While this feature remains active right now, we will be requiring these changes be processed through the Group Dashboard in the near future.

We invite you to access the Group Dashboard now to become familiar with the process.

Eligibility Change Form

Please complete and submit the appropriate elements for eligibility change.

General Information

* All fields are required

If you need assistance with your KCLGB ID# or do not know your ID#, please call 877-266-6767 (producers enter ext. 8200, employers enter ext. 8302)

Employee Information

* All fields are required
Select Eligibility Change Type: