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Small Business

Forms & Documents for Existing Employer Groups

Consolidated Appropriations Act and Transparency in Coverage LOA
Enrollment form for existing groups

Use our new electronic signature form – completed documents will route directly to KP for processing

Quoting Tools for New Employer Groups

2026 New Employer Application
2025 New Employer Application

Get a quote for small groups
Please send all quote inquiries to HI-Sales@kp.org.

Support Documents

Employer designation and authorization letter
Employee Assistance Program (EAP) from TELUS Health:

Other Forms and Support

Contact Sheet
Electronic Fund Transfer Form for Initial and Recurring Payments
COBRA Election Form
COBRA Delegation Form
Creditable Coverage Status

Large Business

View or print commonly used forms.

Enrollment Forms

Enrollment form for new groups
Enrollment forms for existing groups

Quoting Tools for New Employer Groups

Customer rate request form (51+ eligibles)
Employee Census Grid

Support Documents

Employer designation and authorization letter
Employee Assistance Program (EAP) from TELUS Health:

Other Forms and Support

Electronic Fund Transfer Form for Initial and Recurring Payments
Consolidated Appropriations Act and Transparency in Coverage LOA
Contact Sheet
Kaiser Permanente on-the-Job Employee Referral Form
COBRA Election Form
COBRA Delegation Form

Individual and Family

View or print commonly used forms.

2026 Enrollment Materials

2026 KPIF Enrollment Guide
2026 KPIF Rate Chart Guide
2026 KPIF Application
2026 KPIF SEP Guide
2026 KPIF SEP Proof of Triggering Event/Qualifying Life Event Form
2026 KPIF Account Change Form
2026 KPIF Account Change Form for Grandfathered Plans

2025 Enrollment Materials

2025 KPIF Enrollment Guide
2025 KPIF Rate Chart Guide
2025 KPIF Application
2025 KPIF SEP Guide
2025 KPIF SEP Proof of Triggering Event/Qualifying Life Event Form
2025 KPIF Account Change Form
2025 KPIF Account Change Form for Grandfathered Plans

Support Documents

KPIF Broker Frequently Asked Questions

Review the KPIF Broker Frequently Asked Questions below for answers to common questions about selling Kaiser Permanente for Individual and Family Plans (KPIF) and working with KP.

Broker Support Services

For a list of KPIF telephone and online solutions, download this reference sheet.

Official logo from Kaiser Permanente Brand Center

Advertise your status as a Kaiser Permanente Authorized Agent.

Client Inquiry Form: Application Status and Billing
Client Inquiry Form: Compensation
HIPAA Authorization Form

Other Forms and Support

If you have questions, please email the Broker Services Team at KPIF@kp.org or call 1-844-394-3978.