01. Edit your kaiser disabled dependent online
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Disabled dependent enrollment 2026
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02. Sign it in a few clicks
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Send disabled dependent enrollment application via email, link, or fax. You can also download it, export it or print it out.
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- Click ‘Get Form’ to open the Disabled Dependent Enrollment Application in the editor.
- Begin with Part A, where you will input your personal information as the subscriber. Fill in your last name, first name, address, and contact details accurately.
- Next, provide details about your dependent. Include their name, social security number, and medical record number. Ensure all fields are completed to avoid delays.
- In Section IV of Part A, answer the questionnaire regarding your dependent’s financial support and living situation. Be honest and thorough in your responses.
- Attach necessary documentation such as proof of monthly living expenses and a copy of the first page of your most recent tax return that lists your dependent.
- Once all sections are filled out and documents attached, review everything for accuracy before submitting via mail or fax using our platform's features.
Start filling out your Disabled Dependent Enrollment Application today for free using our platform!
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Related links
Step 1: During Open Enrollment, update the individuals dependent details in the benefits portal, mybenefits.pepperdine.edu, to reflect disabled child.
Sep 3, 2025 If you and your dependents meet the requirements here, you may be eligible for higher disability compensation, pension, or DIC payments.
(if you have a disabled dependent, please call us at (855) 672-2784 to request a disabled dependent form, or visit hioscar.com/forms). If you would like to