Get the free KFHP-MAS/KPIC SMALL GROUP ENROLLMENT AND CHANGE FORM HMO PLAN AND FLEXIBLE CHOICE OF...
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MARYLAND
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
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How to fill out kfhp-maskpic small group enrollment
How to fill out kfhp-maskpic small group enrollment
01
To fill out kfhp-maskpic small group enrollment, follow these steps:
02
Obtain the kfhp-maskpic small group enrollment form from the relevant health insurance provider.
03
Fill in the requested information for the small group, including the organization's name, address, and contact details.
04
Provide the number of eligible employees that will be included in the small group coverage.
05
Indicate the desired effective date for the small group enrollment.
06
Complete the section regarding the desired health insurance plan, selecting the appropriate coverage options.
07
If required, provide any additional supporting documentation or forms as specified by the health insurance provider.
08
Review the completed kfhp-maskpic small group enrollment form for accuracy and completeness.
09
Sign and date the form as the authorized representative or employer.
10
Submit the filled-out kfhp-maskpic small group enrollment form to the health insurance provider by the specified method (mail, fax, online submission).
11
Keep a copy of the completed form for your records.
Who needs kfhp-maskpic small group enrollment?
01
kfhp-maskpic small group enrollment is needed by small businesses or organizations that want to provide health insurance coverage for their employees.
02
It is also required for employers who want to join a Kaiser Foundation Health Plan (KFHP) small group health insurance plan.
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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 in a health insurance plan offered by Kaiser Permanente.
Who is required to file kfhp-maskpic small group enrollment?
Employers with a small group of employees who want to provide health insurance coverage through Kaiser Permanente 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 the Kaiser Permanente website or through a Kaiser Permanente representative.
What is the purpose of kfhp-maskpic small group enrollment?
The purpose of kfhp-maskpic small group enrollment is to ensure that employees have access to health insurance coverage through Kaiser Permanente.
What information must be reported on kfhp-maskpic small group enrollment?
Information such as employee names, dates of birth, social security numbers, and dependents must be reported on kfhp-maskpic small group enrollment.
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