Online Document Delivery Agreement (agreement to go paperless).

Thank you for choosing to receive your Enrollment/Coverage information online. Enrollment/Coverage includes the following list of documents:

• Acknowledge Medicare Plan Change
• Acknowledge Request to Decline Part D
• Address Change Confirmation
• Advantage Plus Denial - Not Eligible
• Advantage Plus Enrollment Confirmation
• Automatic Enrollment (AME) Group Member - Acknowledge Enrollment Opt-out
• Automatic Enrollment (AME) Group Member - Enrollment Opt-out Denied
• Automatic Enrollment (AME) Group Member - Passive Enrollment Kit
• Annual Creditable Coverage Notice
• Annual Low Income Subsidy Determination Letter
• Annual Non Creditable Coverage Notice
• Certificate of Creditable Coverage
• Close out Request for Medicare Reinstatement
• CMS Enrollment Cancellation Confirmation
• CMS Reject Letter-Need SSA Correction
• COBRA Rates
• COBRA/CAL-COBRA – Denied
• Combined Accounts Confirmation
• Correction of Erroneous Death
• Correction of Erroneous Part A and/or B Termination
• Coverage Reinstated
• Dental Product Added
• Dental Product Dropped
• Dental Product Not Eligible
• Dental Product Request Denied
• Dependent Other Coverage
• Determination of LIS Eligibility
• Determination of LIS Ineligibility
• Dual Coverage
• Effective Date Change Request Denied
• Effective Date Changed
• Enrollment Submitted Outside Eligibility Period
• FEHB Annual Part D Notice
• Group Open Enrollment for Current Year Effective Date
• Group Member Cancelled in Error - Apology
• Group Open Enrollment for Next Year Effective Date
• Health Insurance Portability Accountability Act (HIPAA) Authorization Letter
• Inform Member of Medicare Auto-Enrollment
• Inform Member of Medicare Facilitated Enrollment
• KPIF - Dual Coverage
• KPIF - Dual Coverage with Exchange
  
• KPIF - Reinstatement Letter
• Live / Work - Out of area allowed
• Medicare Acknowledge Enrollment Cancellation
• Medicare Acknowledge Reinstate After Canceling Enrollment in Another Plan
• Medicare Enroll Acknowledgement
• Medicare Enroll Confirmation
• Medicare Enrollment Status Change
• Medicare Plan Change Confirmation
• Member Inter Regional Transfer
• MRN Correction Letter
• Newborn - Welcome
• Newborn Enrollment Confirmation
• Out of Area Benefits
• Out of area member
• Plan Change Confirmation
• Plan Change – Denied
• Refer to Other KP Department
• Reinstate after Enrolled in Another Plan
• Removal of Part D Low Income Subsidy Periods
• Retroactive Enrollment/Reinstatement Acknowledgement
• Unable to Process Address Change (Out of Area)
• Welcome Back letter/Plan Change
• Welcome Letter

Viewing your Enrollment/Coverage documents online, instead of receiving printed materials by mail, is environmentally friendlier and secure.

Your preference selection tells us how you would like to receive your documents during our normal distribution process. Your preference to receive electronic documents online will be processed within 30 days of your request.

Your electronic Enrollment/Coverage documents will be posted in a format that you can easily open, view, and print using industry standard software at any time.

If you change your mind, you may come back to this site to update your preference at any time. Simply opt back in to the paper process by choosing "U.S Mail". Your preference will be processed within 30 days of your request.

If you would like to request a paper copy, have any questions about your Enrollment/Coverage, or need help with the online feature, please call Member Services.