Kavi Plan Summaries & Booklets

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.

PLAN SUMMARIES
& BOOKLETS

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 Kavi Sales:

Nathan Edmondson at 206.602.3558 or Nathan.Edmondson@advprofessionals.com
Tara Reynolds at 253-541-6538 or Tara.Reynolds@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.

2025 Medical Plans (SBC's & Benefit Summaries & Booklets)

Effective Dates - January 1, 2025 - December 31, 2025

Carrier: Regence BlueShield & Asuris Northwest Health

📂 Health Plan Summaries, Booklets, & SBCs – The DOWNLOAD link has the zip files where you'll find the following documents:

Included in Asuris Zip Folder:

Bronze Essential 7500 RealValue
Bronze HSA 6000 RealValue
Bronze B550 Preferred
Bronze Essential 7500 Preferred
Bronze HSA 6000 Preferred
Gold 1000 Preferred
Gold 1500 Preferred
Gold 2000 Preferred
Gold 2500 Preferred
Gold 3000 Preferred
Gold 3500 Preferred
Gold HSA 1800 Preferred
Platinum 1150 Preferred
Platinum 2500 Preferred
Silver 2000 Preferred
Silver 3000 Preferred
Silver 5000 Preferred
Silver Essential 2500 Preferred
Silver Essential 4000 Preferred
Silver HSA 2700 Preferred
Silver HSA 3500 Preferred
Silver HSA 5100 Preferred
Silver HSA Embedded 3600 Preferred
Gold 2500 RealValue
Gold HSA 1800 RealValue
Silver 3000 RealValue
Silver HSA 2700 RealValue

Included in Regence Zip Folder:

Bronze Essential 7500 Eastside Health Network
Gold 1000 Eastside Health Network
Silver 3000 Eastside Health Network
Silver Essential 4000 Eastside Health Network
Bronze 8550 Preferred
Bronze Essential 7500 Preferred
Bronze HSA 6000 Preferred
Gold 1000 Preferred
Gold 1500 Preferred
Gold 2000 Preferred
Gold 2500 Preferred
Gold 500 Preferred
Gold HSA 1800 Preferred
Gold Sustain 3500 Preferred
Platinum 1150 Preferred
Platinum 250 Preferred
Platinum 500 Preferred
Silver 3000 Preferred
Silver 5500 Preferred
Silver Essential 2500 Preferred
Silver Essential 4000 Preferred
Silver HSA 2700 Preferred
Silver HSA 3500 Preferred
Silver HSA 5150 Preferred
Silver HSA Embedded 3600 Preferred

Kavi Asuris SBC – DOWNLOAD
Kavi Asuris Summary – DOWNLOAD
Kavi Regence SBC – DOWNLOAD
Kavi Regence Summary – DOWNLOAD

Kavi Marketplace Booklets: email kavi@advprofessionals.com

2025 Dental Plans

Effective Dates - January 1, 2025 - December 31, 2025

Carrier: Delta Dental of Washington

📂 Dental Plan Summaries and Booklets – The DOWNLOAD link has the zip files where you'll find the following documents:

Ortho Child Option.pdf
Ortho Family Option.pdf
Kavi Plan A-1 #03875.pdf
Kavi Plan B-1 #03876.pdf
Kavi Plan C-1 #03877.pdf
Kavi Plan D-1 #03878.pdf
Kavi Plan E-1 #09901.pdf
Kavi Plan F-1 #09695.pdf

Spanish summaries

2025 Vision Plans

Effective Dates - January 1, 2025 - December 31, 2025

Carrier: VSP Vision Care Inc.

📂 VSP Plan Summaries (Spanish) and Booklets – DOWNLOAD the zip files. Inside the zip, you'll find the following documents:

Exam Plus Plan.pdf
Kavi Plan A W LightCare.pdf
Kavi Plan B W LightCare.pdf
Kavi Plan C W LightCare.pdf

VSP Certificates – (Exam Plus is Pending)

For additional detail visit https://kavi.vspforme.com/

2025 Basic Life & AD&D Plans

Effective Dates - January 1, 2025 - December 31, 2025

Carrier: USAble

📂 USAble Plan Summaries and Booklets/Certs – The DOWNLOAD link has the zip files where you'll find the following documents:

Kavi Benefit Summary Option 1.pdf
Kavi Benefit Summary Option 2.pdf
Kavi Benefit Summary Option 3.pdf

Spanish summaries

2024 Medical Plans (SBC's & Benefit Summaries & Booklets)

Effective Dates - January 1, 2024 - December 31, 2024

Carrier: Regence BlueShield & Asuris Northwest Health

Kavi Marketplace Bookets: email kavi@advprofessionals.com

Kavi Marketplace Medical Side-by-Side: Regence / Asuris

Disclosure Notice: Regence / (Asuris)

EAP Flyer (included in medical plans)
- Employer Flyers: Regence / Asuris
- Member Flyers: Regence / Asuris

Platinum Plans	SBC	Benefit Summary
Platinum 250	(RBS) (ANH)	(RBS) (ANH)
Platinum 500	(RBS) (ANH)	(RBS) (ANH)
Platinum 900	(RBS) (AHN)	(RBS) (ANH)
Gold Plans	SBC	Benefit Summary
Gold 500	(RBS) (ANH)	(RBS) (ANH)
Gold 1000	(RBS) (ANH)	(RBS) (ANH)
Gold 1500	(RBS) (ANH)	(RBS) (ANH)
Gold 2000	(RBS) (ANH)	(RBS) (ANH)
Gold 2500	(RBS) (ANH)	(RBS) (ANH)
Gold HSA 1600	(RBS) (ANH)	(RBS) (ANH)
Silver Plans	SBC	Benefit Summary
Silver 3000	(RBS) (ANH)	(RBS) (ANH)
Silver 5500	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 2700	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 3200 Embedded	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 3500	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 5150	(RBS) (ANH)	(RBS) (ANH)
Silver Essential 2500	(RBS) (ANH)	(RBS) (ANH)
Silver Essential 4000	(RBS) (ANH)	(RBS) (ANH)
Bronze Plans	SBC	Benefit Summary
Bronze Essential 7500	(RBS) (ANH)	(RBS) (ANH)
Bronze HSA 6000	(RBS) (ANH)	(RBS) (ANH)
Bronze 8550	(RBS) (ANH)	(RBS) (ANH)

*SBC = Summaries of Benefits and Coverage
*RBS = Regence BlueShield / ANH = Asuris Northwest Health

2024 Dental Plans

Effective Dates - January 1, 2024 - December 31, 2024

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
[Plan E] Voluntary	Download	Download
Child Ortho	Download
Family Ortho	Download

2024 Vision Plans

Effective Dates - January 1, 2024 - December 31, 2024

Carrier: VSP Vision Care Inc.

Download: Vision Side-by-Side Comparison

VSP Vision Plans
Plan	Summary	Certificate
Vision Plan A	Download	Download
Vision Plan B	Download	Download
Vision Plan C	Download	Download

For additional detail visit https://kavi.vspforme.com/

2024 Basic Life & AD&D Plans

Effective Dates - January 1, 2024 - December 31, 2024

Carrier: LifeMap

LifeMap Life Insurance Plans	Summary	Certificate
[Option 1] Basic Life and AD&D $20,000	Download	Coming Soon
[Option 2] Basic Life and AD&D $25,000	Download
[Option 3] Basic Life and AD&D $50,000	Download
Voluntary Life Plan	Download	Coming Soon

2023 Medical Plans (SBC's & Benefit Summaries & Booklets)

Effective Dates - January 1, 2023 - December 31, 2023

Platinum Plans	SBC	Benefit Summary
Platinum 250	(RBS) (ANH)	(RBS) (ANH)
Platinum 500	(RBS) (ANH)	(RBS) (ANH)
Platinum 850	(RBS) (AHN)	(RBS) (ANH)
Gold Plans	SBC	Benefit Summary
Gold 500	(RBS) (ANH)	(RBS) (ANH)
Gold 1000	(RBS) (ANH)	(RBS) (ANH)
Gold 1500	(RBS) (ANH)	(RBS) (ANH)
Gold 2000	(RBS) (ANH)	(RBS) (ANH)
Gold 2500	(RBS) (ANH)	(RBS) (ANH)
Gold HSA 1500	(RBS) (ANH)	(RBS) (ANH)
Silver Plans	SBC	Benefit Summary
Silver 3000	(RBS) (ANH)	(RBS) (ANH)
Silver 5500	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 2500	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 3000 Embedded	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 3500	(RBS) (ANH)	(RBS) (ANH)
Silver HSA 4850	(RBS) (ANH)	(RBS) (ANH)
Silver Essential 2500	(RBS) (ANH)	(RBS) (ANH)
Silver Essential 4000	(RBS) (ANH)	(RBS) (ANH)
Bronze Plans	SBC	Benefit Summary
Bronze Essential 7500	(RBS) (ANH)	(RBS) (ANH)
Bronze HSA 5500	(RBS) (ANH)	(RBS) (ANH)
Bronze 8550	(RBS) (ANH)	(RBS) (ANH)

*SBC = Summaries of Benefits and Coverage
*RBS = Regence BlueShield / ANH = Asuris Northwest Health

2023 Dental Plans

Effective Dates - January 1, 2023 - December 31, 2023

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
Family Ortho	Download

2023 Vision Plans

Effective Dates - January 1, 2023 - December 31, 2023

Carrier: VSP Vision Care Inc.

Download: Vision Side-by-Side Comparison

VSP Vision Plans
Plan	Summary	Certificate
Vision Plan A	Download	Download
Vision Plan B	Download	Download
Vision Plan C	Download	Download

2023 Basic Life & AD&D Plans

Effective Dates - January 1, 2023 - December 31, 2023

Carrier: LifeMap

LifeMap Life Insurance Plans	Summary	Certificate
[Option 1] Basic Life and AD&D $20,000	Download	SAMPLE Group-specific certificates created upon enrollment
[Option 2] Basic Life and AD&D $25,000	Download
[Option 3] Basic Life and AD&D $50,000	Download
Voluntary Life Plan	Download	Download

2022 Medical Plans (SBC's & Benefit Summaries & Booklets)

Effective Dates - January 1, 2022 - December 31, 2022

Carrier: Regence BlueShield & Asuris Northwest Health

Kavi Marketplace Medical Side-by-Side (Regence / Asuris)

Disclosure Notice (Regence) / (Asuris)

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

2022 Dental Plans

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

2022 Vision Plans

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

2022 Basic Life & AD&D Plans

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