Individual & Family Plan Documents

Review plan listings of previous evidence of coverage documents.

Base plans

EPO Dental Rider

EPO Ortho Dental Rider

PPO Basic Dental Rider

PPO High Dental Rider

PPO Basic Ortho Dental Rider

PPO High Ortho Dental Rider

Base plan

Copay Dental Rider
C-POS Basic Dental Rider
C-POS High Dental Rider
Copay Ortho Dental Rider
C-POS Basic Ortho Dental Rider
C-POS High Ortho Dental Rider

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.

More resources

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