Click or touch a topic to navigate to the form or document you’re looking for.
- Affidavit of Current Marital Status
- Application for Reinstatement of Eligibility for Leave or Hours Reduction Related to COVID-19
- Working Spouse Affidavit
- Silver Spouse/Domestic Partner Eligibility for Health Care Coverage
- Application for Reinstatement of Eligibility
- Beneficiary Designation (Death Benefit)
- HRA Rx Option
- Notice of Creditable Coverage Part D To All Participants Except E Retirees
- Notice of Creditable Coverage for Plan E Retirees who are members of Kaiser Senior Advantage
- Notice of Non-Creditable Coverage for Plan E Retirees who are enrolled in the Indemnity PPO Medical Plan or UHC Medicare