Kaiser Permanente Bridge Program

To be eligible for the Kaiser Permanente Bridge Program, you must be a Georgia State University Undergraduate or Graduate student, currently enrolled in one of the following programs:

  • Nursing (accepted into the nursing program, not pre-nursing students)
  • Nutrition (accepted into the program, not pre-nutrition students)
  • Respiratory Therapy (accepted into the program, not pre-RT students)
  • Social Work (accepted into the School of Social Work, not pre-social work students)
  • Physical Therapy (accepted into the DPT program)

Requirements for eligibility include:

  • The Applicant must be a GSU student currently enrolled in one of the above programs
  • The Applicant and all applying dependents* must live in Kaiser Permanente’s metro Atlanta 28 county service area
  • The annual aggregate household income of the Applicant and all dependents must be less than the current income guidelines of 100% of the federal poverty guidelines (chart below)
  • The Applicant and all applying dependents cannot be eligible for or enrolled in any other type of health insurance program, including Medicaid, Medicare, PeachCare for Kids or employer-sponsored health care
  • Must be age 64 or under; single subscriber must be age 19 or above
  • No Applicant and/or applying dependent(s) shall have been previously enrolled in the Kaiser Permanente Bridge Program
  • Must be age 64 or under; single subscriber must be age 19 or above
  • Completion of an application and submission of required supporting documents
  • Signed Attestation/Verification Form with University designee’s signature (Contact Felisha Norrington at (404) 413-1000 or fnorrington@gsu.edu to schedule an appointment)*The Subscriber’s spouse and/or child dependent(s) up to the age of 26 (ending at the end of the month of the 26th birthday).

 

Family

Size*

Monthly Gross Income

Annual Gross Income

1

$973

$11,670

2

$1,311

$15,730

3

$1,649

$19,790

4

$1,988

$23,850

5

$2,326

$27,910

6

$2,664

$31,970

 

Please follow these steps to learn more and/or to apply for the program:

  1. Review the attached Kaiser Permanente Bridge Program flyer
  2. Complete the attached Kaiser Permanente for Individuals & Families (KPIF) Application AND the Community Benefit Subsidy Application
  3. Print the attached Verification Form
  4. Have the authorized Georgia State University staff member sign your Verification Form
  5. Include all supporting documentation requested on the attached check list with your applications
  6. Mail the completed KPIF Application, Community Benefit Subsidy Application and all supporting documentation to:

    Charitable Health Coverage Operations
    Kaiser Permanente
    PO Box 24670
    Oakland, CA  94623-1670

Please be patient and allow time for your application to be processed.  If you have questions/issues, contact CHCO at 1-888-387-0180.

Kaiser Permanente Bridge Program Flyer

Kaiser Permanente Bridge Program Brochure

KPIF Application: KP GA Gold 0/20 plan

Community Benefit Subsidy Application

Checklist

Verification Form

Affidavit of Domestic Partnership

Declaration of Zero Income

If you have any questions about the program or the application process, direct all queries to Jill George at Kaiser Permanente Bridge Program (404) 364-3811 or bridge@kp.org.

 

 
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