Our number one priority is to provide our customers with quality customer service and resources. 
Here you will find printable forms, search physician directories, and locate contact information.
 
Have questions? Would you like to speak to one of our representatives, please call us at:

	NEW GROUPS START HERE>   Downloadable Application Forms:  Download printable Employer and Employee health insurance applications. You may also request an application kit be mailed to you. Applications are Adobe Acrobat PDF documents and require free Acrobat Reader.  This form is in the PDF format. In order to print this form, you must have Adobe Acrobat Reader. This software is available for FREE from the Adobe Acrobat Web Site. Click the icon below and verify that your version of Acrobat Reader is the most current version available.
	For Current Clients  - Download Administration Forms Download printable Employee Application, Change Forms and more.   General Administration Forms Cobra Application Cobra Election Form Change of Dependent Status Declination of Coverage Form Domestic Partner Agreement Family Account Change Form Loss of Coverage Form Student Verification Form Termination and Transfer Form New Employee Enrollment Forms Employee Application - Plan 5 Employee Application - Plan 15 Employee Application - Plan 20 Employee Application - Plan 30
	Physician Network Directories: Looking for a doctor or hospital? Use the Provider Networks to locate a doctor near you. You may also find out if a particular physician or practitioner participates in the network you belong to.
	Member Services Get answers to health questions, request appointments, take a personal health assessment, and much more. All services are free to Kaiser Permanente members. Enter your Kaiser Medical #, choose your area, and click "Sign On" to get  these  special services, available only to Kaiser Permanente members.
	Contact Us: If for any reason you cannot find answers to your questions or concerns on our website, you may call our customer service department. You may reach us by email 24/7. A customer representative will respond within a 24 hour time period. We are dedicated to providing honest and hassle free health insurance at your convenience.

Rick Zane, Broker - 12056 Mt. Vernon Ave, Suite 181
Grand Terrace, CA 92313 - License No. 0B38031
1 (800)424-6208 - rzane@insurancehandbook.com