For our employer groups that are being supported by a Broker and that Broker is allowed to receive compensation payments from Kaiser Permanente, a Broker of Record (BOR) form must be filled out and signed by the group. At this time, all BOR forms must have a wet signature on them to be accepted and processed.

Download a blank BOR form.

Save time and submit your Broker of Record Change Request online by signing into your account at business.kp.org. 

For our employer groups that are being serviced by a Consultant, an Agent of Record (AOR) form must be filled out and signed by the group. A Consultant is defined as a partner to the group who is not receiving any compensation directly from Kaiser Permanente. At this time, all AOR forms must have a wet signature on them to be accepted and processed.

Download a blank AOR form (PDF).