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.

This symbol denotes a PDF Document. If it contains a form, you can print it and fill it out.

This symbol denotes a Web Page. If it contains a form, you can fill it out online and submit it.

Prescription Information

Specialty Medications

Commonly Prescribed Medications

Preventative Services

Preventative Services Men/Women

Preventative Services Children

UMR Medical Summary of Benefits and Coverage (SBC)

1/1/2024 - 12/31/2024

SBC Archive Files

Download the full collection of SBC files from 7/1/2022 - 12/31/2023.

Kaiser Medical Summary of Benefits and Coverage (SBC)

7/1/2023 - 6/30/2024

Estimate Your Costs

For covered drugs in your area, click here. Once you are directed to the page, click the Find out what drugs are covered in your area link.

Kaiser Permanente

KP Formulary List Link: (HMO): DB & NoCO

KP Formulary List Link: (HMO): Southern CO

KP Specialty Drug List

Medical Summary Plan Descriptions (SPDs)

EPO3 Medical Benefit Plan

EPO4 Medical Benefit Plan

EPO5 Medical Benefit Plan

EPO6 Medical Benefit Plan

EPO COVID-19 Testing Plan Amendment

PPO2 Medical Benefit Plan

PPO3 Medical Benefit Plan

PPO4 Medical Benefit Plan

PPO5 Medical Benefit Plan

PPO6 Medical Benefit Plan

PPO7 Medical Benefit Plan

PPO8 Medical Benefit Plan

PPO COVID-19 Testing Plan Amendment

PPO Select Benefit Plan

SurgeryPlus Benefit

SurgeryPlus Plan Amendment (EPO)

SurgeryPlus Plan Amendment (PPO)

Employee Assistance Program

HDHP2 Individual Medical Benefit Plan

HDHP2 Family Medical Benefit Plan

HD2800 Individual Medical Benefit Plan

HD2800 Family Medical Benefit Plan

HDHP3 Medical Benefit Plan

HD3500 Medical Benefit Plan

HDHP4 Medical Benefit Plan

HDHP5 Medical Benefit Plan

KP-HMO 40 Benefits

KP-HMO 45 Benefits

KP-DHMO 750 Benefits

KP-DHMO 1000 Benefits

KP-DHMO 1500 Benefits

KP-DHMO 2500 Benefits

KP-HDHP 1500 Benefits

KP-HDHP 2500 Benefits

Dental Plan Documents

Dental Plan Document (Plans A, B & C)

Delta Dental Plan A Summary

Delta Dental Plan B Summary

Delta Dental Plan C Summary

Vision Plan Documents

VSP Summary Plan Description

Life Coverage

Basic Life Certificate

Voluntary Life Certificate

CEBT Voluntary Life Benefit Booklet

Travel Assistance Policies

The Standard Disability

Special District Association

SDA STD Benefit Summary (180 Day Benefit Period)

SDA STD Certificate

SDA LTD1 Benefit Summary (90 Days Benefit Period)

SDA LTD 90 Days Certificate

SDA LTD2 Benefit Summary (180 Days Benefit Period)

SDA LTD 180 Days Certificate

SDA STD Group Policy Amendment 8/1/2020

Small Group

Small Group STD1 Benefit Summary (90 Day Benefit Period)

Small Group STD2 Benefit Summary (180 Days Benefit Period)

Small Group LTD1 Benefit Summary (90 Day Waiting Period)

Small Group LTD2 Benefit Summary (180 Day Waiting Period)

Small Group LTD Certificate

Small Group LTD Policy Document

Small Group STD Certificate

Small Group STD Policy Document

Hospital Reimbursement Plan (HRP)

Hospital Reimbursement Plan Highlights