Important Notice Regarding Coronavirus (COVID-19) and your Benefit Plan
Experience care your way. The PPO plan empowers you to choose how and where you get care, and how to manage your costs.
Quick Documents and Links
Provider Directories
Provider Options by Location:
In Kaiser Permanente States: The PHCS Network for KPIC provides access to care in the Kaiser Permanente states of CA, CO, GA, HI, MD, OR, VA, WA, and DC.
In Non-Kaiser Permanente States: The CignaPPONetwork* only provides access to care in non-Kaiser Permanente states
*Disclaimer: The Cigna PPO Network refers to providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.
Drug Formulary
Formulary with Specialty Drug Tier – MedImpact Pharmacy (Non-grandfathered)
Standard Formulary – MedImpact Pharmacy (Grandfathered)
MedImpact Immunization List for 2022
Claim forms
MedImpact Prescription Drug Claim Form
Documents and forms
Kaiser Permanente Insurance Company – Small Group PPO 2023 Plain Language Filing
Kaiser Permanente Insurance Company - Small Group PPO 2024 Plain Language Filing
Kaiser Permanente Insurance Company - Large Group PPO 2024 Plain Language Filing
Walgreens Home Delivery Prescription Services
Walgreens Home Delivery Prescription Services en Espanol
Filling Prescriptions at MedImpact Retail Pharmacies
Filling Prescriptions at MedImpact Retail Pharmacies, en Espanol
MedImpact Standard Commercial Guidelines
Permanente Advantage – Precertification and Care Management
Permanente Advantage – Precertification and Care Management, en Espanol
Permanente Advantage Precertification Request Form
Member Care Transition Form, en Espanol
Small Group Transparency in Coverage
Preparing for your Appointment
Preparing for your Appointment, en Espanol
Confidential Communication Request Form (English)
Understanding Your Plan and Benefits
Learn about the features and benefits of the PPO plan under the provider and pharmacy tiers.
How to Access Covered Care
Learn how to get care with each of the PPO Tiers.
Finding Doctors and Facilities
With two provider networks, you can choose your provider and where to get care.
Pharmacy
Where and how to fill prescriptions.
Precertification
An overview of precertification and how to obtain it.
Claims
When you need to file a claim and how to submit one to Kaiser Permanente Insurance Company.
Member Support
Where and how to get member support.
Coverage Documents
Need a coverage document?
Documents and Forms
View, download, or print commonly used forms, FAQs, and other documents here.