KEHP Insurance and FSA Checklist for New Employees
Company Name: Northern Kentucky Health Department
Company Number: 90310
Company / Agency Representative: Karen Domaschko (karen.domaschko@nkyhealth.org or 859-344-5476)

The following is a list of your rights and responsibilities regarding enrollment in the Kentucky Employees’ Health Plan (KEHP). Please read all sections of this form carefully and make sure you understand each item.

Please direct questions about coverage to the Department of Employee Insurance (DEI) for Kentucky Employees Health Plan (KEHP) at 888-581-8834.

Please check each item as you read it then submit the form.
Sign in to Google to save your progress. Learn more
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Northern KY Health. Report Abuse