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  • Kaiser Permanente 3190 Cal 2012

Get Kaiser Permanente 3190 Cal 2012-2025

3190DOMESTIC PARTNER AFFIDAVIT Page 1 of 3Instructions: 1. This form cannot be submitted online. 2. Either: a) complete online and print or b) print and complete by printing clearly using blue or.

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As a newlywed, you qualify for a special enrollment period. That means you can enroll in a health plan within 60 days of your marriage or partnership. If you're already an enrolled member, you can also use this time to add your spouse, partner or dependents to your coverage or choose a new plan.

The group number for Kaiser Northern CA is 39044. The group number for Kaiser Southern CA is 225775.

You may register by completing a Confidential Declaration of Domestic Partnership Form DP-1A, having both partners' signatures notarized, and submitting the form with the appropriate fee to the California Secretary of State.

Can my domestic partner be added to my benefits? Yes. After an employee registers their domestic partnership, the employee may enroll a domestic partner in their benefits. The employee will receive the increased employer contribution for the added coverage.

Yes. A domestic partner and the domestic partner's children under age 26 can be added within 60 days after the date of the registration of domestic partnership. The same rules apply to a domestic partner's children. If the children are dependents of the employee, the employee will not have imputed income.

If you and your partner are over 18, or one or both partners are under 18 and have obtained a court order granting permission to establish a domestic partnership, and meet the requirements of California Family Code section 297, you may register a domestic partnership with the California Secretary of State.

Most insurance companies allow unmarried couples to combine coverage—and thereby get discounts and other valuable benefits. But again, not all insurance agents or companies will offer these benefits to an unmarried couple.

If your employer covers dependents, you can enroll your spouse in your employer plan. (Spousal surcharge doesn't apply if your spouse isn't eligible for coverage under his or her employer.) You can also consider individual and family plans for your spouse or even for your whole family.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232