Small Business Plan Documents

These are sample evidence of coverage (EOC) plan documents that may assist you in making an informed decision on which plan to choose. After enrollment, you will receive the most current version that should be used to determine terms of coverage for your plan.

Off Exchange

Select Traditional HMO Plan
Select Deductible HMO Plan
Select Deductible Health Savings Account (HSA) Qualified Plan
Select Point of Service (POS) Plan
Signature Traditional HMO Plan
Signature HMO Plus Plan
Signature Deductible HMO Plan
Signature Deductible HMO Plus Plan
Signature Deductible HMO Virtual Complete Plan
Signature Deductible HMO Virtual Forward Plan
Signature Point of Service (POS) Plan
Signature Three-Tier Point of Service (3TPOS) Plan
Signature Deductible Health Savings Account (HSA) Qualified Plan

On Exchange

Signature Traditional HMO Plan
Signature Deductible HMO Plan
Deductible Health Savings Account (HSA) Qualified Plan
Signature Deductible HMO Virtual Complete Plan
Signature Deductible HMO Virtual Forward Plan

Flex Choice Gold
Flex Choice Gold HDHP/HSA

Off Exchange

Select Traditional HMO Plan
Select Deductible HMO Plan
Select Deductible Health Savings Account (HSA) Qualified Plan
Select Point of Service (POS) Plan
Signature Traditional HMO Plan
Signature HMO Plus Plan
Signature Deductible HMO Plan
Signature Deductible HMO Plus Plan
Signature Deductible Health Savings Account (HSA) Qualified Plan
Signature Deductible HMO Virtual Complete Plan
Signature Deductible HMO Virtual Forward Plan
Signature Point of Service (POS) Plan
Signature Three-Tier Point of Service (3TPOS) Plan

On Exchange

Signature Traditional HMO Plan
Signature Deductible HMO Plan
Signature Deductible Health Savings Account (HSA) Qualified Plan
Signature Deductible HMO Virtual Complete Plan
Signature Deductible HMO Virtual Forward Plan

Select Traditional HMO Plan
Select Deductible HMO Plan
Select Health Savings Account (HSA) Qualified Plan
Signature Traditional HMO Plan
Signature HMO Plus Plan
Signature Deductible HMO Plan
Signature Deductible HMO Plus Plan
Signature Health Savings Account (HSA) Qualified Plan
Signature Point Of Service (POS) Plan
Signature Deductible HMO Virtual Complete Plan
Signature Deductible HMO Virtual Forward Plan
Signature Standard Platinum HMO Plan
Signature Standard Gold/Silver/Bronze Deductible HMO Plan
Signature HMO Dental Plan with Adult Dental
Signature Deductible HMO Dental Plan with Adult Dental

Questions?

Have questions about the sample plan documents? Please visit Small 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

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Small Business Plan Documents

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