2024 Kaiser Permanente Small Group Plan Documents

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2023 Documents

2023 Documents Can Be Found HERE

Documents listed here are current as of September 2023.

2024 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
Summit PPO Bronze HSA
Summit PPO VisitsPlus Silver LX
Summit PPO VisitsPlus Gold LX
Summit PPO VisitsPlus Platinum LX

2024 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
Summit PPO Bronze HSA - Español
Summit PPO VisitsPlus Silver LX - Español
Summit PPO VisitsPlus Gold LX - Español
Summit PPO VisitsPlus Platinum LX - Español

2024 Evidence of Coverage

2024 Core Bronze HSA
2024 Core Silver HSA
2024 Core Silver
2024 Core VisitsPlus Silver LX
2024 Core VisitsPlus Silver LX-EO
2024 Core VisitsPlus Gold HD LX
2024 Core VisitsPlus Gold LX
2024 Core VisitsPlus Gold LX-EO
2024 Core VisitsPlus Platinum LX

2024 Connect Virtual Plus Silver
2024 Connect Virtual Plus Gold
2024 Access PPO Bronze HSA
2024 Access PPO Silver HSA
2024 Access PPO VisitsPlus Silver LD LX
2024 Access PPO VisitsPlus Silver LX
2024 Access PPO VisitsPlus Silver LX EO
2024 Access PPO VisitsPlus Silver HD

2024 Access PPO VisitsPlus Gold LX
2024 Access PPO VisitsPlus Gold HD LX
2024 Access PPO VisitsPlus Platinum HD LX
2024 Access PPO VisitsPlus Platinum LX
2024 Summit PPO Bronze HSA
2024 Summit PPO VisitsPlus Silver LX
2024 Summit PPO VisitsPlus Gold LX
2024 Summit PPO VisitsPlus Platinum LX

2024 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
Summit PPO Bronze HSA
Summit PPO VisitsPlus Silver LX
Summit PPO VisitsPlus Gold LX
Summit PPO VisitsPlus Platinum LX

2024 Dental Benefits Summaries

Adult Dental Plan Flyer
Adult Dental without Rates - Standard

Adult Dental without Rates - Basic
Pediatric Dental Plan Flyer

Pediatric Dental without Rates

EO = employee only
HD = High Deductible
LX = Lab and X-ray