Apply for Small Business Coverage

Affordable care and coverage is just one step away.

Apply for coverage

You’re an important partner, and we’re here to support you as you grow your business and increase your revenue in this exciting market. If you’re new to selling Kaiser Permanente small business plans, we can help you ask the right questions to efficiently qualify, quote, and enroll new groups. Follow the steps below to help your clients find the coverage that’s right for them.

Step 1: Get to know your prospect

We’ve prepared a list of important questions for you to ask a prospective client. These questions will help you:

  • determine if they’re eligible for small group coverage
  • identify potential issues you can address now — before enrollment
  • get the information you need to successfully position a solution to meet their needs

Please record your prospect’s answers on the questionnaire so you can review them with your Kaiser Permanente sales executive.

Step 2: Quote your group

If your group answered "yes" to the questionnaire, it appears the group qualifies for coverage.

  • You can also get a small business quote by emailing a completed census form or excel template with company name and zip code to our broker sales team at The form should include subscribers’ ZIP codes and ages, as well as the ages of their spouses and dependents.

Call your Kaiser Permanente sales executive to review your proposal and get help preparing to present the solution and quote to your prospect. If you have not received a call or email from your sales executive call 800-789-4661 so they can introduce you.

Step 3: You got the sale — what’s next?

Get your new group processed quickly and efficiently by going to our small business forms page for all current forms, producer guidelines, and a requirements matrix. Refer to the enrollment and proposal materials below and additional resource links.

Review plan and product options and additional new group enrollment resources for brokers.

Order sales and enrollment materials online and ship to your office or your customers' locations.

New group submission guidelines

Read these new group submission guidelines to save time and ensure efficient processing.

Once you’ve checked these submission guidelines, email the required documentation for your new group to For assistance, call our New Group Sales Support Team at 800-789-4661.

Apply for coverage

Apply for coverage

To apply for coverage

To apply for coverage or request a quote

  1. Please download and complete the Quoting Intake Form (along with the census on the 2nd tab). We’ll need both tabs completed to provide a proposal.
    An active DOL (Department of Labor) number is required upon the purchase of a group policy.

  2. Email or fax the completed form to:
    Kaiser Foundation Health Plan, Inc.
    Attention: New Group Sales
    Fax: 1-877-661-2747

Companies that are eligible

To be eligible for coverage, the group/company must have an active Department of Labor number from the State of Hawaii, which can be obtained by calling 808-586-8914.

Where our plans are available

Our group plans are available on the islands of Oahu, Maui, Kauai, and Hawaii.

Call us if you have questions

If you have questions about benefits or how to apply, please call a Kaiser Permanente representative at 808-432-5919 (Oahu) or 1-866-381-3044 (Neighbor Islands).

Apply for coverage

There are two ways you can apply for coverage:

Directly through Kaiser Permanente1

Submit via email

Complete the employer application form and the employee enrollment forms.2 You can find these in our Resource Library under the Forms section. Send the completed documents to our secure mailbox:

1In Washington, D.C., your clients can only apply for coverage through the marketplace at

2All fields on the application must be completed and the application submitted with the first month's premium to begin the application process. Unanswered questions and/or incomplete sections will result in the application being returned to you.


Download the forms that you use most, including enrollment forms, and more.

Contact us

Get a quote

Get a quote for businesses with 50 or fewer employees

Account managers

Contact our account managers with questions and requests about your Kaiser Permanente account.

Sales representative

Contact our representatives if you have any questions about our coverage.

Apply for coverage

How to apply

1. Obtain a small group quote. 

 Please note that your quote will contain rates for all available products.

2. Review the Small Business Checklist to make sure you have completed all required forms.

We will review and respond to the application. If the application is incomplete or inaccurate, the review process will be delayed and the requested effective date cannot be guaranteed.

Please contact a representative if you have questions regarding the application process.

New group forms

For commonly used employee forms, please visit the Small Business Forms section in our Resource Library. There, you’ll also be able to select employer forms by line of business and by state.

Brokers: If you're a Washington broker with Kaiser Permanente accounts outside the Vancouver/Longview area, sign on or get information about our plans.

Employers: If you're a Washington employer with employees outside the Vancouver/Longview area, sign on or get information about our plans.