Kaiser Permanente Plan Documents

The following Plan Documents also known as “Evidence of Coverage” (EOC) are documents that explain the benefits, coverage and out-of-pocket costs associated with CVT’s Kaiser Permanente HMO Plans. These documents pertain to the plans available to both active and retired employees as well as COBRA participants.

For any questions regarding these documents please contact Member Services by emailing MemberServices@CVTrust.org or calling 800.288.9870.

Evidence of Coverage (EOC)

• Plan 1 (PDF)
• Plan 2 (PDF)
• Plan 3 (PDF)
• Plan 4 (PDF)
• Plan 5 (PDF)
• Plan 6 (PDF)
• Plan 7 (PDF)
• Plan 8 (PDF)
• Plan 9 - Wellness (PDF)
• Plan 10 - Bronze (PDF)
• Plan 11 - HSA (PDF)
• Plan 12 – Essential (PDF)
• Plan 1 – Senior Advantage (PDF)
• Plan 2 – Senior Advantage (PDF)
• Plan 3 – Senior Advantage (PDF)
• Plan 4 – Senior Advantage (PDF)
• Plan 5 – Senior Advantage (PDF)
• Plan 6 – Senior Advantage (PDF)
• Plan 7 – Senior Advantage (PDF)
• Plan 8 – Senior Advantage (PDF)
• Plan 9 – Senior Advantage (PDF)
• Plan 10 – Senior Advantage (PDF)
• Plan 11 – Senior Advantage (PDF)
• Plan 12 – Senior Advantage (PDF)