Apply for coverage

There are two ways you can apply for coverage:

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

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.

Forms

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.