Get Wa Kaiser Foundation Health Plan District Of Columbia Mid/large Group Employer Application 2016-2025

Filling out the WA Kaiser Foundation Health Plan District Of Columbia Mid/Large Group Employer Application online is a crucial step for employers seeking group health coverage. This guide will provide clear and supportive instructions to help you complete the application accurately and efficiently.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to access the application and open it in your editor.
2. Begin with Section 1, which requires the applicant’s information. Fill in the purchaser's legal business name, group/policy ID number, and other pertinent details such as the street address and executive contact person.
3. Move to Section 2 and provide information regarding employee eligibility. Include the total number of full-time and permanent part-time employees, along with those requesting group health coverage.
4. In Section 3, confirm the billing information. If it is the same as the applicant's information, check the box; otherwise, provide the different billing address and contact person details.
5. Section 4 concerns rates. Indicate the employer contribution percentage and rates for various coverage options, including HMO and POS rates.
6. Proceed to Section 5, where you will disclose other health care coverage information. Answer the questions regarding prior coverage and any cancellations you may have experienced.
7. Complete Section 6 if applicable. This section requires broker information, including the broker's name, firm, and contact details.
8. In Section 7, provide enrollment information such as the annual open enrollment period and the limiting age for dependent children.
9. Review Section 8 to confirm the employer agreement, ensuring you meet eligibility requirements and business certifications.
10. Finally, in Section 9, sign and date the application. Verify that all information is accurate, as it becomes part of the Group Agreement.
11. Once all sections are completed, save your changes, and you may opt to download, print, or share the form as needed.

Complete your WA Kaiser Foundation Health Plan application online today.