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Individual & Family 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.
- Gold HSA
- Bronze HSA
- Gold HSA AI/AN
- Gold HSA AI/AN (No Cost Share)
- Bronze HSA AI/AN
- Bronze HSA AI/AN (No Cost Share)
- Cascade Complete Gold
- Cascade Complete Gold AI/AN
- Cascade Complete Gold AI/AN (No Cost Share)
- Cascade Vital Gold
- Cascade Silver
- Cascade Silver 73
- Cascade Silver 87
- Cascade Silver 94
- Cascade Bronze
- Cascade Vital Gold AI/AN
- Cascade Vital Gold AI/AN (No Cost Share)
- Cascade Silver AI/AN
- Cascade Silver AI/AN (No Cost Share)
- Cascade Bronze AI/AN
- Cascade Bronze AI/AN (No Cost Share)
- VisitsPlus Gold
- VisitsPlus Silver
- VisitsPlus Silver 73
- VisitsPlus Silver 87
- VisitsPlus Silver 94
- VisitsPlus Bronze
- VisitsPlus Gold AI/AN
- VisitsPlus Gold AI/AN (No Cost Share)
- VisitsPlus Silver AI/AN
- VisitsPlus Silver AI/AN (No Cost Share)
- VisitsPlus Bronze AI/AN
- VisitsPlus Bronze AI/AN (No Cost Share)
- Basics Plus Catastrophic
Archive
Review plan listings of previous evidence of coverage documents.
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.