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City of San Jos Office of Retirement Services2025 Kaiser Hawaii and Kaiser Northwest Plans Monthly Retiree Rates Fund PaysLowest Cost Plan Available to Active Employees $3,000 Kaiser High Deductible
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01
Obtain the 2025 Kaiser Hawaii health plan application form.
02
Review the eligibility requirements outlined in the application.
03
Fill out your personal information, including name, address, and contact details.
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Provide your Social Security number and date of birth.
05
Indicate your desired coverage options by selecting them in the form.
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Include information about any dependents you want to cover under your plan.
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Review the terms and conditions carefully before signing.
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Submit the completed application form to the appropriate Kaiser Hawaii office.

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Individuals and families seeking health insurance coverage in Hawaii.
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2025 Kaiser Hawaii refers to a specific plan or form related to health insurance coverage offered by Kaiser Permanente in Hawaii for the year 2025.
Individuals who are enrolled in Kaiser Permanente health plans in Hawaii for the year 2025 are typically required to file the 2025 Kaiser Hawaii forms.
To fill out the 2025 Kaiser Hawaii forms, individuals must provide accurate personal information, insurance details, and any relevant health coverage data as prompted by the form.
The purpose of the 2025 Kaiser Hawaii forms is to facilitate the reporting and management of health insurance coverage for individuals enrolled in Kaiser Permanente plans in Hawaii.
The information that must be reported on the 2025 Kaiser Hawaii forms typically includes personal identification details, insurance policy numbers, coverage dates, and any relevant health care utilization data.
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