Kaiser employee transfer request 2026

1. Click ‘Get Form’ to open the Kaiser Employee Transfer Request in the editor.
2. Begin by entering the 'Today’s date' and 'Purchaser name' in the designated fields. Ensure accuracy as this information is crucial for processing your request.
3. Fill in the 'Purchaser/enrollment unit number' and 'Billing contact name'. If there are any changes, check the box indicating that billing contact information is new.
4. Provide your contact details including telephone number, email address (optional), and fax number. This ensures you can be reached for any follow-up regarding your request.
5. In the 'Termination or transfer requests' section, enter the subscriber's name, medical record number, and Social Security number. Select whether it’s a termination or transfer and provide an effective date along with a reason code from the provided list.
6. If applicable, indicate the new enrollment unit for transfers only. Make sure to review all entries for completeness before submission.

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