Brochures and Forms
View or download plan information and commonly used forms here.
View 2018 Plan Documents
- Kaiser Permanente rates & benefits
- FEHB program plan brochure (RI 73-047)
- Summary of Benefits and Coverage
- FEHB Claims Appeal
- FEHB Prescription Drug Formulary
- Dental Plan for Federal employees
- Care away from home
- Visiting Member Services
- 2017 Being an informed Kaiser Permanente member
- Kaiser Permanente Medical Centers in Mid-Atlantic States
Adding or removing a dependent
Use this form to add or remove a dependent if you currently have Kaiser Permanente Self and Family coverage and |adding or removing a dependent will not change your enrollment, type of enrollment, FEHB plan, or option.