Login to an Existing Application
To finish an online Individual and Family application you previously started, click Login.
To apply by fax, email, or mail, click below:
Small Group Eligibility
Small businesses with at least 2 people on some type of group insurance qualify. Self-employed and Husband-wife businesses often qualify. Call 1-877-752-4731 option 3 or click small group health insurance for more details.
Large Group Health Insurance (51+ employees)
Notes Regarding Additional Enrollment Forms: Businesses with 51 or more employees looking to apply will need to first complete a large group quote request form and submit census data. If you are looking for a Kaiser Permanente job application, click here for general information.