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- KP HI Bronze 6000/65 Plus CAM AI/AN 100%
- KP HI Bronze 6000/65 Plus CAM AI/AN LTD
- KP HI Bronze 6000/65 Plus CAM
- KP HI Gold 0/40 Plus CAM AI/AN 100%
- KP HI Gold 0/40 Plus CAM AI/AN LTD
- KP HI Gold 0/40 Plus CAM
- KP HI Gold - AI/0
- KP HI Gold 1000 Ded/250 Rx Ded AI/AN LTD
- KP HI Gold 1000 Ded/250 Rx Ded
- KP HI Platinum 0/5 Plus CAM AI/AN 100%
- KP HI Platinum 0/5 Plus CAM AI/AN LTD
- KP HI Platinum 0/5 Plus CAM
- KP HI Silver 0/5 CSR94 Plus CAM
- KP HI Silver 25/5 CSR94
- KP HI Silver 200 Ded/100 Rx Ded CSR87 Plus CAM
- KP HI Silver 2850 Ded/600 Rx Ded CSR73 Plus CAM
- KP HI Silver 2000 Ded/300 Rx Ded CSR73
- KP HI Silver - Plus CAM AI/0
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM AI/AN LTD
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM
- KP HI Silver - AI/0
- KP HI Silver 4000 Ded/600 Rx Ded AI/AN LTD
- KP HI Silver 4000 Ded/600 Rx Ded
- KP HI Silver 750/20 CSR87
- KP HI Standard Bronze 7500/50 AI/AN 100%
- KP HI Standard Bronze 7500/50 AI/AN LTD
- KP HI Standard Bronze 7500/50
- KP HI Standard Gold 1500/30 AI/AN 100%
- KP HI Standard Gold 1500/30 AI/AN LTD
- KP HI Standard Gold 1500/30
- KP HI Standard Platinum 0/10 AI/AN 100%
- KP HI Standard Platinum 0/10 AI/AN LTD
- KP HI Standard Platinum 0/10
- KP HI Standard Silver 0/0 CSR94
- KP HI Standard Silver 3000/40 CSR73
- KP HI Standard Silver 5000/40 AI/AN 100%
- KP HI Standard Silver 5000/40 AI/AN LTD
- KP HI Standard Silver 5000/40
- KP HI Standard Silver 500/20 CSR87
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 HI Bronze 6000/65
- KP HI Bronze 6000/65 PedDent
- KP HI Bronze 6000/65 Plus CAM
- KP HI Bronze 6000/65 Plus CAM PedDent
- KP HI Gold 0/40
- KP HI Gold 0/40 PedDent
- KP HI Gold 0/40 Plus CAM
- KP HI Gold 0/40 Plus CAM PedDent
- KP HI Gold 1000 Ded/250 Rx Ded
- KP HI Gold 1000 Ded/250 Rx Ded PedDent
- KP HI Platinum 0/5
- KP HI Platinum 0/5 PedDent
- KP HI Platinum 0/5 Plus CAM
- KP HI Platinum 0/5 Plus CAM PedDent
- KP HI Silver 3000 Ded/600 Rx Ded
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM
- KP HI Silver 3000 Ded/600 Rx Ded PedDent
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM PedDent
- KP HI Silver 4000 Ded/600 Rx Ded
- KP HI Silver 4000 Ded/600 Rx Ded PedDent
- KP HI Standard Bronze 7500/50
- KP HI Standard Bronze 7500/50 PedDent
- KP HI Standard Gold 1500/30
- KP HI Standard Gold 1500/30 PedDent
- KP HI Standard Platinum 0/10
- KP HI Standard Platinum 0/10 PedDent
- KP HI Standard Silver 5000/40
- KP HI Standard Silver 5000/40 PedDent
Archive
Review plan listings of previous evidence of coverage documents.
Questions?
Have questions about the sample plan documents? Visit buykp.org
or call 808-432-5955
(Oahu) and 1-800-966-5955
(Neighbor Islands) (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.