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For Insurance Purposes: |
KPS was established in Bremerton, Washington, in 1946. KPS offers Preferred Provider Organization (PPO) plans that provide healthcare coverage to individuals and
families in Clallam, Clark, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum and Whatcom Counties.
They offer two health plan options for individual enrollees. Both plans are PPO plans which do not require the use of a primary care provider nor referrals in order to see specialist. The Sound Harbor Classic is a comprehensive plan covering vision, preventive care, maternity care and prescription drugs. The Sound Harbor Essential is a catastrophic plan with deductibles ranging from $1500 to $5000. Rates for subscriber and spouse are based upon the age of the subscriber.
Benefit Summaries
Rates
Providers
Kitsap, Mason, Jefferson, and Clallam Counties KPS Network
Washington, Alaska, Montana, and Idaho: Use the First Choice Health Network.
Nationwide: Use MultiPlan providers.
Oregon and Southwest Washington: To allow you more flexibility, KPS has expanded their provider networks! You now have the option to use the Providence Network.
Enrollment
Eligibility
Coverage for individuals and families (except those eligible for Medicare) is available to enrollees
who live in King, Kitsap, Mason, Jefferson, Clallam, Thurston, Grays Harbor, and Pierce Counties. Eligible family members include you, your spouse, and unmarried children under age 23 who are
primarily dependent on you for support.
Need Help? 206.448.7878 or 800.987.8199
Enrollment Forms & Instructions
Completed enrollment materials must be received in our office on or before 20th of the month to be effective on the first of the following month (e.g.,
June 20th for July 1st effective date).
- Complete the KPS Individual Enrollment Application. Be sure to include proof of residency
information as requested. Only one application is necessary per family and we recommend that you complete the SurePay electronic funds transfer form to ensure that premium
payments are not missed by accident.
- Complete the Standard Health Questionnaire. A separate questionnaire must be completed
for each enrolling family member unless:
- COBRA: The applicant has exhausted all COBRA or other continuation coverage. A copy of a HIPAA Certificate from the prior carrier is required.
- PROVIDER CANCELLATION: The applicant’s provider has left his or her prior plan’s network and is in this plan’s network.
- RELOCATION: The applicant has relocated within Washington State and the applicant’s prior plan is not available in the applicant’s new location.
- An individual losing group coverage through their employer and is not eligible for COBRA does not have to complete the Standard Health Questionnaire if they’ve had 24 months of uninterrupted active group coverage and apply within 90 days of specific qualifying events. (After June 10, 2004)
- An individual losing coverage due to the cancellation of their group conversion plan
does not have to complete a Standard Health Questionnaire. (After June 10, 2004)
The applicant must apply within 90 days of relocation, provider cancellation, or exhaustion of COBRA in order to have the Standard Health Questionnaire requirement waived.
- KPS requires a check payable to KPS be submitted with enrollment materials.
- Submit your Enrollment Application, Standard Health Questionnaire, Check for the first month’s Premium and Proof of Residency to:
R. L. Evans Company, Inc. Your Enrollment Application and Standard Health Questionnaire must include an original signature (faxed copy is
not acceptable).
600 Stewart St., Suite 1210
Seattle, WA 98101
Please note: In some situations, not all family members will qualify for coverage through the health insurance carrier based on the Standard Health Questionnaire. If an applicant or any family member does not qualify for coverage from the health insurance carrier, within 15 business days they will be provided with information on how to apply for coverage through WSHIP (Washington State Health Insurance Pool). Those family members who do qualify may still obtain coverage through the carriers they applied to.
Need Help? 206.448.7878 or 800.987.8199
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Plaza 600 Building : 600 Stewart Street : Suite 1210 : Seattle, WA 98101
Telephone 206.448.7878 : Facsimile 206.448.3589
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