Benefit Booklets
View and Search Current Benefit Booklets
Here you can find the details regarding your plan coverage. Please choose the plan you are interested in from the options below. After clicking on a link, use your browser's FIND menu item to search for specific words within the booklet.
Medical Summary of Benefits and Coverage (SBC)
UMR SBCs
| 1/1/2024 - Current | July 1, 2025 |
|---|---|
| [EPO3](https://www.cebt.org/files/d42bb491c/SBC+01-01-2024+00+009+EPO3.pdf) | [EPO3](https://www.cebt.org/files/b4e1b76d8/SBC+07-01-2025+00+009+EPO3+UMR+Final+PDF.pdf) |
| [EPO4](https://www.cebt.org/files/e7a38e11b/SBC+01-01-2024+00+013+EPO4.pdf) | [EPO4](https://www.cebt.org/files/317381e7f/SBC+07-01-2025+00+013+EPO4+UMR+Final+PDF.pdf) |
| [EPO5](https://www.cebt.org/files/2347d6705/SBC+01-01-2024+00+014+EPO5.pdf) | [EPO5](https://www.cebt.org/files/bd5757a23/SBC+07-01-2025+00+014+EPO5+UMR+Final+PDF.pdf) |
| [EPO6](https://www.cebt.org/files/4b3b4821b/SBC+01-01-2024+00+021+EPO6.pdf) | [EPO6](https://www.cebt.org/files/0df479ca3/SBC+07-01-2025+00+021+EPO6+UMR+Final+PDF.pdf) |
| N/A | [EPO7](https://www.cebt.org/files/e6aee2a1b/SBC+07-01-2025+00+030+EPO7+UMR+Final+PDF.pdf) |
| [EPO Select](https://www.cebt.org/files/2d1be2d01/SBC+01-01-2024+00+027+EPO+Select.pdf) | [EPO Select](https://www.cebt.org/files/6c20f3393/SBC+07-01-2025+00+027+EPO+Select+UMR+Final+PDF.pdf) |
| [PPO2](https://www.cebt.org/files/df23d0794/SBC+01-01-2024+00+005+PPO2.pdf) | [PPO2](https://www.cebt.org/files/032ad3791/SBC+07-01-2025+00+005+PPO2+UMR+Final+PDF.pdf) |
| [PPO3](https://www.cebt.org/files/47fa4dfce/SBC+01-01-2024+00+004+PPO3.pdf) | [PPO3](https://www.cebt.org/files/96707f743/SBC+07-01-2025+00+004+PPO3+UMR+Final+PDF.pdf) |
| [PPO4](https://www.cebt.org/files/89293dff0/SBC+01-01-2024+00+006+PPO4.pdf) | [PPO4](https://www.cebt.org/files/09e85284f/SBC+07-01-2025+00+006+PPO4+UMR+Final+PDF.pdf) |
| [PPO5](https://www.cebt.org/files/02f16452f/SBC+01-01-2024+00+007+PPO5.pdf) | [PPO5](https://www.cebt.org/files/8335fbfc8/SBC+07-01-2025+00+007+PPO5+UMR+Final+PDF.pdf) |
| [PPO6](https://www.cebt.org/files/f4fdbf429/SBC+01-01-2024+00+010+PPO6.pdf) | [PPO6](https://www.cebt.org/files/d95ba237b/SBC+07-01-2025+00+010+PPO6+UMR+Final+PDF.pdf) |
| [PPO7](https://www.cebt.org/files/d59e90fee/SBC+01-01-2024+00+011+PPO7.pdf) | [PPO7](https://www.cebt.org/files/d00341d02/SBC+07-01-2025+00+011+PPO7+UMR+Final+PDF.pdf) |
| [PPO8](https://www.cebt.org/files/b1283e89e/SBC+01-01-2024+00+016+PPO8.pdf) | [PPO8](https://www.cebt.org/files/fc27ed388/SBC+07-01-2025+00+016+PPO8+UMR+Final+PDF.pdf) |
| N/A | [PPO9](https://www.cebt.org/files/c2e6e6661/SBC+07-01-2025+00+028+PPO9+UMR+Final+PDF.pdf) |
| [PPO Select](https://www.cebt.org/files/28b3790e4/SBC+01-01-2024+00+022+PPO+Select.pdf) | [PPO Select 1](https://www.cebt.org/files/e3c0bbdf4/SBC+07-01-2025+00+022+PPO+Select+1+UMR+Final+PDF.pdf) |
| N/A | [PPO Select 2](https://www.cebt.org/files/b360893b1/SBC+07-01-2025+00+031+UMR+Final+V1+Updated+Select+2.pdf) |
| N/A | [PPO Select 3](https://www.cebt.org/files/066da2256/SBC+07-01-2025+00+032+PPO+Select+3+UMR+Final+PDF.pdf) |
| [HDHP2](https://www.cebt.org/files/7652033eb/SBC+01-01-2024+00+017+018+HDHP2.pdf) | [HDHP2](https://www.cebt.org/files/1448b0053/SBC+07-01-2025+00+017+018+HDHP2+UMR+Final+PDF.pdf) |
| [HDHP25](https://www.cebt.org/files/0a980524f/SBC+01-01-2024+00+024+025+HDHP2500.pdf) | [HDHP25](https://www.cebt.org/files/f879a13e7/SBC+07-01-2025+00+024+025+HDHP25+UMR+Final+PDF.pdf) |
| [HDHP2800](https://www.cebt.org/files/3e73d532f/SBC+01-01-2024+00+001+023+HDHP2800.pdf) | [HDHP2800](https://www.cebt.org/files/6fe08c3e2/SBC+07-01-2025+00+001+023+HD2800+UMR+Final+PDF.pdf) |
| [HDHP3](https://www.cebt.org/files/eece045e1/SBC+01-01-2024+00+019+026+HDHP3.pdf) | [HDHP3](https://www.cebt.org/files/2b54affb7/SBC+07-01-2025+00+019+026+HDHP3+UMR+Final+PDF.pdf) |
| [HDHP3500](https://www.cebt.org/files/640950fdb/SBC+01-01-2024+00+015+HDHP3500.pdf) | [HDHP3500](https://www.cebt.org/files/56277eacc/SBC+07-01-2025+00+015+HD3500+UMR+Final+PDF.pdf) |
| [HDHP4](https://www.cebt.org/files/fe931ca05/SBC+01-01-2024+00+020+HDHP4.pdf) | [HDHP4](https://www.cebt.org/files/e15b1838d/SBC+07-01-2025+00+020+HDHP4+UMR+Final+PDF.pdf) |
| [HDHP5](https://www.cebt.org/files/418368ecb/SBC+01-01-2024+00+012+HDHP5.pdf) | [HDHP5](https://www.cebt.org/files/434893fe0/SBC+07-01-2025+00+012+HDHP5+UMR+Final+PDF.pdf) |
| N/A | [HDHP6](https://www.cebt.org/files/82f71afe5/SBC+07-01-2025+00+029+HDHP6+UMR+Final+PDF.pdf) |
UHC Surest SBCs
| 1/1/2024 - Current | July 1, 2025 |
|---|---|
| [Surest 5](https://www.cebt.org/files/b43d80672/Surest+5_SBC_07012024.pdf) | [Surest 5](https://www.cebt.org/files/70c2f9e7c/2025_Surest_SBC_CEBT+C5000.pdf) |
| [Surest 7](https://www.cebt.org/files/9d59de4fa/Surest+7_SBC_07012024.pdf) | [Surest 7](https://www.cebt.org/files/f21cd6e7d/2025_Surest_SBC_CEBT+F7000_v2.pdf) |
| N/A | [Surest 9](https://www.cebt.org/files/ea0397c78/2025_Surest_SBC_CEBT+F9000.pdf) |
Kaiser SBCs - Current
| 1/1/2024 - Current | July 1, 2025 |
|---|---|
| [KP-HMO 5](https://www.cebt.org/files/a705668b5/2024_SBC_CEBT_KP-HMO_5.pdf) | [KP-HMO 5](https://www.cebt.org/files/26af69c0e/CEBT+HMO+5+%281%29.pdf) |
| [KP-HMO 10](https://www.cebt.org/files/a4ad49efe/2024_SBC_CEBT_KP-HMO_10.pdf) | [KP-HMO 10](https://www.cebt.org/files/be51116b7/CEBT+HMO+10+%281%29.pdf) |
| [KP-HMO 15](https://www.cebt.org/files/7f2dad3d1/2024_SBC_CEBT_KP-HMO_15.pdf) | [KP-HMO 15](https://www.cebt.org/files/1eb50cd8c/CEBT+HMO+15+%281%29.pdf) |
| [KP-HMO 20](https://www.cebt.org/files/a5ad02082/2024_SBC_CEBT_KP-HMO_20.pdf) | [KP-HMO 20](https://www.cebt.org/files/d3b13dbde/CEBT+HMO+20+%281%29.pdf) |
| N/A | [KP-HMO 30](https://www.cebt.org/files/0495f37b8/CEBT+HMO+30.pdf) |
| [KP-HMO 40](https://www.cebt.org/files/824a2abdf/2024_SBC_CEBT_KP-HMO_40.pdf) | [KP-HMO 40](https://www.cebt.org/files/c345ff30e/CEBT+HMO+40+%281%29.pdf) |
| [KP-HMO 45](https://www.cebt.org/files/889bef22c/2024_SBC_CEBT_KP-HMO_45.pdf) | [KP-HMO 45](https://www.cebt.org/files/30990535d/CEBT+HMO+45+%281%29.pdf) |
| [KP-HMO 50](https://www.cebt.org/files/329d867cb/2024_SBC_CEBT_KP-HMO_50.pdf) | [KP-HMO 50](https://www.cebt.org/files/8007adfa9/CEBT+HMO+50+%281%29.pdf) |
| N/A | [KP-DHMO 500](https://www.cebt.org/files/7256dd666/CEBT+DHMO+500+20%25.pdf) |
| [KP-DHMO 750](https://www.cebt.org/files/f22c06b49/2024_SBC_CEBT_KP-DHMO_750.pdf) | [KP-DHMO 750](https://www.cebt.org/files/c1649a094/CEBT+DHMO+750+20%25+%281%29.pdf) |
| [KP-DHMO 1000](https://www.cebt.org/files/d4b98cdcf/2024_SBC_CEBT_KP-DHMO_1000.pdf) | [KP-DHMO 1000](https://www.cebt.org/files/272f157c9/CEBT+DHMO+1000+20%25+%281%29.pdf) |
| [KP-DHMO 1500](https://www.cebt.org/files/42ecb8365/2024_SBC_CEBT_KP-DHMO_1500.pdf) | [KP-DHMO 1500](https://www.cebt.org/files/9a68e080f/CEBT+DHMO+1500+20%25+%281%29.pdf) |
| [KP-DHMO 2500](https://www.cebt.org/files/27337ec83/2024_SBC_CEBT_KP-DHMO_2500.pdf) | [KP-DHMO 2500](https://www.cebt.org/files/f410b6522/CEBT+DHMO+2500+20%25+%281%29.pdf) |
| [KP-HDHP 1600](https://www.cebt.org/files/a2e5b0239/2024+SBC_CEBT+KP-HDHP+1600+AGG.pdf) | N/A |
| N/A | [KP-HDHP 1650](https://www.cebt.org/files/3b3445e5e/CEBT+HDHP+1650+AGG+20%25.pdf) |
| [KP-HDMO 2500](https://www.cebt.org/files/61dde8ccb/2024_SBC_CEBT_KP-HDHP_2500_AGG.pdf) | [KP-HDHP 2500](https://www.cebt.org/files/6e96b390d/CEBT+HDHP+2500+AGG+20%25+%281%29.pdf) |
| N/A | [KP-HDHP 3500](https://www.cebt.org/files/8abf88133/CEBT+HDHP+3500+EMB+20%25.pdf) |
| N/A | [KP-HDHP 4000](https://www.cebt.org/files/0a71cddb1/CEBT+HDHP+4000+EMB+20%25.pdf) |
Medical Summary Plan Descriptions (SPD)
EPO Medical Benefit Plan
| Current | July 1, 2025 |
|---|---|
| [EP03 Medical Benefit Plan](https://www.cebt.org/files/bae6231b4/Book+07-01-2024+EPO3.pdf) | |
| [EP04 Medical Benefit Plan](https://www.cebt.org/files/d4e66e1b5/Book+07-01-2024+EPO4.pdf) | |
| [EP05 Medical Benefit Plan](https://www.cebt.org/files/b16c813aa/Book+07-01-2024+EPO5.pdf) | |
| [EPO6 Medical Benefit Plan](https://www.cebt.org/files/98c2d3050/Book+07-01-2024+EPO6.pdf) | |
| [EPO Select Medical Benefit Plan](https://www.cebt.org/files/359615a6d/Book+07-01-2024+EPO+Select.pdf) | |
| [EPO COVID-19 Testing Plan Amendment](https://www.cebt.org/files/ebebf0fc3/EPO_A2_COVID_Testing_2.4.20.pdf) |
PPO Medical Benefit Plan
| Current | July 1, 2025 |
|---|---|
| [PPO 2 Medical Benefit Plan](https://www.cebt.org/files/f192e1d8c/PPO2+Medical+Benefit+Plan_072024.pdf) | |
| [PPO3 Medical Benefit Plan](https://www.cebt.org/files/68609e15a/PPO3+Medical+Benefit+Plan_072024.pdf) | |
| [PPO4 Medical Benefit Plan](https://www.cebt.org/files/0aec0d561/PPO4+Medical+Benefit+Plan_072024.pdf) | |
| [PPO5 Medical Benefit Plan](https://www.cebt.org/files/021503f66/PPO5+Medical+Benefit+Plan_072024.pdf) | |
| [PPO6 Medical Benefit Plan](https://www.cebt.org/files/1777af2ea/PPO6+Medical+Benefit+Plan_072024.pdf) | |
| [PPO7 Medical Benefit Plan](https://www.cebt.org/files/3da2e0cd1/PPO7+Medical+Benefit+Plan_072024.pdf) | |
| [PPO8 Medical Benefit Plan](https://www.cebt.org/files/0ff0c60f6/PPO8+Medical+Benefit+Plan_072024.pdf) | |
| [PPO Select Medical Benefit Plan](https://www.cebt.org/files/fcda4c161/PPO+Select+Medical+Benefit+Plan_072024.pdf) | |
| [PPO COVID-19 Testing Plan Amendment](https://www.cebt.org/files/9ef8bc1ba/PPO_A3_COVID_Testing_2.4.20.pdf) |
HDHP Medical Benefit Plan
| Current | July 1, 2025 |
|---|---|
| [HDHP2 Single Medical Benefit](https://www.cebt.org/files/de52576b0/Book+07-01-2024+HDHP2+Single.pdf) | |
| [HDHP2 Family Medical Benefit](https://www.cebt.org/files/19a8bb351/Book+07-01-2024+HDHP2+Family.pdf) | |
| [HDHP25 Single Medical Benefit](https://www.cebt.org/files/2e4273353/Book+07-01-2024+HDHP25+Single.pdf) | |
| [HDHP25 Family Medical Benefit](https://www.cebt.org/files/d19b5b0f9/Book+07-01-2024+HDHP25+Family.pdf) | |
| [HD2800 Single Medical Benefit Plan](https://www.cebt.org/files/c4f796b3a/Book+07-01-2024+HD2800+Single.pdf) | |
| [HD2800 Family Medical Benefit Plan](https://www.cebt.org/files/1fcdc9198/Book+07-01-2024+H2800+Family.pdf) | |
| [HDHP3 Single Medical Benefit](https://www.cebt.org/files/54b8c4e12/Book+07-01-2024+HDHP3+Single.pdf) | |
| [HDHP3 Family Medical Benefit](https://www.cebt.org/files/e60e39911/Book+07-01-2024+HDHP3+Family.pdf) | |
| [HD3500 Medical Benefit Plan](https://www.cebt.org/files/304ea5b10/Book+07-01-2024+HD3500.pdf) | |
| [HDHP4 Medical Benefit Plan](https://www.cebt.org/files/0930c86fb/Book+07-01-2024+HDHP4.pdf) | |
| [HDHP5 Medical Benefit Plan](https://www.cebt.org/files/853ec6945/Book+07-01-2024+HDHP5.pdf) |
UHC Surest Medical Benefit Plan
| Current | July 1, 2025 |
|---|---|
| [UHC Surest 5 Medical Benefit Plan](https://www.cebt.org/files/eefc9090b/2024_SPD_C5000_CEBT_07012024_FINAL.pdf) | |
| [UHC Surest 5 Amendment (Survivorship Benefit)](https://www.cebt.org/files/737cfef72/Surest+5_Amendment-Survivorship_FINAL.pdf) | |
| [UHC Surest 7 Medical Benefit Plan](https://www.cebt.org/files/b32138518/2024_SPD_F7000_CEBT_07012024_FINAL.pdf) | |
| [UHC Surest 7 Amendment (Survivorship Benefit)](https://www.cebt.org/files/0f5383a5a/Surest+7_Amendment-Survivorship_FINAL.pdf) |
CEBT Employee Assistance Program (EAP)
| Current | July 1, 2025 |
|---|---|
| [CEBT Employee Assistance Program (EAP)](https://www.cebt.org/files/7bc0f1c55/CEBT_Triad_EAP_SPD_2020_Final_March_2021.pdf) |
SurgeryPlus Benefit Plan
| Current | July 1, 2025 |
|---|---|
| [SurgeryPlus Benefit Plan](https://www.cebt.org/files/d76874f5e/EDH_SurgeryPlus_Summary_Plan_Description_-_FINAL.pdf) | |
| [SurgeryPlus Plan Amendment (PPO)](https://www.cebt.org/files/77119dec9/SurgeryPlus_PPO_HDHP_Plan_Amendment_eff_07-01-2019_as_revised_by_LLF_2019-07-08.pdf) | |
| [SurgeryPlus Plan Amendment (EPO)](https://www.cebt.org/files/7d8006988/SurgeryPlus_EPO_Plan_Amendment_eff_07-01-2019_REVISED_by_LLF_07-08-2019.pdf) |
KP Medical Benefit Plan
| Current | July 1, 2025 |
|---|---|
| [KP-HMO 20 Medical Benefit Plan](https://www.cebt.org/files/186c37c13/EOC+35545+CEBT+KP-HMO+20.pdf) | |
| [KP-HMO 40 Medical Benefit Plan](https://www.cebt.org/files/884be5b42/2023_EOC_35545-200_CEBT_HMO_40.pdf) | |
| [KP-HMO 45 Medical Benefit Plan](https://www.cebt.org/files/b3d91493d/2023_EOC_35545-206_CEBT_HMO_45.pdf) | |
| [KP-DHMO 750 Medical Benefit Plan](https://www.cebt.org/files/be2842e98/2023_EOC_35545-238_CEBT_DHMO_750.pdf) | |
| [KP-DHMO 1000 Medical Benefit Plan](https://www.cebt.org/files/b09bc91f6/2023_EOC_35545-236_CEBT_DHMO_1000.pdf) | |
| [KP-DHMO 1500 Medical Benefit Plan](https://www.cebt.org/files/ed1a57255/2023_EOC_35545-204_CEBT_DHMO_1500.pdf) | |
| [KP-DHMO 2500 Medical Benefit Plan](https://www.cebt.org/files/17511a149/2023_EOC_35545-220_CEBT_DHMO_2500.pdf) | |
| [KP-DHMO 1600 Medical Benefit Plan](https://www.cebt.org/files/58ad96e5a/2023_EOC_35545-380_CEBT_HDHP_1500.pdf) |
Vision Plan Documents
Prescription Information: CVS/Caremark & Kaiser Permanente
CVS/Caremark Specialty MedicationsCommonly Prescribed Medications
Please note this drug list represents a summary of prescription coverage and is not an all-inclusive list to drugs covered by CEBT. Please contact CEBT customer service to confirm coverage.
For a list of covered drugs under your Kaiser plan, please access the Drug Formulary (Covered Drugs) on the kp.org website. Once you are directed to the page, click the Large Employer Group (50+ Employees) to access the drug lists.
Preventative Services Information
The Standard Life Coverage Plan Documents
The Standard Disability Plan Documents
Special District Association
SDA LTD1 Certificate (90 Day Waiting Period)SDA LTD1 Benefit Summary (90 Day Waiting Period)SDA LTD2 Certificate (180 Day Waiting Period)SDA LTD2 Benefit Summary (180 Day Waiting Period)SDA STD Certificate (All Other Classes)SDA STD Certificate (Firefighter, EMT & Paramedic Class) SDA STD Benefit Summary (180 Day Waiting Period)Small Group
Small Group LTD CertificateSmall Group LTD1 Benefit Summary (90 Day Waiting Period)Small Group LTD2 Benefit Summary (180 Day Waiting Period)Small Group STD CertificateSmall Group STD1 Benefit Summary (90 Day Waiting Period)Small Group STD2 Benefit Summary (180 Day Waiting Period)
Hospital Reimbursement Plan (HRP)