Enrollment Forms and Info
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Enrollment Forms & Info

Kaiser Medical

2025 PLANS

HHI Kaiser Rx Formulary for Jade, Topaz, Onyx, Virtual Plans

HHI Kaiser Rx Formulary for Sapphire, Emerald, Opal, HMO HSA, Pearl, Z2, Quartz, Zircon, Ruby, Diamond, Silver, PPO HSA

2025 Kaiser Plans One Page Summary

NEW! – 2025 HMO Z2 5000 SBC

NEW! – 2025 HMO Z2 5000 Benefit Summary

NEW! – 2025 HMO Silver 3000 SBC

NEW! – 2025 HMO Silver 3000 Benefit Summary

NEW! – 2025 PPO HSA 2500 SBC

NEW! – 2025 PPO HSA 2500 Benefit Summary

2025 Access PPO Diamond 500 SBC

2025 Access PPO Diamond 500 Benefit Summary

2025 Access PPO Emerald 1000 SBC

2025 Access PPO Emerald 1000 Benefit Summary

2025 Access PPO Sapphire 1500 SBC

2025 Access PPO Sapphire 1500 Benefit Summary

2025 Core HMO Pearl 2500 SBC

2025 Core HMO Pearl 2500 Benefit Summary

2025 Access PPO Ruby 3000 SBC

2025 Access PPO Ruby 3000 Benefit Summary

2025 Access PPO Opal 5000 SBC

2025 Access PPO Opal 5000 Benefit Summary

2025 Core HMO Onyx 5000 SBC

2025 Core HMO Onyx 5000 Benefit Summary

2025 Core HMO Jade SBC

2025 Core HMO Jade Benefit Summary

2025 Core HMO Topaz 5000 SBC

2025 Core HMO Topaz 5000 Benefit Summary

2025 HSA Core 2500 SBC

2025 HSA Core 2500 Benefit Summary

2025 Access PPO Quartz 2500 SBC

2025 Access PPO Quartz 2500 Benefit Summary

2025 Core HMO Zircon 5000 SBC

2025 Core HMO Zircon 5000 Benefit Summary

2025 Virtual Plus 1000 SBC

2025 Virtual Plus 1000 Benefit Summary

2025 Virtual Plus 2000 SBC

2025 Virtual Plus 2000 Benefit Summary

2025 Virtual Plus 3000 SBC

2025 Virtual Plus 3000 Benefit Summary

2025 Virtual Plus 5000 SBC

2025 Virtual Plus 5000 Benefit Summary

2026 PLANS

Access PPO Diamond 500 Benefit Summary

Access PPO Diamond 500 SBC

Access PPO Emerald 1000 Benefit Summary

Access PPO Emerald 100 SBC

Access PPO Sapphire 1500 Benefit Summary

Access PPO Sapphire 1500 SBC

Access PPO Quartz 2500 Benefit Summary

Access PPO Quartz 2500 SBC

Access PPO Ruby 3000 Benefit Summary

Access PPO Ruby 3000 SBC

Access PPO Opal 5000 Benefit Summary

Access PPO Opal 5000 SBC

Core HMO Pearl 2500 Benefit Summary

Core HMO Pearl 2500 SBC

Core HMO Jade 2500 Benefit Summary

Core HMO Jade 2500 SBC

HSA Core HMO 2500 Benefit Summary

HSA Core HMO 2500 SBC

Core HMO Everyday Care Plan 4000 Benefit Summary

Core HMO Everday Care Plan 4000 SBC

Core HMO Onyx 5000 Benefit Summary

Core HMO Onyx 5000 SBC

Core HMO Topaz 5000 Benefit Summary

Core HMO Topaz 5000 SBC

Core HMO Zircon 5000 Benefit Summary

Core HMO Zircon 5000 SBC

Core HMO Z2 5000 Benefit Summary

Core HMO Z2 5000 SBC

Virtual Plus 1000 Benefit Summary

Virtual Plus 1000 SBC

Virtual Plus 3000 Benefit Summary

Virtual Plus 3000 SBC

Virtual Plus 5000 Benefit Summary

Virtual Plus 5000 SBC

Waiver of Health Coverage (English)

Waiver of Health Coverage (Español)

Domestic Partner Form

Eligibility Guidelines

Contact Information

Contact Information

Hospitality Health Insurance Trust: 866-897-0488

Kaiser Permanente Washington Customer Service: (888) 901-4636

Ameritas Customer Service: 800.487.5553

Willamette Customer Service: 855.433.6825

TransAmerica Customer Service: 800.797.2643

Teladoc Customer Service: 800.835.2362

ComPsych Customer Service: 877.357.4322

Vimly Benefit Solutions: 206-456-9940

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