Forms Directory
See below for a general list of forms that can be downloaded or printed. Please use the search bar or filter buttons to find a specific form. (Some forms may only be found behind your secure participant login.)
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Blue Shield UEBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
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CA State Disability Insurance Form (EDD)
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Death Beneficiary Designation Change Form
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Dismemberment and Loss of Sight Form
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Domestic Partner Declaration of Dependency for Tax Purposes
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Elixir Designation of Personal Representative (English)
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Elixir Designation of Personal Representative (Spanish)
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Federal Tax Withholding Form (W-4P)
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2024 Kaiser HIPAA Authorization Form
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Kaiser/Kaiser Dual Reimbursement Form
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Kaiser Medicare Enrollment Packet
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Kaiser Medicare Senior Advantage Disenrollment Form