Get Oregon Small Group Employee Enrollmentchange Form - Brokernet Kp

This guide provides clear and detailed instructions on how to complete the Oregon Small Group Employee Enrollment/Change Form - Brokernet Kp online. By following these steps, users can successfully enroll or make changes to their health coverage with Kaiser Foundation Health Plan of the Northwest.

Follow the steps to complete your enrollment form accurately.

1. Press the ‘Get Form’ button to access the enrollment form and open it in your preferred editor.
2. In the employer section, the company name, group number, and other identifiers must be filled out by the employer. Ensure all entries are accurate as they impact the enrollment process.
3. Next, move to section A, where the employee must provide their personal details including name, date of birth, and home address. Ensure to use black or blue ink for clarity.
4. Select the benefit type, which includes medical, adult dental, or pediatric dental. Users must specify plan choices if applicable.
5. Proceed to section B to enter dependent information. If enrolling a spouse, partner, or children, provide their names, dates of birth, and any relevant health insurance details.
6. Review section C carefully as it requires the employee's signature and date. Ensure that all necessary information is complete and correct before signing.
7. Submit the completed form to the employer who will then send it to Kaiser Foundation Health Plan. This can be done by mail or fax, ensuring one submission at a time.

Complete your enrollment form online today to ensure timely access to your health benefits.