Sales

Source: OIC Provider Network Form A

* Balance billing may apply.


Renewals

Source: OIC Provider Network Form A

* Members may have in-network cost shares for out-of-network First Choice Health and First Health Network providers outside Kaiser Permanente's service area, when preauthorization is obtained.
** Balance billing may apply.
† Plans will be closing to renewals with effective dates Jan. 1, 2015, and later.

This is an overview of benefits. The contents are not to be accepted or construed as a substitute for the provisions of the medical coverage agreement. Other terms and conditions may apply. A list of excluded services and other limitations can be found in each plan's Summary of Benefits and Coverage document.