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
    Email: Hi-Sales@kp.org
    Fax: 1-877-661-2747