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California Region Kaiser Permanent Group Enrollment Form Please print or type in black ink only. Make a copy for your records. TO BE COMPLETED BY EMPLOYER: District Name:Santa Monica Malibu Unified
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How to fill out sisc kaiser enrollment form
How to fill out sisc kaiser enrollment form
01
Obtain a copy of the SISC Kaiser enrollment form.
02
Fill out your personal information including your full name, date of birth, address, and contact information.
03
Provide details of any dependents you wish to include in the enrollment.
04
Select the desired coverage options and plans offered by Kaiser.
05
Sign and date the form to confirm your enrollment.
06
Submit the completed form to the appropriate department or contact person at your organization.
Who needs sisc kaiser enrollment form?
01
Employees who are eligible for health insurance benefits through their employer on the SISC Kaiser plan.
02
Dependents of employees who are being added to the health insurance coverage.
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What is sisc kaiser enrollment form?
The sisc kaiser enrollment form is a document used to enroll in a Kaiser Permanente health plan through the State of California's Schools Insurance Program.
Who is required to file sisc kaiser enrollment form?
All eligible employees of participating schools and educational agencies in California are required to file the sisc kaiser enrollment form.
How to fill out sisc kaiser enrollment form?
The sisc kaiser enrollment form can be filled out online through the State of California's Schools Insurance Program website or by contacting a representative for assistance.
What is the purpose of sisc kaiser enrollment form?
The purpose of the sisc kaiser enrollment form is to enroll eligible employees in a Kaiser Permanente health plan, providing them with access to healthcare services.
What information must be reported on sisc kaiser enrollment form?
The sisc kaiser enrollment form requires information such as personal details of the employee, dependent information, and desired health plan options.
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