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FEHB Documents

View or download plan information and commonly used forms here.

View 2025 FEHB Plan Documents

  • 2025 FEHB Enrollment Guide Northern California

    2025 FEHB Enrollment Guide Northern California

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  • 2025 FEHB Benefits & Rates Northern California

    2025 FEHB Benefits & Rates Northern California

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  • 2025 FEHB Brochure Northern California RI 73-003

    2025 FEHB Brochure Northern California RI 73-003

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  • 2025 CA Delta Dental Kaiser Permanente Program

    2025 CA Delta Dental Kaiser Permanente Program

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  • 2025 NCAL FEHB High Option SBC

    2025 NCAL FEHB High Option SBC

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  • 2025 NCAL FEHB Standard Option SBC

    2025 NCAL FEHB Standard Option SBC

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  • 2025 NCAL FEHB Prosper SBC

    2025 NCAL FEHB Prosper SBC

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View 2024 FEHB Plan Documents

  • 2024 Enrollment Guide

    2024 Enrollment Guide

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  • 2024 Benefits & Rates

    2024 Benefits & Rates

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  • 2024 FEHB Brochure (RI 73-003)

    2024 FEHB Brochure (RI 73-003)

    View
  • 2024 Summary of Benefits and Coverage High Option

    2024 Summary of Benefits and Coverage High Option

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  • 2024 Summary of Benefits and Coverage Standard Option

    2024 Summary of Benefits and Coverage Standard Option

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  • 2024 Summary of Benefits and Coverage Prosper

    2024 Summary of Benefits and Coverage Prosper

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  • 2024 CA Dental Programs for KP FEHB Members

    2024 CA Dental Programs for KP FEHB Members

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View 2025 FEHB Medicare Plan Documents

  • 2025 FEHB Guide to Medicare

    2025 FEHB Guide to Medicare

    View
  • One Pass® Fitness Program Flyer

    One Pass® Fitness Program Flyer

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  • 2025 FEHB Senior Advantage Enrollment Kit

    2025 FEHB Senior Advantage Enrollment Kit

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  • 2025 FEHB Senior Advantage 2 Enrollment Application

    2025 FEHB Senior Advantage 2 Enrollment Application

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  • 2025 FEHB Senior Advantage 2 Program Description

    2025 FEHB Senior Advantage 2 Program Description

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  • 2025 FEHB Senior Advantage 2 Part B Premium Reimbursement Instruction Flyer

    2025 FEHB Senior Advantage 2 Part B Premium Reimbursement Instruction Flyer

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  • 2025 FEHB Senior Advantage 2 Proof of Part B Premium Instructions Form

    2025 FEHB Senior Advantage 2 Proof of Part B Premium Instructions Form

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  • 2025 Northern California FEHB Senior Advantage EOC

    2025 Northern California FEHB Senior Advantage EOC

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View 2024 FEHB Medicare Plan Documents

  • 2024 FEHB Guide to Medicare

    2024 FEHB Guide to Medicare

    View
  • 2024 Senior Advantage Enrollment Kit

    2024 Senior Advantage Enrollment Kit

    View
  • 2024 Senior Advantage 2 Enrollment Application

    2024 Senior Advantage 2 Enrollment Application

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  • Senior Advantage 2 Program Description

    Senior Advantage 2 Program Description

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  • Senior Advantage 2 Part B Premium Reimbursement Instruction Flyer

    Senior Advantage 2 Part B Premium Reimbursement Instruction Flyer

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  • 2024 Senior Advantage 2 Proof of Part B Premium Submission Form

    2024 Senior Advantage 2 Proof of Part B Premium Submission Form

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  • Silver&Fit Exercise and Health Aging Program flyer

    Silver&Fit Exercise and Health Aging Program flyer

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  • Over-the-Counter Wellness Benefit Flyer

    Over-the-Counter Wellness Benefit Flyer

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  • Non-Emergency Transportation Benefit Flyer

    Non-Emergency Transportation Benefit Flyer

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  • Meal Delivery Benefit Flyer

    Meal Delivery Benefit Flyer

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  • 2024 Northern California FEHB Senior Advantage EOC

    2024 Northern California FEHB Senior Advantage EOC

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Enrollment Change Form

Use this form to add or remove an eligible dependent if you currently have Kaiser Permanente Self and Family coverage and adding or removing a dependent will not change your FEHB plan, plan option or enrollment type.

  • Enrollment Change Form

    Enrollment Change Form

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Other forms and publications

  • Getting Care While Traveling for Federal Members

    Getting Care While Traveling for Federal Members

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  • Visiting Member Services

    Visiting Member Services

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  • FEHB Claims Appeal Form

    FEHB Claims Appeal Form

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  • Glossary of Health Coverage and Medical Terms

    Glossary of Health Coverage and Medical Terms

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  • Bariatric Surgery Criteria Overview

    Bariatric Surgery Criteria Overview

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  • Kaiser Permanente FEHB Plans Infertility Coverage

    Kaiser Permanente FEHB Plans Infertility Coverage

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  • Transgender Care and Coverage for FEHB Members

    Transgender Care and Coverage for FEHB Members

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  • Kaiser Permanente FEHB Contraceptive Exception Overview

    Kaiser Permanente FEHB Contraceptive Exception Overview

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