Our products are a great all-in-one solution that can help please your employees, while giving you the convenience of working with a single carrier. How? This PPO Plan combines a Participating Provider Tier and a Non-Participating Provider Tier, to offer your employees more choices in one plan.
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 Cigna Healthcare PPO Network* only provides access to care in non-Kaiser Permanente states
*Disclaimer: The Cigna Healthcare PPO Network refers to providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.
Drug Formulary
PPO Formulary with Specialty Drug Tier – Medimpact Pharmacy (Non-Grandfathered)
PPO Standard Formulary – MedImpact Pharmacy (Grandfathered)
Claim forms
MedImpact Prescription Drug Claim Form
Documents and forms
PPO Plan Overview for Brokers, in Chinese
PPO Plan Overview for Brokers, en Espanol
Kaiser Permanente Insurance Company – Small Group PPO 2025 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)
Confidential Communication Revocation Form (English)
Your Rights and Protection Against Surprise Medical Bills
Overview
Plan overview and pricing information.
Employer & Broker Support
Where and how to get employer and broker support.
Onboarding Employees and Groups
How to implement the PPO Plan and onboard employees and groups.