The right choice for a healthier you.
To enroll for Kaiser Permanente health coverage, make changes, or determine eligibility, contact your benefits advisor/coordinator.
Want to enroll:
Fill out the application and email it to your administrator Gabriela Cisneros.
gCisneros@zenith-american.com
Phone Number: (626) 732-2616
Enrollment Applications English
Please note: If you are enrolling more than 2 dependents, please print out page 2 of the enrollment form, fill out the additional dependent and submit along with the rest of the completed enrollment form.
Enrollment Application Spanish
Nota: Si estas inscribiendo/aumentando mas de 2 dependientes, favor de imprimir la pagina #2 de la forma de inscripcion, agrega tus dependientes restantes y mandalas con el resto the la aplicacion.
HIPAA Authorization or Disclosure of Patient Health Information
HIPAA Autorizacion or Divulgacion de Information Medica del Paciente
