Kaiser Permanente WA SoundChoice (PEBB non-Medicare retirees) Certificate of Coverage (COC) 2020

This benefits book describes what is covered under Kaiser Permanente WA SoundChoice, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

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Kaiser Permanente WA SoundChoice (PEBB) Summary of Benefits and Coverage (SBC) 2020

A summary of what the PEBB Kaiser Permanente WA SoundChoice plan covers and what it costs.

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Kaiser Permanente WA Value (PEBB non-Medicare retirees) Certificate of Coverage (COC) 2020

This benefits book describes what is covered under Kaiser Permanente WA Value, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

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Kaiser Permanente WA Value (PEBB) Summary of Benefits and Coverage (SBC) 2020

A summary of what the PEBB Kaiser Permanente WA Value plan covers and what it costs.

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Medical benefits comparison (PEBB) 2020

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This chart briefly compares the per-visit costs of some in-network benefits for PEBB plans. Some copays and coinsurance do not apply until after you have paid your annual deductible.

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Medicare Advantage disenrollment form (form D) 2020

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Use this form to disenroll from Medicare Advantage.

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Medicare Advantage plan election form (form C) 2020

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Use this form to enroll in Medicare Advantage plans.

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Medicare benefits comparison (PEBB) 2020

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This chart briefly compares the per-visit costs of some in-network benefits for PEBB plans. Some copays and coinsurance do not apply until after you have paid your annual deductible. Call the plans directly for more information on specific benefits, including preauthorization requirements and exclusions. Kaiser Permanente NW and Kaiser Permanente WA offer Medicare Advantage plans, but not in all areas.

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Medicare supplement plan G benefits 2020 (outline)

Outline of Medicare Supplement Plan G Coverage. Shows the benefits included in each of the standard Medicare supplement plans.

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MetLife (PEBB) life insurance beneficiary designation

Use this form to name the persons or entities you want to receive your life insurance proceeds after your death. Return this form to MetLife.

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