Medical Benefits
If you need assistance, have questions, or would like to learn how to best utilize your medical benefits, call your dedicated Kempton Care Advocates (KCAs).
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Your KCAs can assist you with things like:
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KPPFree™ services and Cash Price Agreements
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KPPFree™ travel accommodations
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Medical benefits with zero out-of-pocket
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Medical benefit and coverage questions
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Finding a medical provider
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How to save money by using your best benefit
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Claims and out-of-pocket questions Connecting to Zelis for pre-service or post-service advocacy
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Questions about our website, portal, or mobile apps
Spooner Medical Plan effective January 1st, 2025
Employee Contributions
Important Notes:
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*14-Day Pre-Approval is required on all non-urgent, non-emergent services and procedures. Contact Kempton Group at 800-324-9396 for Pre-Approval. Banner facilities are excluded from the Plan.
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**If you select a brand name drug when a generic drug is available, you pay the copay PLUS the difference in cost between the generic and the brand name drug. There are specific Name Brand prescriptions that have a generic therapeutic alternative. Refer to the Therapeutic Alternative Drug list. If you do not choose one of these Generic Therapeutic Alternatives, the copay will be 50% of the brand therapeutic alternative drug cost.
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***Employees and spouses/domestic partners (as applicable) who attend one of the quarterly educational seminars will receive a monthly premium reduction.
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The premium reduction of 25% starts the first of the month following the seminar through the end of the calendar year. Covered spouses/domestic partners must attend in order to receive the premium reduction.
Contact Human Resources for more information.
14-Day Pre-Approval
If you are planning a non-urgent, non-emergent service or procedure, you must call Kempton Group at least 14-days prior to your scheduled service date and receive pre-approval. If you do not receive pre- approval, your service or procedure will not be covered by the Plan.
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Banner Health Exclusion
Banner facilities do not accept our Plan reimbursement rates and will charge upwards of 400% more than what the Plan reimbursement is. They will not negotiate and have a history or bringing more cost to you, the member.
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What that means to you: Your Plan will not cover services performed at a Banner facility. Should you or your dependents obtain services at a Banner facility, you will be responsible for 100% of the bill. Some Banner facilities do not specify they are a Banner facility. Call the Kemper Care Advocates to confirm whether a facility is a Banner facility.
Identification Cards
Once you enroll you will receive a welcome packet from Kempton Group with your identification card. If you misplace or need a new card, call Kempton Group at 800.324.9396.
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Online Services
To help you make the most of your healthcare benefits, it pays to be involved, aware and incontrol. Kempton Group offers a secure member website: www.kemptongroup.com
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You can view claims, benefit accumulation (deductible, number of visits used, etc), and search for a provider within your area.
