2023 Kaiser Permanente Small Group Plan Documents
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2022 Documents
Documents listed here are current as of November 2, 2022.
Summaries of Benefits and Coverage - English
Core Bronze HSA
Core Silver HSA
Core Silver
Core VisitsPlus Silver LX
Core VisitsPlus Silver LX - EO
Core VisitsPlus Gold HD LX
Core VisitsPlus Gold LX
Core VisitsPlus Gold LX - EO
Core VisitsPlus Platinum LX
Connect Virtual Plus Silver
Connect Virtual Plus Gold
Access PPO Bronze HSA
Access PPO Silver HSA
Access PPO VisitsPlus Silver HD
Access PPO VisitsPlus Silver LD LX
Access PPO VisitsPlus Silver LX
Access PPO VisitsPlus Silver LX - EO
Access PPO VisitsPlus Gold LX
Access PPO VisitsPlus Gold HD LX
Access PPO VisitsPlus Platinum HD LX
Access PPO VisitsPlus Platinum LX
Summaries of Benefits and Coverage - Español
Core Bronze HSA - Español
Core Silver HSA - Español
Core Silver - Español
Core VisitsPlus Silver LX - Español
Core VisitsPlus Silver LX - EO - Español
Core VisitsPlus Gold HD LX - Español
Core VisitsPlus Gold LX - Español
Core VisitsPlus Gold LX - EO - Español
Core VisitsPlus Platinum LX - Español
Connect Virtual Plus Silver - Español
Connect Virtual Plus Gold - Español
Access PPO Bronze HSA - Español
Access PPO Silver HSA - Español
Access PPO VisitsPlus Silver HD - Español
Access PPO VisitsPlus Silver LD LX - Español
Access PPO VisitsPlus Silver LX - Español
Access PPO VisitsPlus Silver LX - EO - Español
Access PPO VisitsPlus Gold LX - Español
Access PPO VisitsPlus Gold HD LX - Español
Access PPO VisitsPlus Platinum HD LX - Español
Access PPO VisitsPlus Platinum LX - Español
Evidence of Coverage
2023 Core Bronze HSA
2023 Core Silver HSA
2023 Core Silver
2023 Core VisitsPlus Silver LX
2023 Core VisitsPlus Silver LX-EO
2023 Core VisitsPlus Gold HD LX
2023 Core VisitsPlus Gold LX
2023 Core VisitsPlus Gold LX-EO
2023 Core VisitsPlus Platinum LX
2023 Connect Virtual Plus Silver
2023 Connect Virtual Plus Gold
2023 Access PPO Bronze HSA
2023 Access PPO Silver HSA
2023 Access PPO VisitsPlus Silver LD LX
2023 Access PPO VisitsPlus Silver LX
2023 Access PPO VisitsPlus Silver LX EO
2023 Access PPO VisitsPlus Silver HD
2023 Access PPO VisitsPlus Gold LX
2023 Access PPO VisitsPlus Gold HD LX
2023 Access PPO VisitsPlus Platinum HD LX
2023 Access PPO VisitsPlus Platinum LX
Medical Benefit Summaries
Core Bronze HSA
Core Silver HSA
Core Silver
Core VisitsPlus Silver LX
Core VisitsPlus Silver LX-EO
Core VisitsPlus Gold HD LX
Core VisitsPlus Gold LX
Core VisitsPlus Gold LX-EO
Core VisitsPlus Platinum LX
Connect Virtual Plus Silver
Connect Virtual Plus Gold
Access PPO Bronze HSA
Access PPO Silver HSA
Access PPO VisitsPlus Silver HD
Access PPO VisitsPlus Silver LD LX
Access PPO VisitsPlus Silver LX
Access PPO VisitsPlus Silver LX EO
Access PPO VisitsPlus Gold LX
Access PPO VisitsPlus Gold HD LX
Access PPO VisitsPlus Platinum HD LX
Access PPO VisitsPlus Platinum LX
Dental Benefits Summaries
EO = employee only
HD = High Deductible
LX = Lab and X-ray