Kavi Marketplace has designed a website to provide you with the latest announcements and the ability to view, print and download information about the employee benefit plans available to qualified groups.


FORMS LIBRARY

This section will allow you to access forms including Enrollment Forms, Claim Forms, Administrative Forms, and other forms.
Please choose a year or industry below to find information for various Trust Forms.

If you have any questions, please contact the Trust Program Manager, Nathan Edmondson at 206-602-3558 or Nathan.Edmondson@advprofessionals.com.


 

Enrollment Forms & Other Forms


2020 Kavi - Enrollment Forms  
  Kavi Marketplace Enrollment Form Regence / Asuris
  Kavi Marketplace Census Enrollment Form Download
  [AP-Standardized] Life Beneficiary Enrollment Census Form Download
  Sound Benefit Administrators COBRA Application Download


Other forms  
  Affidavit of Qualifying Domestic Partnership Regence / Asuris
  Electronic Funds Transfer Authorization Agreement Download
  Health Equity Integration Form Download
  Late Submission Form Download

2019 Kavi - Enrollment Forms  
  Kavi Marketplace Enrollment Form Regence / Asuris
  Kavi Marketplace Census Enrollment Form Download
  Sound Benefit Administrators COBRA Application Download


Other forms  
  Electronic Funds Transfer Authorization Agreement Download
  Health Equity Integration Download
  Late Submission Form Download

2018 Kavi - Enrollment Forms  
  Kavi Marketplace Enrollment Form Regence / Asuris
  Kavi Marketplace Census Enrollment Form Download
  Sound Benefit Administrators COBRA Application Download


Other forms  
  Electronic Funds Transfer Authorization Agreement Download
  Health Equity Integration Download


Insurance Carrier Forms


Medical




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Dental




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Life




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Vision




Reimbursement Form




 

 

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