Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.


2101 East Jefferson Street
Rockville, MD 20852
Telephone: (301) 816-2424
Member Services: (800) 777-7902
Provider Services: (877) 806-7470

Web site: www.kaiserpermanente.org

Key Staff
President – Kim Horn
Medical Director – Bernadette Loftus, MD, Assoc. Exec. Dir., Mid-Atlantic Permanente Medical Group
Provider Relations – Kenya Onley, Director
Government Relations – Laurie Kuiper, Sr. Director; John Lupo, Sr. Manager, Community & Government Affairs

Other Contacts
General Company Information – Che Parker, Dir., Public Relations
Grievance/Appeals Procedures – Sheila Blackman, Exec. Dir., Benefit Adm & Acct. Experience Customer Engagement Unit
Quality Improvement – Kay Lewis, VP
Pharmacy Benefits – Megan Famodu, Pharmacy Benefits Mgr.

Specialized Health Care Services
Service In-House Contracted
Mental Health X
Pharmacy Benefit Mgmt.  x-MedImpact;Catamaran;OptumRx
Vision Care X
Dental Care  x-Dominion Dental; DentaQuest
Disease Mgmt. X
Utilization Mgmt. X

 

Market Segment
Market Segment HMO/POS PPO (Flex)
Individual X
Small Group (2-49 Employees) X  X
Large Group (50+ Employees) X  X
Administrative Services Only (ASO)  X

 

Network Providers Under Contract (numbers are combined HMO/PPO)
Network Providers HMO Signature HMO Select  
PCPs 110  233
Physician Specialists 199  1,845
Hospitals 3  11
OB/GYNs 39  180

 

Enrollment (as of January 31, 2014:  195,693)
Standard HMO 170,544
Point-of-Service (POS) 779
Medicare Cost 17,669

 

Virginia HMO Service Area:
Counties
Arlington, Caroline, Culpeper, Fairfax, Fauquier, Hanover, King George, Loudoun, Louisa, Orange, Prince William, Spotsylvania, Stafford, Westmoreland

Cities
Alexandria, Fairfax City, Falls Church, Fredericksburg, Manassas, Manassas Park