Individuals and families (KPIF)
Accessing the right forms for your clients is easy. Below are commonly used forms for the KPIF line of business.
These forms can be used to apply for individual or family coveraged provided by Kaiser Foundation Health Plan of the Northwest. Individuals can also apply online at buykp.org/apply
Outside of the open enrollment period, individuals can enroll or change coverage if they have experienced a situation known as a tiggering event. Examples of triggering events include getting married, having a baby, or losing coverage due to the loss of a job. For more information regarding special enrollment periods, please visit kp.org/specialenrollment.
2022 English (PDF) – Coming Soon | 2022 Spanish (PDF) – Coming Soon
Authorization for insurance agent/producer to act on behalf of an applicant.
Oregon Form for Reduced Non-Tobacco Premium
Clark and Cowlitz Counties form for Reduced Non-Tobacco Premium
Flier outlining contact information for inquiries on enrollment status & membership, compensation, and new sales.
To download an SBC, please visit kp.org/sbc and select your region and plan.
Accessing the right forms for your clients is easy. Below are commonly used forms for the small businesses line of business.
Accessing the right forms for your clients is easy. Below are commonly used forms for the large businesses line of business.