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- KP CO Bronze 6500/35%/HSA
- KP CO Bronze 6500/50
- KP CO Bronze 7500/60 RX Copay
- KP CO Bronze 8500/50
- KP CO Catastrophic
- KP CO Gold 0/25 RX Copay
- KP CO Gold 1500/20
- KP CO Gold 2000/20
- KP CO Silver 2200/25 X
- KP CO Silver 3700/20%/HSA X
- KP CO Silver 4000/25 X
- KP CO Silver 4500/30 RX Copay X
- KP CO Silver 5500/25 X
- KP Colorado Option Bronze
- KP Colorado Option Gold
- KP Colorado Option Silver X
- KP Select CO Bronze 6500/35%/HSA
- KP Select CO Bronze 6500/50
- KP Select CO Bronze 7500/60 RX Copay
- KP Select CO Bronze 8500/50
- KP Select CO Catastrophic
- KP Select CO Gold 0/25 RX Copay
- KP Select CO Gold 1500/20
- KP Select CO Gold 2000/20
- KP Select CO Silver 2200/25 X
- KP Select CO Silver 3700/20%/HSA X
- KP Select CO Silver 4000/25 X
- KP Select CO Silver 4500/30 RX Copay X
- KP Select CO Silver 5500/25 X
Individual & Family Plan Documents
These are sample evidence of coverage (EOC) plan documents that may assist you in making an informed decision on which plan to choose. After enrollment, you will receive the most current version that should be used to determine terms of coverage for your plan.
- KP CO American Indian/Alaskan Native 100%
- KP CO American Indian/Alaskan Native LTD
- KP CO Bronze 6500/35%/ - AIAN
- KP CO Bronze 6500/35%/ - LTD
- KP CO Bronze 6500/35%/HSA
- KP CO Bronze 6500/50
- KP CO Bronze 6500/50 - AIAN
- KP CO Bronze 6500/50 - LTD
- KP CO Bronze 7500/60 RX Copay - AIAN
- KP CO Bronze 7500/60 RX Copay
- KP CO Bronze 7500/60 RX Copay - LTD
- KP CO Bronze 8500/50
- KP CO Bronze 8500/50 - AIAN
- KP CO Bronze 8500/50 - LTD
- KP CO Catastrophic
- KP CO Gold 0/25 RX Copay
- KP CO Gold 0/25 RX Copay - AIAN
- KP CO Gold 0/25 RX Copay - LTD
- KP CO Gold 1500/20
- KP CO Gold 1500/20 - AIAN
- KP CO Gold 1500/20 - LTD
- KP CO Gold 2000/20
- KP CO Gold 2000/20 - AIAN
- KP CO Gold 2000/20- LTD
- KP CO Silver 1000/20/87% CSR
- KP CO Silver 200/5%/94% CSR
- KP CO Silver 2200/25
- KP CO Silver 2200/25 - AIAN
- KP CO Silver 2200/25 - LTD
- KP CO Silver 2200/25/73% CSR
- KP CO Silver 275/25/87% CSR
- KP CO Silver 2900/20%/73% CSR
- KP CO Silver 3000/20/73% CSR
- KP CO Silver 3700/20%/ - AIAN
- KP CO Silver 3700/20%/ - LTD
- KP CO Silver 3700/20%/HSA
- KP CO Silver 4000/25
- KP CO Silver 4000/25 - AIAN
- KP CO Silver 4000/30 RX Copay 73% CSR
- KP CO Silver 4500/30 RX Copay
- KP CO Silver 4500/30 RX Copay - AIAN
- KP CO Silver 4500/30 RX Copay - LTD
- KP CO Silver 50/5 RX Copay 94% CSR
- KP CO Silver 50/5/94% CSR
- KP CO Silver 500/20 RX Copay 87% CSR
- KP CO Silver 5000/25 - LTD
- KP CO Silver 75/10/94% CSR
- KP CO Silver 850/10%/87% CSR
- KP Colorado Option Silver - AI/0
- KP Colorado Option Silver - AI/LTD
- KP Colorado Option Bronze
- KP Colorado Option Bronze - AI/0
- KP Colorado Option Bronze - AI/LTD
- KP Colorado Option Gold
- KP Colorado Option Gold - AI/0
- KP Colorado Option Gold - AI/LTD
- KP Colorado Option Silver
- KP Colorado Option Silver 73% AV
- KP Colorado Option Silver 87% AV
- KP Colorado Option Silver 94% AV
- KP Select CO American Indian/Alaskan Native 100%
- KP Select CO American Indian/Alaskan Native LTD
- KP Select CO Bronze 6500/35%/ - LTD
- KP Select CO Bronze 6500/35%/ - AIAN
- KP Select CO Bronze 6500/35%/HSA
- KP Select CO Bronze 6500/50
- KP Select CO Bronze 6500/50 - AIAN
- KP Select CO Bronze 6500/50 - LTD
- KP Select CO Bronze 7500/60 RX Copay - AIAN
- KP Select CO Bronze 7500/60 RX Copay
- KP Select CO Bronze 7500/60 RX Copay- LTD
- KP Select CO Bronze 8500/50
- KP Select CO Bronze 8500/50 - LTD
- KP Select CO Bronze 8500/50 - AIAN
- KP Select CO Catastrophic
- KP Select CO Gold 0/25 RX Copay
- KP Select CO Gold 0/25 RX Copay - AIAN
- KP Select CO Gold 0/25 RX Copay - LTD
- KP Select CO Gold 1500/20
- KP Select CO Gold 1500/20 - AIAN
- KP Select CO Gold 1500/20 - LTD
- KP Select CO Gold 2000/20
- KP Select CO Gold 2000/20 - LTD
- KP Select CO Gold 2000/20- AIAN
- KP Select CO Silver 1000/20/87% CSR
- KP Select CO Silver 200/5%/94% CSR
- KP Select CO Silver 2200/25
- KP Select CO Silver 2200/25 - AIAN
- KP Select CO Silver 2200/25 - LTD
- KP Select CO Silver 2200/25/73% CSR
- KP Select CO Silver 275/25/87% CSR
- KP Select CO Silver 2900/20%/73% CSR
- KP Select CO Silver 3000/20/73% CSR
- KP Select CO Silver 3700/20%/ - AIAN
- KP Select CO Silver 3700/20%/ - LTD
- KP Select CO Silver 3700/20%/HSA
- KP Select CO Silver 4000/25
- KP Select CO Silver 4000/25 - AIAN
- KP Select CO Silver 4000/30 RX Copay 73% CSR
- KP Select CO Silver 4500/30 RX Copay
- KP Select CO Silver 4500/30 RX Copay - AIAN
- KP Select CO Silver 4500/30 RX Copay - LTD
- KP Select CO Silver 50/5 RX Copay 94% CSR
- KP Select CO Silver 50/5/94% CSR
- KP Select CO Silver 500/20 RX Copay 87% CSR
- KP Select CO Silver 5000/25 - LTD
- KP Select CO Silver 75/10/94% CSR
- KP Select CO Silver 850/10%/87% CSR
If your plan is not listed above, please access these additional EOCs
.
Archive
Review plan listings of previous evidence of coverage documents.
Questions?
Have questions about the sample plan documents? Visit buykp.org or call 1-800-488-3590 (TTY 711).
Kaiser Permanente Member
The sample documents may vary from your actual benefits. To view a copy of your specific plan documents, please log into www.kp.org or contact Member Services.