Thank you for your interest in our HIPAA (Health Insurance Portability & Accountability Act) and Open Enrollment Plans. We know choosing a health care plan is an important, and sometimes confusing, decision for you and your family.  We’ve outlined the steps for you to take to apply for coverage and the key differences between the HIPAA and Open Enrollment plans in an effort to assist you in making the best choice for your health care needs.  This Web site contains information on coverage and rates available to individuals who are either Federally Eligible (HIPAA) or non-Federally Eligible (Open Enrollment).

Rates, Benefits, and Eligibility
The rates vary based on which plan you choose and how many members are enrolled  The following chart outlines the key differences between eligibility and waiting periods for both options.

Key Differences

HIPAA

Open Enrollment

Must be a Federally Eligible Individual

Cannot be a Federally Eligible Individual

Submit a Certificate of Creditable Coverage with your application

No certificate needed

Must have 18 months of creditable coverage

Not required to have previous creditable coverage

Coverage becomes effective the first of the month after receipt of your application

Coverage becomes effective 90 days after receipt of your application.

No wait period on benefits

One year wait period on transplants

No enrollment quota or waiting list

Enrollment quota applies.  Waiting list becomes effective after quota has been met.*

No eligibility restriction based on confinement to a health care facility due to a chronic illness or permanent injury.

Eligibility restriction based on confinement to a health care facility due to chronic illness or permanent injury.

*At the time of print, Kaiser Permanente of Ohio does not have a waiting list in effect for Open Enrollment.  You will be notified by Health Plan if the quota has been met and will automatically be placed on the waiting list in the order in which you applied.

Steps to apply for a HIPAA or Open Enrollment plan:

  1. Read the Key Differences in the chart above
  2. Read the Information on Eligibility sections for both HIPAA and Open Enrollment
  3. Determine if you are a Federally Eligible Individual or non-Federally Eligible Individual so you know which plan to apply for
  4. Complete the enrollment application/questionnaire answering all questions for both HIPAA and Open Enrollment, sign and date – be sure to choose a plan, Basic or Standard
  5. Print and return the application with your first month’s premium.  Include your credit card information or a check made payable to: Kaiser Permanente.
  6. We will notify you by mail of your acceptance and effective date.

Kaiser Permanente
Attn: Individual Membership Program
1001 Lakeside Avenue, Suite 1200
Cleveland, OH 44114

Downloadable PDF Documents

  1. HIPAA and Open Enrollment Plans
  2. Enrollment Eligibility
  3. Benefits and Services
  4. Rates
  5. Application
  6. Provider Directory
  7. 2012 HIPAA Basic Plan Evidence of Coverage
  8. 2012 HIPAA Standard Plan Evidence of Coverage
  9. 2012 Open Enrollment Basic Plan Evidence of Coverage
  10. 2012 Open Enrollment Standard Plan Evidence of Coverage

If you have questions, please contact:
Associate Account Manager
Monday - Friday, 8:15 a.m. to 5:00 p.m. (EST)
1-800-524-7371, ext. 5613
Email: OH-IND-OE@kp.org

This site requires Adobe Acrobat reader.
Please click here to download if you do not have this program.

KPOH-126367789

#91039