Kavi Marketplace has designed a website to provide you with the latest announcements and the ability to view, print and download information about the employee benefit plans available to qualified groups.
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PLAN SUMMARIES |
This section provides you access to medical and dental SBC's, summaries and booklets for all other lines of coverage offered by Kavi Marketplace. If you have any questions, please contact the Trust Program Manager, Nathan Edmondson at 206-602-3558 or Nathan.Edmondson@advprofessionals.com. |
- These documents are provided to assist employers in fulfilling their obligations to provide employees with SBC's within the time frame and circumstances required by the Affordable Care Act.
- The SBC is a standardized description of the benefits and coverage available under the group health plan. SBC's and Glossary of Health Coverage and Medical Terms must be provided to all participants and beneficiaries.
Effective Dates - January 1, 2022 - December 31, 2022
Carrier: Regence BlueShield & Asuris Northwest Health
Kavi Marketplace Medical Side-by-Side (Regence / Asuris)
Medical Plan Highlights (pediatric benefit summaries included) - pending
- Regence: (HSA) (Platinum & Gold) (Silver & Bronze)
- Asuris: (HSA) (Platinum & Gold) (Silver & Bronze)
EAP Flyer (included in medical plans)
- Download: Regence
- Download: Asuris
| Platinum Plans | SBC | Benefit Summary |
Booklets |
| Platinum 250 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Platinum 500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Gold Plans | SBC | Benefit Summary |
Booklets |
| Gold 500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Gold 1000 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Gold 1500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Gold 2000 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Gold 2500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Gold HSA 1500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver Plans | SBC | Benefit Summary |
Booklets |
| Silver 3000 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver 5500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver HSA 2000 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver HSA 3000 Embedded | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver HSA 3500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver HSA 4250 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver Essential 2500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Silver Essential 4000 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Bronze Plans | SBC | Benefit Summary |
Booklets |
| Bronze Essential 7500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Bronze HSA 5500 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
| Bronze 8550 | (RBS) (ANH) | (RBS) (ANH) | (RBS) (ANH) |
*SBC = Summaries of Benefits and Coverage
*RBS = Regence BlueShield / ANH = Asuris Northwest Health
Effective Dates - January 1, 2022 - December 31, 2022
Carrier: Delta Dental of Washington
| Delta Dental Plans | ||
| Plan | Summary | Booklet |
| Dental Side by Side | Download | |
| [Plan A] $50 / $1000 / 100% / 80% / 50% | Download | Download |
| [Plan B] $50 / $1500 / 100% / 80% / 50% | Download | Download |
| [Plan C] $50 / $2000 / 100% / 80% / 50% | Download | Download |
| [Plan D] $50 / $2000 / 100% / 90% / 50% | Download | Download |
| Child Ortho | Download | Download |
| Family Ortho | Download | Download |
Effective Dates - January 1, 2022 - December 31, 2022
Carrier: VSP Vision Care Inc.
Download: Vision Side-by-Side Comparison
| VSP Vision Plans | ||
| Plan | Summary | Certificate |
| VSP-Kavi: Certificate of Coverage 2022 | Download | |
| Vision Plan A | Download | Download |
| Vision Plan B | Download | Download |
| Vision Plan C | Download | Download |
Effective Dates - January 1, 2022 - December 31, 2022
Carrier: LifeMap
| LifeMap Life Insurance Plans | Summary | Booklet |
| [Option 1] Basic Life and AD&D $20,000 | Download | Download |
| [Option 2] Basic Life and AD&D $25,000 | Download | Download |
| [Option 3] Basic Life and AD&D $50,000 | Download | Download |
| Voluntary Life Plan | Download | Download |
Effective Dates - January 1, 2021 - December 31, 2021
Carrier: Regence BlueShield & Asuris Northwest Health
Download: Kavi Marketplace Medical Side-by-Side (Regence / Asuris)
Download: Medical Plan Highlights (pediatric benefit summaries included)
- Regence: (HSA) (Platinum & Gold) (Silver & Bronze)
- Asuris: (HSA) (Platinum & Gold) (Silver & Bronze)
Download: EAP Flyer (included in Regence medical plans)
*SBC = Summaries of Benefits and Coverage
| Platinum Plans | SBC | Benefit Summary |
| Platinum 250 | Regence/ Asuris | Regence/ Asuris |
| Platinum 500 | Regence/ Asuris | Regence/ Asuris |
| Gold Plans | SBC | Benefit Summary |
| Gold 500 | Regence/ Asuris | Regence/ Asuris |
| Gold 1000 | Regence/ Asuris | Regence/ Asuris |
| Gold 1500 | Regence/ Asuris | Regence/ Asuris |
| Gold 2000 | Regence/ Asuris | Regence/ Asuris |
| Gold 2500 | Regence/ Asuris | Regence/ Asuris |
| Gold HSA 1500 | Regence/ Asuris | Regence/ Asuris |
| Silver Plans | SBC | Benefit Summary |
| Silver 3000 | Regence/ Asuris | Regence/ Asuris |
| Silver 5500 | Regence/ Asuris | Regence/ Asuris |
| Silver HSA 2000 | Regence/ Asuris | Regence/ Asuris |
| Silver HSA 3000 Embedded | Regence/ Asuris | Regence/ Asuris |
| Silver HSA 3500 | Regence/ Asuris | Regence/ Asuris |
| Silver HSA 4250 | Regence/ Asuris | Regence/ Asuris |
| Silver Essential 2500 | Regence/ Asuris | Regence/ Asuris |
| Silver Essential 4000 | Regence/ Asuris | Regence/ Asuris |
| Bronze Plans | SBC | Benefit Summary |
| Bronze Essential 7500 | Regence/ Asuris | Regence/ Asuris |
| Bronze HSA 5500 | Regence/ Asuris | Regence/ Asuris |
| Bronze 8550 | Regence/ Asuris | Regence/ Asuris |
Effective Dates - January 1, 2021 - December 31, 2021
Carrier: Delta Dental of Washington
| Delta Dental Plans | ||
| Plan | Summary | Booklet |
| Dental Side by Side | Download | |
| [Plan A] $50 / $1000 / 100% / 80% / 50% | Download | Download |
| [Plan B] $50 / $1500 / 100% / 80% / 50% | Download | Download |
| [Plan C] $50 / $2000 / 100% / 80% / 50% | Download | Download |
| [Plan D] $50 / $2000 / 100% / 90% / 50% | Download | Download |
| Child Ortho | Download | Download |
| Family Ortho | Download | Download |
Effective Dates - January 1, 2021 - December 31, 2021
Carrier: VSP Vision Care Inc.
Download: Vision Side-by-Side Comparison
| VSP Vision Plans | ||
| Plan | Summary | Certificate |
| VSP-Kavi Certificate of Coverage 2021 |
Download | |
| Vision Plan A | Download | Download |
| Vision Plan B | Download | Download |
| Vision Plan C | Download | Download |
Effective Dates - January 1, 2020 - December 31, 2020
Carrier: Regence BlueShield & Asuris Northwest Health
Kavi Marketplace Medical Side-by-Side (Regence / Asuris)
| Platinum Plans | SBC |
| Platinum 250 | Regence / Asuris |
| Platinum 500 | Regence / Asuris |
| Gold Plans | SBC |
| Gold 500 | Regence / Asuris |
| Gold 1000 | Regence / Asuris |
| Gold 1500 | Regence / Asuris |
| Gold 2000 | Regence / Asuris |
| Gold 2500 | Regence / Asuris |
| Gold HSA 1500 | Regence / Asuris |
| Silver Plans | SBC |
| Silver 3000 | Regence / Asuris |
| Silver 5500 | Regence / Asuris |
| Silver HSA 2000 | Regence / Asuris |
| Silver HSA 3000 Embedded | Regence / Asuris |
| Silver HSA 3500 | Regence / Asuris |
| Silver HSA 4250 | Regence / Asuris |
| Silver Essential 2500 | Regence / Asuris |
| Silver Essential 4000 | Regence / Asuris |
| Bronze Plans | SBC |
| Bronze Essential 5500 | Regence / Asuris |
| Bronze HSA 5000 | Regence / Asuris |
| Bronze 8150 | Regence / Asuris |
Effective Dates - January 1, 2020 - December 31, 2020
Carrier: Delta Dental of Washington
| Delta Dental Plans | ||
| Plan | Summary | Booklet |
| Dental Side by Side | Download | |
| Plan A $50 / $1000 / 100% / 80% / 50% |
Download | Download |
| Plan B $50 / $1500 / 100% / 80% / 50% |
Download | Download |
| Plan C $50 / $2000 / 100% / 80% / 50% |
Download | Download |
| Plan D $50 / $2000 / 100% / 90% / 50% |
Download | Download |
| Child Ortho | Download | Download |
| Family Ortho | Download | Download |
Effective Dates - January 1, 2020 - December 31, 2020
Carrier: VSP Vision Care Inc.
| VSP Vision Plans | ||
| Plan | Summary | Certificate |
| VSP Side by Side Comparison |
Download | |
| VSP-Kavi Certificate of Coverage 2019 |
Download | |
| Vision Plan A | Download | SBC Schedule of Benefits |
| Vision Plan B | Download | SBC Schedule of Benefits |
| Vision Plan C | Download | SBC Coming Soon Schedule of Benefits |
Effective Dates - January 1, 2019 - December 31, 2019
Carrier: Regence BlueShield & Asuris Northwest Health
Kavi Marketplace Medical Side-by-Side (Regence / Asuris)
| Platinum Plans | SBC |
| Platinum 250 | Regence / Asuris |
| Platinum 500 | Regence / Asuris |
| Gold Plans | SBC |
| Gold 500 | Regence / Asuris |
| Gold 1000 | Regence / Asuris |
| Gold 2000 | Regence / Asuris |
| Gold 2500 | Regence / Asuris |
| Gold HSA 1500 | Regence / Asuris |
| Silver Plans | SBC |
| Silver 3250 | Regence / Asuris |
| Silver 5500 | Regence / Asuris |
| Silver HSA 2000 | Regence / Asuris |
| Silver HSA 3000 | Regence / Asuris |
| Silver HSA 3500 | Regence / Asuris |
| Silver HSA 4000 | Regence / Asuris |
| Silver Essential 4000 | Regence / Asuris |
| Bronze Plans | SBC |
| Bronze Essential 5000 | Regence / Asuris |
| Bronze HSA 5000 | Regence / Asuris |
| Bronze 7900 | Regence / Asuris |
Effective Dates - January 1, 2019 - December 31, 2019
Carrier: Delta Dental of Washington
| Delta Dental Plans | ||
| Plan | Summary | Booklet |
| Dental Side by Side | Download | |
| Plan A $50 / $1000 / 100% / 80% / 50% |
Download | Download |
| Plan B $50 / $1500 / 100% / 80% / 50% |
Download | Download |
| Plan C $50 / $2000 / 100% / 80% / 50% |
Download | Download |
| Plan D $50 / $2000 / 100% / 90% / 50% |
Download | Download |
| Child Ortho | Download | Download |
| Family Ortho | Download | Download |
Effective Dates - January 1, 2019 - December 31, 2019
Carrier: VSP Vision Care Inc.
| VSP Vision Plans | ||
| Plan | Summary | Certificate |
| VSP Side by Side Comparison |
Download | |
| VSP-Kavi Certificate of Coverage 2019 |
Download | |
| Vision Plan A | Download | SBC Schedule of Benefits |
| Vision Plan B | Download | SBC Schedule of Benefits |
| Vision Plan C | Download | SBC Coming Soon Schedule of Benefits |
Effective Dates - January 1, 2018 - December 31, 2018
Carrier: Regence BlueShield & Asuris Northwest Health
| Platinum Plans | SBC |
| Platinum 250 | Regence / Asuris |
| Platinum 500 | Regence / Asuris |
| Gold Plans | SBC |
| Gold 500 | Regence / Asuris |
| Gold 1000 | Regence / Asuris |
| Gold 2000 | Regence / Asuris |
| Gold 2500 | Regence / Asuris |
| Gold HSA 1500 | Regence / Asuris |
| Silver Plans | SBC |
| Silver 3250 | Regence / Asuris |
| Silver 5500 | Regence / Asuris |
| Silver HSA 2000 | Regence / Asuris |
| Silver HSA 3500 | Regence / Asuris |
| Silver HSA 4000 | Regence / Asuris |
| Silver Essential 4000 | Regence / Asuris |
| Bronze Plans | SBC |
| Bronze Essential 5000 | Regence / Asuris |
| Bronze HSA 5000 | Regence / Asuris |
Effective Dates - January 1, 2018 - December 31, 2018
Carrier: Delta Dental of Washington
| Delta Dental Plans | ||
| Plan | Summary | Booklet |
| Dental Side by Side | Download | |
| Plan A $50 / $1000 / 100% / 80% / 50% |
Download | Download |
| Plan B $50 / $1500 / 100% / 80% / 50% |
Download | Download |
| Plan C $50 / $2000 / 100% / 80% / 50% |
Download | Download |
| Plan D $50 / $2000 / 100% / 90% / 50% |
Download | Download |
| Child Ortho | Download | Download |
| Family Ortho | Download | Download |
Effective Dates - January 1, 2018 - December 31, 2018
Carrier: VSP Vision Care Inc.
| VSP Vision Plans | ||
| Plan | Summary | Certificate |
| VSP Side by Side Comparison |
Download | |
| VSP-Kavi Certificate of Coverage 2018 |
Download | |
| Vision Plan A - 12 month exam - 24 month lenses - 24 month frames |
Download | SBC Schedule of Benefits |
| Vision Plan B - 12 month exam - 12 month lenses - 24 month frames |
Download | SBC Schedule of Benefits |
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