For All Members:
For C.A.R. Group Insurance Program Members:
Thank you for your participation in the C.A.R. Insurance Plan. Below are important policy notices that you should read, print and retain for safekeeping.
2019 CAR Required Notices (Combined Anthem & Kaiser)
Required Notices – MetLife (PDF)
- Required Notices Include:
- HIPAA Notice of Special Enrollment Rights
- Newborns’ and Mothers’ Health Protection Act
- Women’s Health & Cancer Rights Act
- Patient Protections Notice
- CMS Creditable Coverage Notices
Important Kaiser Permanente Documents and Links
Medicare/CMS Creditable Coverage Notices
- 2019 Creditable Coverage Notice Kaiser
- 2019 Creditable Coverage Notice Anthem
- 2019 Non-Creditable Coverage Notice Anthem
- 2019 Non-Creditable Coverage Notice Kaiser
Evidence of Coverage Booklets (EOC)
2019 Kaiser and Anthem EOC documents
- 2019 Kaiser Permanente Plans
- Bronze 60 HMO 6300/75 North
- Bronze 60 HMO 6300/75 South
- Bronze 60 HDHP HMO 6000/40% (HSA) North
- Bronze 60 HDHP HMO 6000/40% (HSA) South
- Silver 70 HMO 1000/55 North
- Silver 70 HMO 1000/55 South
- Silver 70 HMO 1800/55 North
- Silver 70 HMO 1800/55 South
- Silver 70 HMO 2000/45 North
- Silver 70 HMO 2000/45 South
- Silver 70 HDHP HMO 2500/20% (HSA) North
- Silver 70 HDHP HMO 2500/20% (HSA) South
- Gold 80 HMO 0/30 North
- Gold 80 HMO 0/30 South
- Gold 80 HMO 500/30 North
- Gold 80 HMO 500/30 South
- Gold 80 HRA HMO 2250/35 North
- Gold 80 HRA HMO 2250/35 South
- Platinum 90 HMO 0/10 North
- Platinum 90 HMO 0/10 South
- Platinum 90 HMO 0/15 North
- Platinum 90 HMO 0/15 South
- Kaiser Acupuncture-Chiropractic North
- Kaiser Acupuncture-Chiropractic South
- Child Dental Plan HMO Flyer 2019
- DME Benefits Flyer 2019
- 2019 Anthem Blue Cross Plans
- Anthem Bronze PPO 6600/0% w/HSA (3KDB)
- Anthem Bronze PPO 5000/45% w/HSA (3KD3)
- Anthem Bronze PPO 70/6300/35% (3KER)
- Anthem Bronze PPO 40/5600/40% (306D)
- Anthem Bronze PPO 65/4600/40% (3KJ9)
- Anthem Silver PPO 2000/25% w/HSA – RxC (Single) (3KJ5)
- Anthem Silver PPO 2000/25% w/HSA – RxC (Family) (3KF3)
- Anthem Silver PPO 50/2000/40% (3KG5)
- Anthem Silver PPO 55/1750/35% (3KH7)
- Anthem Silver PPO 40/1500/40% (3KGV)
- Anthem Silver HMO 55/2250/40% (3KL7)
- Anthem Silver HMO 55 (3KJR)
- Anthem Gold PPO 35/1000/20% (3KGM)
- Anthem Gold PPO 30/750/20% (3KGD)
- Anthem Gold PPO 30/500/20% (3KFF)
- Anthem Gold PPO 20/30% (3KF7)
- Anthem Gold HMO 25 (3KHF)
- Anthem Gold HMO 35 (306V)
- Anthem Platinum PPO 15/250/10% (3KFX)
- Anthem Platinum PPO 20/10% (3KHP)
2019 MetLife Group Dental, Vision and Life Evidence of Coverage Documents
- MetLife Evidence of Coverage – VALUE Plan
- MetLife Evidence of Coverage – SELECT Plan
- MetLife Evidence of Coverage – CHOICE Plan
- MetLife Voluntary AD&D
- MetLife Term Life and AD&D
Summary of Benefits & Coverage (SBC)
2019 Anthem Blue Cross Plans
- Anthem Bronze PPO 6600/0% w/HSA (3KDB)
- Anthem Bronze PPO 5000/45% w/HSA (3KD3)
- Anthem Bronze PPO 70/6300/35% (3KER)
- Anthem Bronze PPO 40/5600/40% (306D)
- Anthem Bronze PPO 65/4600/40% (3KJ9)
- Anthem Silver PPO 2000/25% w/HSA – RxC (Single) (3KJ5)
- Anthem Silver PPO 2000/25% w/HSA – RxC (Family) (3KF3)
- Anthem Silver PPO 50/2000/40% (3KG5)
- Anthem Silver PPO 55/1750/35% (3KH7)
- Anthem Silver PPO 40/1500/40% (3KGV)
- Anthem Silver HMO 55/2250 (3KL7)
- Anthem Silver HMO 55 (3KJR)
- Anthem Gold PPO 35/1000/20% (3KGM)
- Anthem Gold PPO 30/750/20% (3KGD)
- Anthem Gold PPO 30/500/20% (3KFF)
- Anthem Gold PPO 20/30% (3KF7)
- Anthem Gold HMO 25 (3KHF)
- Anthem Gold HMO 35 (306V)
- Anthem Platinum PPO 15/250/10% (3KFX)
- Anthem Platinum PPO 20/10% (3KHP)
2019 Kaiser Permanente Plans
- Bronze 60 HMO 6300/75
- Bronze 60 HDHP HMO 6000/40% (HSA)
- Silver 70 HMO 1000/55
- Silver 70 HMO 1800/55
- Silver 70 HMO 2000/45
- Silver 70 HDHP HMO 2500/20% (HSA)
- Gold 80 HMO 0/30
- Gold 80 HMO 500/30
- Gold 80 HRA HMO 2250/35
- Platinum 90 HMO 0/10
- Platinum 90 HMO 0/15
If you have any questions about your health plan or would like a copy of these documents mailed to you, please call RealCare at (800) 939-8088, Option 2
