Kaiser Permanente

BROKER TOOL KIT

General Information

Member Material Ordering

Enrollment

This program requires 100% enrollment form submission via your FMO’s instance of Sunfire.

  • GS National
    • Once logged into Propelicy account, you will access SunFire through the Enrollment Section with Single Sign On
  • Health Markets
  • Integrity
    • You will be given access to quote and sell via MedLink in MedicareCENTE 

Medicare Broker Manager

Christel Finley
404-895-8985

Medicare Broker Support Line

800-700-7131

Enrollment Platform Access Instructions

Once logged into Propelicy account, you will access SunFire through the Enrollment Section with a Single Sign On.

  • You will click on the Enrollment icon in the top right corner of the screen and then click on Quote & Enroll. This will automatically log you into your SunFire account.
  • For questions/issues: agentinfo@gsnational.com or they can call at 855-330-5566.

Golden Outlook

You will be given access to quote and sell Kaiser Medicare Advantage via QuoteConnect.

  • Once you log on to QuoteConnect, Click on Dashboard. Next Click on “Build a Proposal”.
  • Continue enrollment leveraging Connecture DRX
  • Or you have the option to use Sunfire: sunfirematrix.com/app/agent/hthmkts.
  • Kaiser Permanente Medicare quoting will be available in QuoteConnect if you have completed all the Ready the to Sell Requirements.
  • For questions/issues: contact HealthMarkets’ Field Support at 888-731-4447.

You will be given access to quote and sell Kaiser Medicare Advantage via MedLink (Sunfire) in MedicareCENTER.

  • Please note, Kaiser quoting will be available in MedApp (Connecture), however, enrollments must be submitted via MedLink (SunFire).
  • Log in is provided by your FMO. If you already have access, then Kaiser Permanente Medicare Advantage plans will be visible once you have completed all your Ready to Sell requirements.
  • For questions/issues: MedicareCENTER@integritymarketing.com.

Kaiser Permanente Senior Advantage Member FAQ

Q: If I enroll in a KP Senior Advantage plan will I lose my Original Medicare?

If you enroll in our plan you will not lose your Original Medicare. You’re just choosing to allow a private company to administer your benefits instead of the federal government. You do not lose your Medicare benefits and you must continue to pay your Part B premiums.

Q: What happens if I seek services outside of Kaiser Permanente?

KP offers only HMO products. With an HMO, you will be assigned a Primary Care Provider (PCP) at a center closest to you. You can change this PCP as often as you like. Your PCP will coordinate all of your care at Kaiser and can direct you to Specialists or hospitals if you require additional care. You must get your care from providers that are in the Kaiser Permanente locations unless authorized by your PCP. If you go to a provider outside of our network without authorization, you will be responsible for the entire cost.

With the HMO, you have the freedom to choose physicians and specialists from within our network or seek care out of network. If you choose to see a provider that is not in the KP Medicare Advantage network, you may be responsible for the entire cost of that service/visit.

Kaiser Permanente members are covered both nationally and internationally for Urgent and Emergent situations.

Q: Is it possible the amount I pay each month for KP Senior Advantage coverage (insurance premium) will change throughout the year?

A: Your premium will stay the same every month during the calendar year. The only way your premium will change is if you receive a Part D Late Enrollment Penalty (LEP) from the Social Security Administration or if you add or remove the Advantage Plus rider.

Q: What is a Late Enrollment Penalty?

A: The late enrollment penalty is an amount added to your Medicare Part D monthly premium. You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

  1. A Medicare Prescription Drug Plan (Part D)
  2. A Medicare Advantage Plan (Part C) (like an HMO or PPO)
  3. Another Medicare health plan that offers Medicare prescription drug coverage
  4. Creditable prescription drug coverage

Q: If I opt to pay my KP Senior Advantage premium via automatic withdrawal from my Social Security check, how long will it take to set up?

A: It will take a minimum of 90 days to start or stop automatic withdrawal from Social Security checks.

Q: If I enroll in the Advantage Plus supplemental benefit (dental/hearing), will I receive a separate ID card?

A: No. Your KP Senior Advantage ID card and Member ID number will be accepted and recognized by the supplemental vendors, but you are also welcome to go online to Delta Dental to create an account and print a card. Hearing aid services happen at Kaiser Permanente facilities with Kaiser Permanente doctors.

Q: Can I assume that all providers in the Kaiser Permanente facilities will be in network?

A: Yes, all of our Physicians in the Kaiser Permanente facilities are in network. We do have many Community Providers outside of our facilities in network, but you should check with Member Services if you need authorization and a referral from your KP Primary Care Doctor to see them.

Q: What happens if I go to a provider who is not in network?

You will be responsible for 100% of the bill unless you received prior authorization from Kaiser Permanente. There is no out of network coverage on this plan except for Emergency, Urgent Care and Out of Area Renal Dialysis nationwide. Emergency and Urgent Care is also covered outside of the U.S.

Q: Does your HMO plan require referrals to see a specialist?

Our HMO plan requires referrals for some specialist visits. Your Primary Care Provider will help to coordinate your care with any Specialists you may require.

Q: If I sign up for the Advantage Plus rider what is the premium and is there a waiting period for the benefits to begin?

Our rider has a $9 monthly premium in addition to any plan premiums and there is no waiting period for the benefits to begin.

Q: Does Kaiser Permanente offer any financial assistance to members in need?

A: Yes. Kaiser Permanente does offer Member Financial Assistance. It is needs based and the member must meet certain income requirements to qualify. Have your member call the Medical Financial Assistance Program phone number: 404-949-5112 (TTY 800-255-0056) or go online at kp.org/mfa/ga.