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This document outlines the group health coverage agreement between Kaiser Foundation Health Plan of the Northwest and the City of San Jose, including premium amounts, eligibility criteria, benefits,
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How to fill out Kaiser Foundation Health Plan Group Agreement

01
Gather necessary information about your organization, including legal name, address, and tax identification number.
02
Determine the type of coverage you wish to offer, such as medical, dental, or vision.
03
Complete the Group Agreement form with accurate details, ensuring all required fields are filled out.
04
Provide information about the proposed effective date of coverage.
05
Include contact information for the designated plan administrator and any additional contacts.
06
Submit the completed Group Agreement to Kaiser Foundation Health Plan, ensuring that you have copies for your records.
07
Await confirmation from Kaiser regarding the acceptance of your application and the terms of coverage.

Who needs Kaiser Foundation Health Plan Group Agreement?

01
Businesses seeking to provide health insurance benefits to their employees.
02
Organizations looking to offer comprehensive health coverage as part of their employee benefits package.
03
Employers who want to comply with healthcare regulations and provide required health coverage options.
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The Kaiser Foundation Health Plan Group Agreement is a contract between Kaiser Permanente and an employer or group to provide health care coverage and services to eligible members.
Employers or organizations that wish to offer Kaiser Permanente health care coverage to their employees or members are required to file the Kaiser Foundation Health Plan Group Agreement.
To fill out the Kaiser Foundation Health Plan Group Agreement, employers should provide necessary information such as group details, eligible member information, and coverage options, and then submit the completed form to Kaiser Permanente for review.
The purpose of the Kaiser Foundation Health Plan Group Agreement is to establish terms and conditions under which health care services will be provided to members of the group, including coverage benefits and responsibilities.
Information that must be reported includes the group's name, address, contact information, number of eligible members, selected coverage options, and any specific requirements or agreements related to services.
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