For years, Kaiser Permanente has won accolades for delivering high-quality care at an affordable price. The Oakland company's unique HMO model kept a lid on costs, and big employers flocked to enroll their workers to the point that Kaiser has become the largest health plan in California, grabbing more than 40% of the market. Now, some of Kaiser's biggest customers are complaining that the company is no longer a bargain and, even worse, standing in the way of controlling healthcare costs. Critics say the company is so entrenched in the workplace that it refuses to negotiate rates or to fully explain why its premiums keep rising.