California employee application 2026

1. Click ‘Get Form’ to open the California Employee Application in our editor.
2. Begin by filling out the Subscriber Information section. Enter your last name, first name, middle initial, and Social Security number. Ensure all fields are completed to avoid processing delays.
3. In the Reason for Application section, select the appropriate checkbox that corresponds to your enrollment reason, such as 'New hire' or 'Open enrollment'. Provide any necessary dates where indicated.
4. Proceed to Section 1a for Health Plan Selection. Choose one health plan from the options provided by your employer. Make sure to review each plan's details before making a selection.
5. Continue to Section 1b for Specialty Benefits. Select any dental, vision, or life insurance plans offered by your employer that you wish to enroll in.
6. Complete Section 2a with your home address and contact information. This includes your email address which is required for paperless communications.
7. Finally, review all entered information for accuracy and sign at the end of the form before submitting it through our platform.

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