Healthcare Coverage

At Willamette, our comprehensive health care plans are designed to provide the highest quality care. We strive to provide our benefit eligible faculty and staff with access to evidence-based, comprehensive medical, behavioral health, vision, prescription, alternative care, dental, and orthodontic benefits that encourage healthy living.

Willamette University offers a PPO medical insurance plan through Added Choice - First Choice Health Network. Added Choice is a comprehensive PPO provider network and Kaiser Permanente is the Third Party Administrator / claims processor.  Employees who select this plan have the flexibility to receive the care they want from the provider of their choice:

Contact Information

Phone: 1-866-616-0047
Group #: 2014
Website: kp.org/addedchoice
Claims address:
PO Box 370050, Denver, CO 80237-9998

Find Your Provider:

  • In-Network, First Choice Health PPO Network
  • In-Network, First Health Network (Members in states other than OR, WA, ID, MT, WY, ND, SD, and AK) If you have any questions or need help with any of the PPO providers, you can also call them at the following numbers:
    • First Choice Health Network
      1-800-467-5281
    • First Health Network
      1-888-685-7774
  • In-Network, Kaiser Permanente
  • Out-of-Network, Non-participating providers
  • The CHP Group, Alternative Care Provider Search (Participating Plan - "Kaiser Permanente Self-Referred")

The out-of-network component of the plan provides you with the ability to see any physician of your choice, but at a greater cost.

Be sure to take your Added Choice ID card with you to your appointment. This will let your provider's office know that Added Choice uses the First Choice Health Network. It will also help with claims and prior authorization information. Before obtaining care or undergoing a procedure, be sure that you know whether your provider is in-network or out-of-network, and the corresponding level of coverage you can expect. We encourage our employees to choose in-network providers when possible. Certain procedures and/or treatments require precertification in order to be covered under the plan.

Added Choice Member Reimbursement Form for Medical, Rx, Vision Claims (PDF)

Print and fill out the above form to request reimbursement for medical, Rx, and Vision services. Reimbursement requests must be received by Kaiser within 12 months from the date of service. 

Attach an itemized statement from the provider which includes the following information:

  • Member name and identification number
  • Provider name and address
  • Date of service
  • Place of service (doctor’s office, emergency room, urgent care, etc.)
  • Physician/medical provider’s name
  • Itemized charges and proof of payment

You should be able to obtain this information from the provider. Valid proof of payment includes a charge card receipt, a canceled check, or a statement from the provider showing the services have been paid.

Mail the completed form to:

Kaiser Permanente
Attn: Claims Administration
PO Box 370050
Denver, CO 80237-9998

Claims processing can take four to six weeks. Keep a copy of all documents for your records. Please be aware, claims with missing required information may be returned without reimbursement. 

Prescription Benefits
When you enroll in the Added Choice PPO Medical Plan, you will also be provided with prescription benefits. Your prescription benefits include different pricing structures or “tiers” that enable you to control cost based on the types of medications you select. In most cases, more than one drug is available to treat the same medical condition. Generic medications include the same active ingredients as brand name medications, but cost less. Therefore, selecting a formulary generic medication over a formulary brand name medication will result in you paying a lower copay. Your prescriptions can be filled at any of these locations or at a participating MedImpact pharmacy. Specific copay amounts are listed within the “Prescription Drugs” section of the Medical Plan Summary.

There are four ways to get an Added Choice prescription filled

1)  Take it to a Kaiser Permanente Pharmacy
2)  Call it in (or use the transfer your prescription form) to Kaiser's Mail order pharmacy
3)  Take the prescription to any network pharmacy - all major chains are MedImpact pharmacies, like RiteAid, Walgreens, Safeway, Freddies, Walmart, Costco, etc...and many more.  If you are already using one of these pharmacies, you just have to show your new Added Choice card to get the billing/coverage changed to your new insurer.  
4) Use the Caremark mail-order pharmacy.  The quickest way to transfer a current prescription from a MedImpact pharmacy (like Walgreens) to Caremark mail order pharmacy is to call them with prescription in hand.  Call 1-800-237-2767.  The Caremark pharmacy technician will gather the prescription information found on the medication label, call Walgreens and have it transferred for you.   They can take payment information over the phone.   You can also use the tools found at caremark.com/micro/kpnw,  register and create an online account to order your prescriptions or print out the order form and mail it in by US mail.

Mail Order Pharmacy
You can save money and time with the pharmacy mail order prescription program. This home-delivery service allows you to purchase up to 90-day supplies of maintenance medications (medications taken on a daily or routine basis) for the cost of two copayments, or 3-for-2 savings. In addition, the mail order prescription program saves you trips to the pharmacy because prescriptions are delivered right to your door. For more details on the mail order prescription program, please see the kp mail-order pharmacy. You also have the option to use the Caremark pharmacy but there is no discounted benefit co-pay savings for a 90 day supply.

Vision Benefits
The Added Choice PPO Medical Plan also provides vision benefits. These benefits provide you with access to affordable, quality vision care coverage. You and your family may receive a complete eye examination and materials (if needed). You can choose to receive care from a participating provider through Kaiser or Added Choice (in-network) or from any doctor of your choosing (out-of-network). Dollar for dollar, you get the best value from your vision benefit when you visit a participating provider. If you decide to see an out-of-network provider, you will receive a lesser benefit and typically pay more out-of-pocket.

Acupuncture, Chiropractic, Naturopathic, and Massage Therapy
To help you achieve total health, your PPO plan also includes alternative care benefits. For your convenience, no referral is required and you are free to choose from more than 700 qualified and credentialed complementary and alternative medicine providers. Choose your alternative care provider at chpgroup.com or through Added Choice and call the provider you select to schedule an appointment at a time that works for you.

Willamette University offers a PPO dental insurance plan through LifeMap.  Employees on the LifeMap plan have the flexibility to receive the care they want from the provider of their choice.

Contact Information

LifeMap Assurance Company
Phone: 1 (800) 286-1129
Group #: OR301163-0000-01
Website: www.lifemapco.com
Claims address:
LifeMap P.O. Box 1650, Milwaukee, WI 53201-1650

Maximum Allowable Charges (MAC)
The benefit reimbursement levels are the same both in-network and out-of-network, but the maximum allowable charges are different. LifeMap network dentists have agreed not to charge more than the LifeMap schedule of Maximum Allowable Charges (MAC). Therefore, you will pay only the difference between the scheduled benefit and the MAC. Out-of-network dentists, on the other hand, may charge you for the difference between the scheduled benefit and their actual fee, which may be much higher than the MAC. You will get the most from your dental benefits and pay less out-of-pocket by visiting network providers.

Pre-Treatment Estimate
It is recommended that you receive a pretreatment estimate for any dental work that you consider expensive. Simply ask your dentist to submit the information for a pre-treatment estimate to LifeMap. LifeMap will then inform you and your dentist of the exact amount your insurance will cover and the amount you will be responsible for paying.

Willamette University offers a HMO medical insurance plan through the Kaiser Permanente. With this plan, you must receive all of your care through an integrated system of Kaiser participating physicians, hospitals and other healthcare providers.

Contact Information

Phone: 503-813-2000 (local), 800-813-2000 (out of area)
Group #: 02014
Website: www.kaiserpermanente.org

Each family member on your plan can choose his or her own primary care physician (PCP) to manage your health care, including referrals to specialists. You may self-refer to another Kaiser physician for routine and preventive care, well baby visits or OB/Gyn care. If you’d like a second opinion, you can ask to see another Kaiser physician. You may change your Kaiser physician at any time for any reason. Kaiser offers 5 hospitals and 44 medical offices and other outpatient facilities in the Northwest region to choose from. Some centers serve as after-hours care centers, where participants with urgent medical problems may be seen when regular medical centers are closed. To participate in this plan you must live in one of the zip code service areas served by this HMO. Most services are covered at 100% after you pay your required copayment which will help you to have clear upfront costs. Please refer to your Kaiser Evidence of Coverage for a detailed list of this plan's services, exclusions and limitations.

Prescription Benefits
When you enroll in the Kaiser HMO, you automatically receive prescription drug coverage. To save money, request that your doctor write your prescriptions for “generic” drugs whenever possible. Generic drugs are often the therapeutic equivalent of their brand-name counterparts, but cost significantly less. Also, women's generic prescription contraceptives are covered with a $0 co-pay to comply with requirements of the Affordable Care Act. Kaiser covers prescription drugs with a $20/$40/$60 copayment for prescriptions purchased at a Kaiser center and a $40/$80/$120 copayment for prescriptions purchased through mail order pharmacy for a 90-day supply.

Vision Benefits
Vision and eye health are key components of overall health and quality of life. We support your efforts to maintain good vision health. Your vision care is covered under your medical plan and will pay for one eye examination every 12 months and your plan provides an allowance for eyeglass lenses and frames, or contact lenses.

Acupuncture, Chiropractic, Naturopathic, and Massage Therapy
To help you achieve total health, your plan also includes alternative care benefits. For your convenience, no referral is required and you are free to choose from more than 700 qualified and credentialed complementary and alternative medicine providers. Choose your alternative care provider at chpgroup.com and call the provider you select to schedule an appointment at a time that works for you.

Online Resources for Kaiser Members
Learn how to see your lab results, access your medical records, make and review future doctor's appointments, check immunizations and contact your physician - online! Through Kaiser's My Health Manager program Kaiser members have access to a host of online resources at no extra cost.  Click here to find out more.

The Kaiser Permanente Dental HMO plan is a copay-based network-only offering that requires selection of a primary care dentist. Each family member on your plan can choose his or her own dentist. Because services are prepaid, you have clear upfront costs.

Contact Information

Phone: 503-813-2000 (local), 800-813-2000 (out of area)
Group #: 02014
Website: www.kaiserpermanente.org

Kaiser offers 17 dental offices in the Northwest region to choose from and you must reside in the Kaiser Permanente service area to enroll in Kaiser Permanente dental coverage. This plan brings together a team of experienced dental professionals committed to providing you with high-level, preventive dental care and treatment planning based on the latest dental research. They believe in establishing a dentist-patient relationship as essential to providing consistent, high-quality care.

If you have an immediate need, Kaiser dental insurance offers several advantages. Among them: there are no waiting periods on any procedure and the costs are low relative to other types of plans in your area. Your first examination with your own personal dentist will include the following; diagnostic X-ray, gum disease test, tooth decay assessment, head and neck cancer screening, and blood pressure check. Your dentist will work with you to plan your treatment and identify any needed follow-up appointments, including cleanings. Any future care that you need will be under the direction of your personal dentist.

The University recognizes that not every employee is in need of coverage under the University-sponsored health plan. Eligible employees that do not need coverage and provide evidence of their other coverage can choose to receive a $100 per month University-provided contribution into a medical flexible spending account in lieu of being covered on the University health plan. As with other medical flexible spending monies, these funds can be used to pay for out-of-pocket medical expenses.