Kaiser Employee Enrollment Form |
1. KP CO Bronze 6500/100/HSA |
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2. HMO Bronze 5250/50/HSA |
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3. HMO Silver 2750/30/HSA |
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Employee Change FormUse this form to terminate, change or modify employees.
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Your Delta Benefit information.
IMPORTANT: Your company offers "Plan 2" for Adults only. Children are covered under the Kaiser Pediatric Dental included in your medical coverage. |
Click on the button below to enroll in your
Delta Dental Program. Employee Monthly Rate per Adult
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Clint Perry - Unlimited Benefits Representative |
Kaiser Member Services |
888-681-7878
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Kaiser Physician Selection Services |
855-208-7221
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Q. What is an HSA and how much can I contribute? |
Did you know that in 2017 you can put up to $6750 per family or $3400 per individual into your HSA account to pay for qualified medical expenses? They are also tax-deferred! However, you must set up a bank account with an HSA status in order to deposit funds tax free. For further information call Clint at 719-358-6519. He'll help direct you to a qualified bank.
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Q: When do Medical maximums and deductibles reset? |
A: Annual Deductibles, maximums and limits add up throughout the coverage year, then reset and begin again on the anniversary date of your coverage year. In this case, December 1.
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Q: What are qualified events? |
A: If you are eligible to make coverage changes, your changes must be consistent with the change in status
The rules vary for each employer but here are some situations that qualify as a change in status: 1. Your legal marital status changes 2. The number of your eligible children changes 3. You or your spouse lose coverage from a different employer |
Q: What is my member ID number? |
A: Your member ID number is a unique number provided to you by your employer or health plan, or it could be the last four digits of your Social Security number. If you’re not sure, your eye doctor or dental provider can usually access your benefit information with the last four digits of your Social Security number.
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