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Nursing Services Organization

Nursing Services Organization

You can use the Nursing Services Organization (NSO) to supplement your health plan benefits. This program provides you with a way to manage your out-of-pocket expenses when you get sick or injured.

Nursing Services Organization (NSO)

Nursing Services Organization (NSO) is a self-funded program that provides supplemental coverage to eligible employees and their dependents. Supplemental coverage through NSO is secondary to your primary plan, in which case the primary plan will pay first and then any remaining expenses will be paid by NSO. The costs of treatment are shared between you and your employer based on the percentage of your annual salary; however, co-payments may apply.

NSO is a self-funded program that provides supplemental coverage to eligible employees and their dependents.

The NSO is a self-funded program that provides supplemental coverage to eligible employees and their dependents. Eligible employees are those who, as of January 1 of the year in which they first enroll in the plan, have been employed by you full-time for three or more consecutive months.

All other employees who work part-time or on an intermittent basis are considered eligible when they have worked at least three continuous months during this same period (including any periods before or after January 1).

Supplemental coverage through NSO is secondary to your primary plan.

  • Supplemental coverage through NSO is secondary to your primary plan.
  • If you have a claim, you will be reimbursed first by your primary plan.

Eligibility

To be eligible, you must be enrolled in a qualifying insurance plan and:

  • Be an employee of Kaiser Permanente or one of its affiliated organizations. An eligible employee is defined as a person who works at least 30 hours per week for any Kaiser Permanente entity, including full-time employees and part-time employees;
  • Be a dependent of an eligible employee.

You are eligible for NSO if you are enrolled in a qualifying insurance plan listed below:

If you are eligible for the Medicare Part D Low-Income Subsidy (LIS), you may be eligible for the Nursing Services Organization. Your eligibility will depend on whether you are enrolled in a qualifying insurance plan listed below:

  • A plan that is not a high deductible health plan (HDHP) or single plan.
  • A Kaiser Permanente HDHP, which is called the Kaiser Single Plan. Also, if you have an HDHP and buy an additional Kaiser Catastrophic Plan from Covered California or another Marketplace, you cannot get NSO benefits until January 2020 because of regulations regarding LIS eligibility requirements.

Enrolled in a Blue Cross Medical Plan – No payroll deduction required.

  • Enrolled in a Blue Cross Medical Plan – No payroll deduction required.
  • Please call our toll-free number to enroll at 1-800-234-1234 (option 1).
  • The following benefits are available:
  • Emergency Room Visits
  • Ambulance Service
  • Prescription drugs, supplies and appliances available through pharmacies or mail order pharmacies or home delivery pharmacy services (where available). Certain restrictions apply to the use of this benefit for the purchase of certain prescription medications. Consult your plan documents for details.

Enrolled in the Kaiser employee or dependent PPO plan(s). – Payroll deduction required.

  • Payroll deduction required
  • Enrollment is automatic if you’re enrolled in a Kaiser Permanente plan (PPO). Payroll deduction amounts vary based on your coverage. You can also enroll by calling 1-877-857-7400 (TTY users call 711). For more information, see “How to enroll” below.
  • Changes: To change your payroll deductions, you’ll need to call 1-877-857-7400 (TTY users call 711) or contact your human resources department at the office of your employer.
  • Cancel: If you don’t want to have insurance coverage through Kaiser Permanente for any reason, you can cancel it at any time by calling 1-877-857-7400 (TTY users call 711), visiting any hospital or medical group facility and asking for a return of premium refund form or completing the online cancellation request form located here: https://secure3.kp.org/AdobeFormCentral/Forms/FormViewer?formID=4073945&act=viewform
  • *Note that if we receive notice from an employer stating that they will no longer cover their employees’ health care expenses with us, they must complete the following steps before coverage stops:* Complete a Return of Premium Refund Request Form.* Send original form along with original dated letter stating how long they intend to be covered by another provider; provide proof of enrollment into new coverage; send copies of medical bills already submitted.* Mail completed forms along with copies of cancelled checks showing payments made directly to their new providers.* Fax completed forms and other documents listed above directly from employer’s office back through our fax line at 510 558 0486

Enrolled in the Kaiser employee or dependent HMO plan(s). – No payroll deduction required.

If you are enrolled in the Kaiser employee or dependent HMO plan(s), you must enroll in a supplemental medical plan (Kaiser PPO or Non-Medicare Dental PPO). If you have not done so, please contact your local HR office for assistance.

Employees who elect the Kaiser HDHP, Kaiser Single Plan, or Kaiser Catastrophic Plan are not eligible for NSO coverage unless they are enrolled in a supplemental medical plan (Kaiser PPO or Non-Medicare Dental PPO).

If you are an employee who elects the Kaiser HDHP, Kaiser Single Plan, or Kaiser Catastrophic Plan, you are not eligible for NSO coverage. If you are enrolled in a supplemental medical plan (Kaiser PPO or Non-Medicare Dental PPO), however, your dependents will be eligible for NSO coverage regardless of which plan type you select.

In addition to these limitations on eligibility based on plan types, there is also an annual dollar limit per dependent: $3,000 per year ($1,500 per child) under age 19; $2,000 per year ($1,000 per child) ages 20–23; and $638 per month ($432 every other month) if age 24+ and living with parents who have elected Kaiser Health Maintenance Organization (HMO).

For information about how to enroll, visit the Enrollment page.

If you would like to learn more about how to enroll, visit the Enrollment page.

To enroll yourself in this benefit, visit the Enrollment page.

Enroll yourself in this benefit.

  • Enroll yourself in this benefit.
  • Get more information about this benefit.
  • Get help with enrollment in this benefit.

The Nursing Services Organization is a great benefit for Kaiser employees and their dependents. It provides supplemental coverage to eligible employees and their dependents. This is a self-funded program that provides supplemental coverage to eligible employees and their dependents. Eligibility for this program is based on your enrollment in one of the qualifying insurance plans listed above. If you are eligible, please enroll in this program as soon as possible so that we can begin processing claims for you!