Kaiser Spotlight: New Plans, New Underwriting Guidelines, and Important Reminders
Kaiser Permanente has announced several recent updates affecting California Small Group plans, along with a few important reminders to keep in mind.
NEW: Startup Payroll Documentation Requirement
Effective June 1, 2026, new California startup groups with 5 or fewer enrolling will require at least two consecutive weeks of payroll records prior to enrollment. W-4 forms and paystubs will no longer be access.
Document Requirement Updates for Groups with 1-5 Enrolling
Effective January 1, 2026, new enrolling groups with 1-5 enrolling will need to provide the following documentation:
- DE-9C or equivalent payroll report for startups
- Waivers (if applicable)
- Business-entity verification
Employer Recertification Beginning with May 2026 Renewals
Kaiser Permanente announced they are relaunching their small group recertification process beginning with May 2026 renewal dates. This process helps confirm continued eligibility and supports a smoother renewal process.
More information can be found on the Kaiser Permanente Forms and Documents page under the Employer Recertification. Below is a copy of the information from the Employer Recertification section of that page:
Employer Recertification
Small business recertification is required annually to confirm that your business still meets the criteria of a small business as defined by the state of California and still qualifies for small business coverage with us.
Recertification booklet
Reference this booklet to review the recertification process, get answers to frequently asked questions, a summary of your appeal rights, and a checklist of documents required to submit.
Documents required for recertification
To ensure your recertification is processed quickly and accurately, please submit the following documents along with a copy of your current business license.
- Current DE 9C: The DE 9C form is the quarterly wage and withholding report for California employers and is used to report wage and payroll tax withholding information for each employee. Please note each employee’s health coverage status next to their name as shown in this Sample DE 9C.
- Employer’s Confirmation of Workers’ Compensation
Complete this form, if requested, to confirm that you have workers’ compensation coverage for all eligible employees in your small business. If requested, this form will be provided by a Kaiser Permanente representative.
If you have additional questions, please call the Recertification Team at 877-490-4983.
Email the required recertification documents to recert@kp.org.
Rates
As a reminder, Kaiser Permanente only changes rates once a year, so their January 2026 rates will be the same for the entire year (you could quote your December 2026 renewals today if you wanted).
Participation
- Groups with 1-19 eligible employees must have at least 1 enrolling.
- Groups with 20-50 eligible employees must have at least 3 enrolling.
- Groups with 51-100 eligible employees must have at least 5 enrolling.
KP Plus Plan Design
Kaiser Permanente introduced their KP Plus plan design to the California Small Group market effective January 1, 2026. KP Plus helps attract customers and members who wouldn't ordinarily consider Kaiser Permanente. These plans are unique because members get access to top-rated care from Kaiser Permanente and affiliated providers, plus the flexibility to get care from out-of-network providers a set number of times each year.
Each year, members receive:
- 10 out-of-network office visits and outpatient medical services (combined)
- 5 out-of-network prescription fills or refills
KP Plus offers affordability and flexibility:
- Lower monthly rates and out-of-pocket costs when compared to typical PPO and point-of-service (POS) plans
- Freedom to select an in-network or out-of-network provider for care as needed
There will be two new KP Plus plans:
- Platinum 90 0/10 PCP KP Plus + Child Dental Alt
- Gold 80 250/35 PCP KP Plus + Child Dental Alt
Please note: these new KP Plus plans are labeled as "HMO" plans in bpQuote since they only have some out-of-network benefits.
If you have any questions or would like help with a Kaiser quote or renewal, please contact a member of your B&P Sales Team – (888) 722-3373.