Get the free KFHP-MAS/KPIC SMALL GROUP ENROLLMENT AND CHANGE FORM

VIRGINIA Kaiser Foundation Health Plan of the mid-Atlantic States, Inc. (THOMAS) 2101 East Jefferson Street Rockville, MD 20852Kaiser Permanent Insurance Company(EPIC) One Kaiser Plaza Oakland, CA

How to fill out kfhp-maskpic small group enrollment

How to fill out kfhp-maskpic small group enrollment

1. Obtain a copy of the kfhp-maskpic small group enrollment form from the designated source.
2. Carefully read through the form and familiarize yourself with the required information.
3. Begin by filling out the basic details such as the name of the group, effective date, and group identification number.
4. Provide the necessary information for each individual member of the small group, including their full name, date of birth, and gender.
5. Specify the coverage options for each member, including medical, dental, and vision.
6. If any members require additional coverage or have specific requests, make sure to include those details.
7. Review the completed form to ensure accuracy and completeness.
8. Sign and date the form as the authorized representative of the small group.
9. Submit the filled-out kfhp-maskpic small group enrollment form to the appropriate entity as per the instructions provided.

Who needs kfhp-maskpic small group enrollment?

1. Any small group looking to enroll in the kfhp-maskpic small group coverage would need to complete the kfhp-maskpic small group enrollment form. This includes organizations or employers with a small number of employees seeking health insurance coverage. It is important for the authorized representative of the small group to complete the enrollment process correctly to ensure the group's healthcare needs are met.

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What is kfhp-maskpic small group enrollment?

kfhp-maskpic small group enrollment is the process of enrolling a small group of individuals into Kaiser Foundation Health Plan coverage.

Who is required to file kfhp-maskpic small group enrollment?

Employers with a small group of employees who wish to provide them with Kaiser Foundation Health Plan coverage are required to file kfhp-maskpic small group enrollment.

How to fill out kfhp-maskpic small group enrollment?

kfhp-maskpic small group enrollment can be filled out online through Kaiser Foundation Health Plan's website or by contacting their customer service.

What is the purpose of kfhp-maskpic small group enrollment?

The purpose of kfhp-maskpic small group enrollment is to ensure that all eligible individuals in a small group have access to Kaiser Foundation Health Plan coverage.

What information must be reported on kfhp-maskpic small group enrollment?

kfhp-maskpic small group enrollment requires basic information about the employer, the employees, and the desired coverage options.