Documents and Forms
Looking for information about you Choice Products plan? View, download, or print commonly used forms, FAQs, reference guides, and other documents here.
Links to important forms and documents:
Provider Directories
Provider Options by Location:
In Colorado: Find Network providers and locations.
In Kaiser Permanente States: The 3T POS, PPO, and OOA’s First Health Network provides access to care in the Kaiser Permanente states of CA, CO, GA, HI, MD, OR, VA, WA, and DC.
Non-Kaiser Permanente States: The Cigna HealthcareSM PPO Network* only provides access to care in non-Kaiser Permanente states.
*Disclaimer: The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.
Your Rights and Protection Against Surprise Medical BillsNetwork Access Plans
2024 KPIC Colorado Network Access Plan - SG
2024 KPIC Colorado Network Access Plan - LG
Formularies
KPIC Colorado POS and PPO Formulary
KPIC Colorado POS and PPO Formulary en espanol
Prior Approval forms
Medical: Permanente Advantage Pre-Certification Form
Pharmacy:Pharmacy Prior Authorization Request Form (KPIC MRF)
MedImpact Standard Commercial Guidelines
Oncology Step Regulation PA Guidelines
Claim forms
Medical: Choice Products Medical Claim Form
Pharmacy: Drug Reimbursement Form
Other documents and forms
PPO Flyer for Physicians and Care Providers
Preparing for your Appointment with a Non-Kaiser Permanente Provider
Diversity Questionnaire FAQs for Colorado Option PPO Members
