Now Available: 2022 Mid-Large Group Forms

Please be advised the following 2022 Mid-Large Group forms are available for use in the District of Columbia, Maryland, and Virginia.

2022 Mid-Large plan summaries detail brochure

2022 Mid-Large enrollment/change form

  • Our new products, Virtual Forward and Virtual Complete have been added to this form.

2022 Mid-Large application (digital download only)

  • Our new products, Virtual Forward and Virtual Complete have been added to this application.

Mid-Large risk questionnaire

  • No updates have been made.
  • Please ensure this form is completed and returned with any Mid-Large application you submit.

Please familiarize yourself with these resources. If you have any questions, please contact your Kaiser Permanente Sales Executive or Account Management representative.