Cover Page

Page numbers referenced within this brochure apply only to the printed brochure

Kaiser Permanente - Hawaii

www.kp.org/feds
Member Services 800-966-5955

2023



IMPORTANT:
  • Rates
  • Changes for 2023
  • Summary of Benefits
A Health Maintenance Organization (High and Standard Options)

This plan’s health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See page (Applies to printed brochure only) for details.  This plan is accredited.  See page (Applies to printed brochure only).

Serving:  Islands of Oahu, Hawaii, Kauai, Lanai, Maui, and Molokai.

Enrollment in this Plan is limited. You must live or work in our geographic service area to enroll. See page 13 for requirements.

Enrollment codes for this Plan:
     631 High Option - Self Only
     633 High Option - Self Plus One
     632 High Option - Self and Family

     634 Standard Option - Self Only
     636 Standard Option - Self Plus One
     635 Standard Option - Self and Family

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