Large group plan documents

Review plan listings of previous evidence of coverage documents.

MAS MD - Select Deductible HMO Plan
MAS MD - Signature Deductible HMO Plan
MAS MD - Select Deductible Health Savings Account (HSA)
MAS MD - Signature Deductible Health Savings Account (HSA)
MAS MD - Select Traditional HMO Plan
MAS MD - Signature Traditional HMO Plan
MAS MD - Select Traditional Point-of-Service Plan
MAS MD - Signature Traditional Point-of-Service Plan

POS Certificate of Insurance
PPO Certificate of Insurance

MAS - VA - Large Group Select Deductible HMO Plan
MAS - VA - Large Group Signature Deductible HMO Plan
MAS - VA - Large Group Select Deductible Health Savings Account (HSA)
MAS - VA - Large Group Signature Deductible Health Savings Account (HSA)
MAS - VA - Large Group Select Traditional HMO Plan
MAS - VA - Large Group Signature Traditional HMO Plan
MAS - VA - Large Group Select Added Choice Plan
MAS - VA - Large Group Signature Added Choice Plan

POS Certificate of Insurance
PPO Certificate of Insurance

MAS DC - Select Deductible HMO Plan
MAS DC - Select Deductible Health Savings Account (HSA)
MAS DC - Select Traditional HMO Plan
MAS DC - Select Added Choice Plan
MAS DC - Signature Deductible HMO Plan
MAS DC - Signature Deductible Health Savings Account (HSA)
MAS DC - Signature Traditional HMO Plan
MAS DC - Signature Added Choice Plan

POS Certificate of Insurance
PPO Certificate of Insurance

Kaiser Permanente's Point-of-Service Plan is underwritten by Kaiser Foundation Health Plan, Inc. (KFHP) and Kaiser Permanente Insurance Company (KPIC). The HMO tier is underwritten by KFHP and the PPO and Out-of-Network tier is underwritten by KPIC, a subsidiary of KFHP.

Kaiser Permanente's PPO Plans are underwritten by KPIC, a subsidiary of KFHP.

If your plan is not listed above, please access these additional EOCs.

Questions?

Have questions about the sample plan documents? Please call 855-249-5018 (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

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Large group plan documents

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