1. Kaiser Permanente Health Reimbursement Account For Eligible Kaiser Permanente Employees Northern California Region November 2009

2. Overview  Effective January 1, 2010  Health Reimbursement Account (HRA)  Offered to eligible employees represented by Labor Management Partnership (LMP) Unions  Tax-free reimbursement for:  out-of-pocket eligible medical, dental, and vision care expenses.  HRA account funded with 80% of value of unused sick leave as of termination date  An account will be opened automatically when eligible  No action required  Retiree medical eligibility, medical plan and benefit levels are not affected by the HRA

3. Regions Affected  Colorado  Georgia  Mid-Atlantic States  Northern California  Northwest  Ohio  Southern California

4. Eligible Groups - NCal  Engineers and Scientists of California, Local 20, IFPTE, Clinical Laboratory Scientists  Engineers and Scientists of California, Local 20, IFPTE, Optometrists  Office and Professional Employees International Union, Local 29, AFL-CIO  United Healthcare Workers—West  United Healthcare Workers-West, Dietitians  United Healthcare Workers—West, Integrated Behavioral Health Services

5. Eligible Groups – NCal (Cont’d)  United Healthcare Workers—West, Health Educators  United Healthcare Workers-West, Post Acute Care Center  United Healthcare Workers—West, Medical Social Workers  United Healthcare Workers—West, Optical Workers  The Guild for Professional Pharmacists

6. What is the HRA?  What is a Health Reimbursement Account?  The HRA, also referred to as a Health Reimbursement Arrangement, allows retirees and their eligible dependents to pay for out-of- pocket qualified medical, dental, vision, and hearing care expenses, as well as premiums paid to a Kaiser Permanente medical plan, on a tax-free basis.

7. Eligibility  Eligibility requirements at termination of employment:  At least age 55  15 or more years of Service  as defined under the KP-sponsored defined benefit plan, or the pension plan under the union trust, as applicable  HRA eligibility is independent of retirement eligibility  Age and years of Service requirement waived for Disability Retirement

8. Eligibility (cont’d)  Eligibility requirements at termination of employment (cont’d):  eligible for KP medical coverage on last day of employment  enrollment in plan not required  must be in an employee group that participates in the HRA  ACP may participate

9. Eligible Dependents  Legal spouse  Unless divorced or legally separated  Must be of the opposite sex to whom legally married under federal law  Domestic partner  If they qualify as a dependent on employee’s federal income taxes  May not use HRA account to pay expenses for the child of domestic partner if domestic partner claims the child as a dependent on his or her tax return  Your unmarried dependent children under age 25  If divorced, children will be considered eligible under the plan if employee is responsible for children’s support and have custody of children for more than half of the calendar year, per the IRC

10. Eligible Expenses  IRS determines which expenses are eligible (qualified) for reimbursement  May not also claim the expense through your health care plan, insurance program, or income taxes  Consult a tax advisor for tax implications

11. Eligible Expenses*  Acupuncture  Chiropractic care  Dental implants, supplies  Dental insurance premiums and copayments  Hearing exams and treatment  Long-term care insurance premiums *Sample list only, not a complete list

12. Eligible Expenses (cont’d)  Medical insurance premiums paid for a Kaiser Permanente medical plan only*  Medical copayments  Medicare premiums  Premiums paid under COBRA (medical, dental)  Substance Abuse Treatment  Vaccinations  Wheelchair * Unless you live in an area where KP medical is not offered

13. Ineligible Expenses*  Baldness treatments or hair transplants  Dancing lessons  Exercise equipment  Herbal and holistic drugs or remedies  Special diet foods  Swimming lessons  Vacation expenses (even if recommended by a doctor)  *Sample list only; not a complete list

14. How the HRA is established  On termination or retirement:  HRA-convertible sick leave hours converted at 80% of value  Kaiser Permanente deposits into HRA  No employee contributions allowed  $100 minimum required to establish account  No cost for this new benefit  Automatic participation, if eligible  No opt-out option

15. Enhanced Sick Leave Program  Banked Sick Leave (BSL)  Unused hours accrued in 2006 and thereafter converted at 80% of value  Deposited into HRA  No Credited Service for post-2005 BSL hours

16. Sick Leave Program (with Annual Refresh)  On an annual basis, up to 15 days of unused sick leave set aside on your behalf  Hours converted at 80% of value and deposited into your HRA  No Credited Service for HRA-convertible sick leave hours

17. Extended Sick Leave (ESL)  Extended Sick Leave (ESL)  Effective first pay period of 2010, two ESL banks  A current ESL bank  A pre-2010 ESL bank  ESL hours beginning first pay period 2010 go into current ESL bank  Unused ESL hours last pay period 2009 used to establish pre-2010 ESL bank  Accrued, unused ESL in current ESL account converted at 80% of value and deposited into HRA  No Credited Service for unused post-2009 ESL hours

18. When Your Account Opens  Welcome Kit from the HRSC  Notification of Enrollment Letter from Ceridian  Kaiser Permanente’s contribution to your HRA  Quarterly Statements

19. How to File for Reimbursement  Submit claims through Ceridian  Fax: 1-866-717-3820  Mail : Ceridian FSA Services P.O. Box 534200 St. Petersburg, FL 33747-4200  Reimbursement via check or direct deposit  Check on the status of your claim or payment at  www.ceridian-benefits.com Submitting claims is easy

20. Claims Guidelines  Claims processed weekly  No limit on number of claims  No minimum/maximum dollar amount  Submit claims within 60 days  Unused funds carry over from year to year

21. Account Closes  HRA Account closes if:  Account balance is $0  Account is abandoned  Death, with no surviving eligible dependents  Upon the death of surviving eligible dependents  If during the termination or retirement process, you are deemed ineligible for the HRA

22. Account Suspended  Account suspended  If you are rehired and return to work at Kaiser Permanente in any capacity  Account Reactivated  When you terminate again  No minimum balance required

23. Customer Service  Ceridian Customer Service  1-866-370-2534 or  Online at www.ceridian-benefits.com  Social Security number (with dashes)  Initial password/PIN  (last 4 numbers of your SSN reversed)

24. Contact Information  For HRA detailed questions, covered expenses and claims:  Ceridian  Monday-Friday, 5 a.m.-5 p.m. Pacific Time  1-866-370-2534  www.ceridian-benefits.com  For HRA general questions:  My HR Web site  http://insidekp.kp.org/myhr  Human Resources Service Center (HRSC)  1-877-4KP-HRSC (1-877-457-4772)

25. HRA Communications Timeline  Late November 2009  Customized communications sent to all impacted employees  Cover letter from region  Brochure containing  Summary of Material Modification (SMM)  Frequently Asked Questions (FAQ)  Claims process  January 1, 2010 - HRA becomes effective

26. Thank you!