Large Group Plan Documents

These EOCs are plan samples that may assist you in making an informed decision on the right type of plan. EOCs that are issued as part of your group’s contract with Kaiser Permanente will differ from these samples. For example, these EOCs do not include customer-specific coverage, cost share, and eligibility information, and the sample EOCs may be updated at any time for accuracy, to comply with laws and regulations, or to reflect changes in how coverage is administered.

Deductible HMO
Health Savings Qualified
Traditional HMO

PPO with HSA Option
PPO - Grandfathered
PPO - Grandfathered+
PPO
3-Tier POS Added Choice with HSA Option
3-Tier POS Added Choice - Grandfathered
3-Tier POS Added Choice
3-Tier POS Added Choice - Grandfathered+
3-Tier POS Added Choice Deductible Coinsurance
Choice PPO
Choice PPO with HSA Option

Questions?

Have questions about the sample plan documents? Please visit Large Business Plans or call 1-877-305-7933 (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.

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Evidence of coverage: Individual & Family | Small Business | Large Business

Benefits

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Cost estimates

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Appointments & Care

Appointments

Care options

Doctors & locations

Care while traveling

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Records

Frequently used records

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Managing your records

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Pharmacy

Refilling medications

Managing medications

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Large Group Plan Documents

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