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Our goal at KaiserInsuranceOnline.com is to secure for our clients the best possible coverage at the lowest possible rates. In order to accomplish this, we need somewhat specific information about your company and its employees. Please take the time to enter and submit the information requested below. We will immediately acknowledge your request and provide your quote to you as soon as possible, typically within three business days.
Please complete the following form. All fields are required.
 
Company Name
Your Name
Company Address
City
State

Zip
Business Type
Industry Type
Total # of Employees
Email
Phone
Fax
   
 
Proof of Business: Proof of business documentation must be for the company applying for coverage. ONE of the following are acceptable proofs of business.
  • 1065 Annual Income Tax Return
  • 1120 Annual Income Tax Return
  • 990 or 990 EZ Annual Income Tax Return
  • 941 Quarterly Wage and Tax
  • 940 Annual Wage and TAx
  • Tax Exempt Form
  • 1040 Individual Income Tax Return

Proof of Employment: ONE of the following are acceptable proofs of Employment

  • UITR Unemployment Insurance Tax Report
  • Payroll Records
  • Schedule K-1 (for each share holder)

 

 
 

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About Kaiser Permanente Insurance


CA Lic. #0512978
Authorized Broker for Kaiser Permanente®

This web site is owned and maintained by Gordon Paul, which is solely responsible for its content. This site is not maintained by or affiliated with Kaiser Permanente®, and Kaiser Permanente bears no responsibility for its content. The e-mail addresses and telephone numbers that appear throughout this site belong to Gordon Paul, and cannot be used to contact Kaiser Permanente. Gordon Paul is an authorized Agent for Kaiser Permanente and Kaiser Permanente Northwest.
"Kaiser," "Kaiser Permanente", "Kaiser Foundation Health Plan" and the Kaiser Permanente are registered trademarks or service marks of Kaiser foundation Health Plan Inc., in the United States.
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