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Kaiser Permanente fax number

(855) 355-5334

Enrollment & Eligibility (Small Business Services) - California Service Center

Used for: Enrollment applications and account changes; eligibility/plan-change submissions (faxed to 1-855-355-5334).

Fax destination details

Department
Enrollment & Eligibility (Small Business Services) - California Service Center
Purpose
Enrollment applications and account changes; eligibility/plan-change submissions (faxed to 1-855-355-5334).
Form
Account Change Form — Account Change Form
Address
Kaiser Permanente California Service Center: Northern California — P.O. Box 23219, San Diego, CA 92193-3219; Southern California — P.O. Box 23250, San Diego, CA 92193-3250

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Kaiser Permanente Account Change Form instructions: fill out Section A with member information, select the desired changes in Section B, and complete any relevant sections for added/terminated coverages; WA version includes guidance on open enrollment and special enrollment events.

Official form instructions are published as a downloadable file on the organization's website.

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