Main Content

Brochures & Forms

View or download plan information and commonly used forms here.

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View 2019 Plan Documents

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    2019 Enrollment Guide

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    2019 Benefits and Rates

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    FEHB program plan brochure (RI 73-003)

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    Summary of Benefits and Coverage

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    CA Dental Programs for KP FEHB Members

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Archive (2018 Plan Documents)

  • document

    2018 FEHB program plan brochure (RI 73-003)

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    Summary of Benefits and Coverage

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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.

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    Enrollment Change Form

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Other forms and publications

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    Care away from home

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    Visiting Member Services

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    FEHB Claims Appeal

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    Paying for care

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    Uniform Glossary of Health Coverage and Medical Terms

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