Enrollment Kit

These materials are available in English and Spanish and can be used to enroll clients or email them directly. Each kit includes the following:

• Freedom, Signature, Core Plan Guide (ENG | SPA)
• 2025 Benefit Features Chart with Kelsey-Seybold Clinic Map (ENG | SPA)
• Important Numbers to Contact (ENG | SPA)
• Top Utilized Medications (ENG | SPA)
• CMS Star Rating (ENG | SPA)
• Summary of Benefits (ENG | SPA)
• Scope of Appointment (ENG | SPA)
• Application and Multi Language Insert
• Optional OSB Dental Application (for those on Core plan)

If using these forms, please print them and ensure your clients sign them before submission back to KelseyCare Advantage.

Looking for a paper enrollment kit?

Please speak to your Broker Manager.