Regional Medical Plans (Kaiser, Quartz & UPMC)

In addition to our national plans, regional medical plans are available to colleagues in certain areas of California, Oregon, Washington, Wisconsin, Illinois and Pennsylvania. Find full details and decision support tools on MyBenefits so you can choose the right plan for you and your family.

Regional Plan Options

Depending on your home ZIP code, you may be eligible for a regional medical plan:

Colleagues in California – Kaiser California Health Maintenance Organization (HMO)
Colleagues in Oregon and Washington – Kaiser Northwest Health Maintenance Organization (HMO)
Colleagues in Wisconsin and Illinois – Quartz Health Maintenance Organization (HMO) or Point of Service (POS)
Colleagues in Pennsylvania – University of Pittsburgh Medical Center (UPMC) Exclusive Provider Organization (EPO)

It’s important for you to understand their key features and how costs work before deciding if this type of plan truly is the right fit.

Plan Summaries

If you’re eligible for one of the regional medical plans, select the appropriate tab to review plan highlights.

	KAISER CALIFORNIA (NORTH AND SOUTH)	KAISER NORTHWEST	QUARTZ HMO (WISCONSIN AND ILLINOIS) IN-NETWORK COVERAGE ONLY	QUARTZ POS (WISCONSIN AND ILLINOIS) IN-NETWORK COVERAGE	UPMC MEDICAL PLAN
Annual Deductible	$500 Individual / $1,000 Family	$500 Individual / $1,500 Family	$250 Individual / $500 Family	$250 Individual / $500 Family	$500 Individual / $1,000 Family
Coinsurance	You pay 20%	You pay 20%	You pay 20%	You pay 20%	You pay 10%
Annual Out-of-Pocket Maximum includes deductible, copays and coinsurance	$3,000 Individual / $6,000 Family	$3,000 Individual / $9,000 Family	$1,000 Individual / $2,000 Family	$1,000 Individual / $2,000 Family	$1,500 Individual / $3,000 Family
Pediatric Routine Physical Exams & Immunizations	You pay nothing	You pay nothing	You pay nothing	You pay nothing	You pay nothing
Preventive Exams & Tests including routine physicals, gynecological exams, mammograms	You pay nothing	You pay nothing	You pay nothing	You pay nothing	You pay nothing
Non-Preventive Lab Work — Independent Lab or Physician’s Office	You pay $10, after deductible	You pay $20	20%, after deductible	20%, after deductible	You pay 10%, after deductible
Office Visits — PCP	You pay $20	You pay $5 copay for first three (combined) qualified outpatient visits, then you pay $20	You pay $35 copay	You pay $35 copay	You pay $20 copay
Office Visits — Specialist	You pay $20	You pay $30	You pay $35 copay	You pay $35 copay	You pay $35 copay
Urgent Care	You pay $20	You pay $40	You pay $35 copay	You pay $35 copay	You pay 10%, after deductible
Prescription Drug Coverage
Deductible	$100 Individual / $100 Family for brand and specialty only	N/A	N/A	N/A	N/A
Out-of-Pocket Maximum	N/A	N/A	$2,000 Individual / $4,000 Family	$2,000 Individual / $4,000 Family	$1,500 Individual / $3,000 Family
Retail up to 31-day supply	Generic (Tier 1) – $10 copay* Brand Name (Tier 2) – $30 copay* after you meet the prescription drug deductible Specialty (Tier 4) – 20% coinsurance after you meet the prescription drug deductible, up to $150*	Generic – $15 copay Preferred Brand – $30 copay Non-Preferred Brand – $50 copay	Generic (Tier 1) – $5 copay/value $10 copay/other Preferred Brand (Tier 2) – $5 copay/value $35 copay/other Non-preferred and generics (Tier 3) – $60 copay Specialty (Tier 4) – $35 copay/preferred $60 copay/non-preferred	Generic (Tier 1) – $5 copay/value $10 copay/other Preferred Brand (Tier 2) – $5 copay/value $35 copay/other Non-preferred and generics (Tier 3) – $60 copay Specialty (Tier 4) – $35 copay/preferred $60 copay/non-preferred	Generic (Tier 1) – $10 copay Preferred Brand (Tier 2) – $35 copay Non-Preferred Brand or Generic (Tier 3) – $50 copay Specialty (Tier 4) – $50 copay ($0 for oral chemotherapy) Preventive (Tier 5) – $0 copay
Mail Order up to 90-day supply	Generic (Tier 1) – $10 copay* Brand Name (Tier 2) – $30 copay* after you meet the prescription drug deductible Specialty (Tier 4) – 20% coinsurance after you meet the prescription drug deductible, up to $150* * For Kaiser CA, prescription drug costs are for up to a 100-day supply for tiers 1 and 2 and up to a 30-day supply for tier 4.	Generic – $30 copay Preferred Brand – $60 copay Non-Preferred Brand – $100 copay	Generic (Tier 1) – $15 copay/value $30 copay/other Preferred Brand (Tier 2) – $15 copay/value $105 copay/other Non-preferred and generics (Tier 3) – $180 copay Specialty (Tier 4) – $105 copay/preferred $180 copay/non-preferred	Generic (Tier 1) – $15 copay/value $30 copay/other Preferred Brand (Tier 2) – $15 copay/value $105 copay/other Non-preferred and generics (Tier 3) – $180 copay Specialty (Tier 4) – $105 copay/preferred $180 copay/non-preferred	Generic (Tier 1) – $25 copay Preferred Brand (Tier 2) – $87.50 copay Non-Preferred Brand or Generic (Tier 3) – $125 copay Preventive (Tier 5) – $0 copay

Key Considerations

A few things to keep in mind as you weigh your options include:

Network restrictions – Unlike the national medical plans where the plan pays a lower benefit if you use an out-of-network provider, the HMO and EPO require that you stay in their networks. Otherwise, you are responsible for paying the full cost as if you did not carry health insurance.
Contribution increases are outside our control – Our regional plans are “fully insured,” meaning that insurance carriers assume the financial responsibility for covering healthcare claims but also keep any profits after paying out actual claims. In addition, these plans are influenced by broader community health trends outside of Thermo Fisher.
Healthy rewards only apply to our national plans – Unlike the regional plans, our national medical plans are “self-insured,” meaning Thermo Fisher assumes the financial responsibility for paying healthcare claims, and our costs are directly influenced by colleagues and family members who use our health plans. This approach offers us greater flexibility in how we structure our national medical plans to more closely match your needs. When actual claims are below expectations, we have the opportunity to retain those savings to reinvest in programs and services for our colleagues. So, as we all continue to take steps to live healthier, we not only achieve better outcomes for our own health, but we also directly influence healthcare costs and future benefit offerings for everyone at Thermo Fisher.
More predictable out-of-pocket costs – The regional plans offer more predictable out-of-pocket costs due to copays and lower deductibles in many cases.

Emotional Wellbeing Support for Kaiser Participants

Kaiser offers three apps to support your emotional wellbeing, at no cost to their medical plan participants.

Calm is a free meditation and mindfulness app to help lower stress, reduce anxiety and improve sleep quality and is available to Kaiser plan participants.
The myStrength app offers a personalized program with interactive activities, in-the-moment coping tools, inspirational resources and community support at no cost to plan members.
Use the Ginger app to text one-on-one with an emotional support coach anytime, anywhere.

Get started: Visit kp.org/selfcareapps.

Emotional Wellbeing Support for UPMC Participants

Access emotional wellbeing with the RxWell app. Expert techniques and coaching support to help you deal with anxiety, tobacco use and sleep issues all from your smartphone. Sign up for text tips and mindfulness exercises to keep your stress in check. This app is available at no cost to you and your covered family members age 18 or older.

Get started: Download the RxWell app on the Apple App Store or Google Play and enter your UPMC member ID or Social Security number to create an account. If you already have a UPMC account, log in with your username and password. Need help logging in? Call 1-877-539-3080.

24/7 Virtual Doctor Visits

Take advantage of convenient virtual doctor visits available through UPMC, Quartz and Kaiser.

Kaiser – Make appointments for phone or video visits, correspond with your doctor via email or complete a short questionnaire about your symptoms and receive personalized guidance. To get started, sign in to kp.org or call 1-866-454-8855.
UPMC – UPMC AnywhereCare connects you and your covered dependents with virtual visits for many non-emergency issues. Screening for COVID-19 symptoms is also available. To get started, visit anywherecare.upmc.com or download the UPMC AnywhereCare mobile app. For health-related questions, you can also use UPMC 24/7 Nurse Line. Call 1-866-918-1591 anytime or log onto MyHealth Online.
Quartz – Members have access to providers 24/7 through a smartphone, tablet or computer. To get started, visit quartzbenefits.com/members.

What to Expect

Colleague Contributions: To better understand and compare costs, view full-time colleague contributions for 2024 here. If you choose to cover your spouse/domestic partner and they have access to subsidized medical coverage through their employer, you will pay an additional $100 per month for coverage.

ID Cards: If you are new to Kaiser or UPMC or updated your enrollment, you will receive a combined medical and pharmacy plan ID card mailed to your home address. All those enrolled in Quartz will receive a combined medical and pharmacy plan ID card mailed to your home address.

Find Your PCP: After you’ve enrolled, use your UPMC, Quartz or Kaiser account to find an in-network primary care physician (PCP) or OB-GYN and see them for your recommended care.

Check Your Options

If you’re considering a regional medical plan or are currently enrolled and are thinking about making a switch, we strongly encourage you to use the decision support tool embedded within the enrollment experience on MyBenefits to review your options and costs.

2024 Benefits Guide