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- KP GA 0/0/AI
- KP GA BRONZE 6500/40%/HSA
- KP GA BRONZE SIGNATURE VIRTUAL COMPLETE 5500 DED/1500 RX DED
- KP GA BRONZE VIRTUAL COMPLETE 5500 DED/1500 RX DED
- KP GA CATASTROPHIC 9200
- KP GA GOLD 1000 DED/500 RX DED
- KP GA GOLD 2000 DED/500 RX DED
- KP GA GOLD 500 DED/500 RX DED
- KP GA SIGNATURE 0/0/AI
- KP GA SIGNATURE BRONZE 6500/40%/HSA
- KP GA SIGNATURE CATASTROPHIC 9200
- KP GA SIGNATURE GOLD 1000 DED/500 RX DED
- KP GA SIGNATURE GOLD 2000 DED/500 RX DED
- KP GA SIGNATURE GOLD 500 DED/500 RX DED
- KP GA SIGNATURE SILVER 0/94% CSR
- KP GA SIGNATURE SILVER 150/5/94% CSR
- KP GA SIGNATURE SILVER 3300 DED/500 RX DED/73% CSR
- KP GA SIGNATURE SILVER 3400 DED/500 RX DED
- KP GA SIGNATURE SILVER 3500/35 73% CSR
- KP GA SIGNATURE SILVER 750/87% CSR
- KP GA SIGNATURE SILVER 850/15/87% CSR
- KP GA SIGNATURE SILVER VIRTUAL COMPLETE 3000/73% CSR
- KP GA SIGNATURE SILVER VIRTUAL COMPLETE 500/87% CSR
- KP GA SIGNATURE SILVER VIRTUAL COMPLETE 5000
- KP GA SIGNATURE STANDARD BRONZE 7500/50
- KP GA SIGNATURE STANDARD GOLD 1500/30
- KP GA SIGNATURE STANDARD SILVER 0/0/94% CSR
- KP GA SIGNATURE STANDARD SILVER 5000/40
- KP GA SIGNATURE STANDARD SILVER 3000/40/73% CSR
- KP GA SIGNATURE STANDARD SILVER 500/20/87% CSR
- KP GA SIGNAUTRE SILVER 4500/35
- KP GA SILVER 0/94% CSR
- KP GA SILVER 150/5/94% CSR
- KP GA SILVER 3300 DED/500 RX Ded/73% CSR
- KP GA SILVER 3400 DED/500 RX DED
- KP GA SILVER 3500/35 73% CSR
- KP GA SILVER 4500/35
- KP GA SILVER 750/87% CSR
- KP GA SILVER 850/15/87% CSR
- KP GA SILVER VIRTUAL COMPLETE 0/94% CSR
- KP GA SILVER VIRTUAL COMPLETE 3000/73% CSR
- KP GA SILVER VIRTUAL COMPLETE 500/87% CSR
- KP GA SILVER VIRTUAL COMPLETE 5000
- KP GA STANDARD BRONZE 7500/50
- KP GA STANDARD GOLD 1500/30
- KP GA STANDARD SILVER 0/0/94% CSR
- KP GA STANDARD SILVER 5000/40
- KP GA STANDARD SILVER 3000/40/73% CSR
- KP GA STANDARD SILVER 500/20/87% CSR
- KP GA SIGNATURE SILVER VIRTUAL COMPLETE 0/94% CSR ON
Individual & family plan documents
These are plan samples that may assist you in making an informed decision on the right plan. The actual plan you choose may vary from these samples and may contain new state regulations still in process.
- KP GA BRONZE 6500/40%/HSA
- KP GA BRONZE VIRTUAL COMPLETE 5500 DED/1500 RX DED
- KP GA CATASTROPHIC 9200
- KP GA GOLD 1000 DED/500 RX DED
- KP GA GOLD 2000 DED/500 RX DED
- KP GA GOLD 500 DED/500 RX DED
- KP GA SIGNATURE BRONZE 6500/40%/HSA
- KP GA SIGNATURE BRONZE VIRTUAL COMPLETE 5500 DED/1500 RX DED
- KP GA SIGNATURE CATASTROPHIC 9450
- KP GA SIGNATURE GOLD 1000 DED/500 RX DED
- KP GA SIGNATURE GOLD 2000 DED/500 RX DED
- KP GA SIGNATURE GOLD 500 DED/500 RX DED
- KP GA SIGNATURE SILVER 3400 DED/500 RX DED
- KP GA SIGNATURE SILVER 4500/35
- KP GA SIGNATURE SILVER VIRTUAL COMPLETE 5500
- KP GA SIGNATURE STANDARD BRONZE 7500/50
- KP GA SIGNATURE STANDARD GOLD 1500/30
- KP GA SIGNATURE STANDARD SILVER 5000/40
- KP GA SILVER 3400 DED/500 RX DED
- KP GA SILVER VIRTUAL COMPLETE 5000
- KP GA SILVER VIRTUAL COMPLETE 5500
- KP GA STANDARD BRONZE 7500/50
- KP GA STANDARD GOLD 1500/30
- KP GA STANDARD SILVER 5000/40 OFF
- KP GA SILVER 4500/35 OFF
Archive
Review plan listings of previous evidence of coverage documents.
Questions?
Have questions about the sample plan documents? Visit buykp.org
or call us at 1-888-865-5813
(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.