Who’s Attending – Evergreen High School

First Name	Maiden Name	Last Name	Email	Address	Address 2	City	State	Zip Code	Country	Phone
Dayvid	Dayvid Dishler	Dishler	qasabt@gmail.com	1933 N ROSE ST	1933 N ROSE ST	Porterville	CA	93257	US	+15058590920
Melvinia	Melvinia Mochalov	Mochalov	socalgecko@gmail.com	1148 Main St	1148 Main St	Wartburg	TN	37887	US	+17302186928
Allizon	Allizon Sandvoss	Sandvoss	allatrien@gmx.de	535 Summer Ave	535 Summer Ave	Newark	NJ	07104	US	+15059912742
Colter	Colter Chickaway	Chickaway	mwshells77@gmail.com	1200 E WOODHURST DR	1200 E WOODHURST DR	Springfield	MO	65804	US	+17322517183
Liesje	Liesje Guenet	Guenet	o.zenge@gmx.de	2651 Snowberry Ln	2651 Snowberry Ln	Lima	OH	45806	US	+15058564893
Corrinna	Corrinna Echarte	Echarte	death2bone@web.de	39 Brookhollow Cv	39 Brookhollow Cv	Jackson	TN	38305	US	+15056442781
Shayenne	Shayenne Maria Lucrecia	Maria Lucrecia	ruth.clark@greenspuncorp.com	609 NORTH AVE	609 NORTH AVE	Westside	IA	51467	US	+15056485262
Shuraim	Shuraim Abrahao Martin	Abrahao Martin	mmyers10@gmail.com	4701 E ABRAHAM LN	4701 E ABRAHAM LN	Phoenix	AZ	85050	US	+15058740552
Charo	Charo Tirados	Tirados	danigasparini@comcast.net	7007 Pine Hollow Dr	7007 Pine Hollow Dr	Mount Dora	FL	32757	US	+15056547143
Elisjah	Elisjah Teasdale	Teasdale	martin.h@hrmtcpas.com	11395 N Flying Bird Dr	11395 N Flying Bird Dr	Tucson	AZ	85737	US	+16412189130
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<p style="text-align: center;"><strong>ENROLLMENT / WAIVER FORMS:</strong></p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong><span style="font-size: 12pt;">Kaiser Medical/Dental <br />Enrollment/Change Form</span></strong><br /><a href="https://thequintanagroup.sharefile.com/d-s5fdc698935b44512b4d3158b0891ad01" target="_blank" data-link="webAddress" rel="noopener">English</a> &nbsp;-&nbsp; Espa&ntilde;ol</p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong>Kaiser Waiver of Coverage</strong><br />English&nbsp; -&nbsp; Espa&ntilde;ol&nbsp;<span style="background-color: #f1c40f;"></span></p>
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<p style="text-align: center;"><strong>PLAN INFORMATION:<br /></strong></p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong>Welcome to Kaiser Permanente</strong><br /><a href="https://healthy.kaiserpermanente.org/oregon-washington/new-members/?kp_shortcut_referrer=kp.org/newmember#register-to-kp-org" target="_blank" rel="noopener">English</a>&nbsp; - &nbsp;<a href="https://espanol.kaiserpermanente.org/es/oregon-washington/new-members#register-to-kp-org" target="_blank" rel="noopener">Espa&ntilde;ol</a>&nbsp;</p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong>How to Use Your HMO Medical Plan</strong><br /><a href="https://thequintanagroup.sharefile.com/d-sc7a62502f7174cb38086f133aadcc4d4" target="_blank" data-link="webAddress" rel="noopener">English</a> &nbsp;- &nbsp;Espa&ntilde;ol</p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong><span style="font-size: 12pt;">Base Plan:&nbsp; $2,000 Deductible</span></strong><span style="font-size: 12pt;"><br /><a href="https://thequintanagroup.sharefile.com/d-s3e3cd49fd9554f958a6571a3a06f5078" target="_blank" data-link="webAddress" rel="noopener">Summary</a> - </span><span style="font-size: 12pt;">&nbsp;<a href="https://thequintanagroup.sharefile.com/d-s13af5845ea304d57af44c03adc73cc87" target="_blank" data-link="webAddress" rel="noopener">SBC</a></span></p>
<p>&nbsp;</p>
<p style="text-align: center;"><span style="font-size: 12pt;"><strong>Buy-Up Plan:&nbsp; $1,000 Deductible</strong><br /></span><span style="font-size: 12pt;"><a href="https://thequintanagroup.sharefile.com/d-s512b692c2424427398fc0e6b902ca48b" target="_blank" data-link="webAddress" rel="noopener">Summary</a> &nbsp;- </span><span style="font-size: 12pt;">&nbsp;<a href="https://thequintanagroup.sharefile.com/d-s4475a1ddb5d649dba46261b5a5922df7" target="_blank" data-link="webAddress" rel="noopener">SBC</a></span></p>
<p>&nbsp;</p>
<p style="text-align: center;"><span style="font-size: 12pt;"><strong>HMO Dental $2,000 Benefit</strong></span></p>
<p style="text-align: center;"><span style="font-size: 12pt;">(Kaiser Providers)</span></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-sf112f7db6edf4a4f99b8df4a5faa1f79" target="_blank" data-link="webAddress" rel="noopener">About Your HMO Dental Plan</a></p>
<p style="text-align: center;"><span style="font-size: 12pt;">HMO Dental - <a href="https://thequintanagroup.sharefile.com/d-sfd32659b6ebc4b6ea6f61126ac44f412" target="_blank" data-link="webAddress" rel="noopener">Summary</a></span></p>
<p>&nbsp;</p>
<p style="text-align: center;"><span style="font-size: 12pt;"><strong>PPO Dental $2,000 Benefit</strong></span></p>
<p style="text-align: center;"><span style="font-size: 12pt;">(Kaiser and Dental Choice PPO Providers)</span></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-saed4457ca78e4e3c922064ee4b623dc4" target="_blank" data-link="webAddress" rel="noopener">About Your PPO Dental Plan</a></p>
<p style="text-align: center;"><span style="font-size: 12pt;">PPO Dental&nbsp; - &nbsp;<a href="https://thequintanagroup.sharefile.com/d-s816cf12e278043419e0b6836efb38873" target="_blank" data-link="webAddress" rel="noopener">Summary</a></span></p>
<p>&nbsp;</p>
<p style="text-align: center;"><span style="font-size: 12pt;"><strong>Out-of-Area Medical Plan<br /></strong><span style="color: #000000;">(For Members Working/Residing <br />Outside of </span><span style="color: #000000;">the Kaiser Service Area)</span><strong><br /></strong></span></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-se85b9532f2ba46a984283e38a03703c0" target="_blank" data-link="webAddress" rel="noopener">How to Use Your Out-of-Area Plan</a></p>
<p style="text-align: center;"><span style="font-size: 12pt;"><a href="https://thequintanagroup.sharefile.com/d-sbd59e046fb6a4206a124722fc12b925c" target="_blank" data-link="webAddress" rel="noopener">Summary</a> &nbsp;- &nbsp;<a href="https://thequintanagroup.sharefile.com/d-s4751980af533411b847964b34242ab30" target="_blank" data-link="webAddress" rel="noopener">SBC</a></span></p>
<p>&nbsp;</p>
<p style="text-align: center;"><span style="font-size: 12pt;"><strong>Medicare Senior Advantage</strong> - <a href="https://thequintanagroup.sharefile.com/d-s212f36583bff49898409e37be0c59507" target="_blank" data-link="webAddress" rel="noopener">Summary</a></span><span style="font-size: 12pt;"><br /></span><span style="color: #2880b9;"></span></p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p style="text-align: center;"><span style="font-size: 12pt;"></span></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-s06393bb6c52c480c9fcce9b17ec548e0" target="_blank" data-link="webAddress" rel="noopener">Summary of Plan Changes for 2022-2023</a></p>
<p>&nbsp;</p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-s181b0ce9597f497e961e51f47d24da80" target="_blank" data-link="webAddress" rel="noopener">Non-Discrimination Notice</a></p>
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<p style="text-align: center;"><strong>ADDITIONAL RESOURCES:</strong></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/get-care" title="Get Care" target="_blank" rel="noopener">Ways to Get Care</a></p>
<p style="text-align: center;"><a href="https://thrive.kaiserpermanente.org/care-near-oregon-southwest-washington/community/telehealth-video-phone-visit?kp_shortcut_referrer=kp.org/telehealth/nw" target="_blank" rel="noopener">Video and Phone Visits</a></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/pages/mobile-app" target="_blank" rel="noopener">Kaiser Mobile App</a></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/health-wellness/drug-formulary" target="_blank" rel="noopener">Kaiser Drug Formulary</a>&nbsp;</p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-s9def0d6a40c64974ba16a709060889a8" target="_blank" data-link="webAddress" rel="noopener">Using Alternative Care</a></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-scee8eb65766442919edd2bb9e1ef23ff" target="_blank" data-link="webAddress" rel="noopener">Using Vision Care</a></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/health-wellness/mental-health/tools-resources/digital" title="Wellness Apps" target="_blank" rel="noopener">Calm &amp; myStrength Apps - Free!</a></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/health-wellness/fitness-deals" target="_blank" rel="noopener">ClassPass - On Demand - Free!</a></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/health-wellness" title="Resources" target="_blank" rel="noopener">Additional Member Resources</a></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-s1923ec15dc66415094536d4e3c59aea8" target="_blank" data-link="webAddress" rel="noopener">Paying for Care</a></p>
<p style="text-align: center;"><a href="https://healthy.kaiserpermanente.org/oregon-washington/support/estimating-your-costs?kp_shortcut_referrer=kp.org/treatmentestimates" target="_blank" rel="noopener">Estimate Your Treatment Costs</a></p>
<p style="text-align: center;"><a href="https://about.kaiserpermanente.org/community-health/about-community-health/medical-financial-assistance-program?kp_shortcut_referrer=kp.org/mfa" target="_blank" rel="noopener">Kaiser Medical Financial Assistance Program</a></p>
<p style="text-align: center;">Getting Care Away From Home:<br /><a href="https://healthy.kaiserpermanente.org/oregon-washington/get-care/traveling?kp_shortcut_referrer=kp.org/travel" title="Care Away From Home - Eng" target="_blank" rel="noopener">English</a>&nbsp; - <span>&nbsp;</span><a href="https://espanol.kaiserpermanente.org/es/oregon-washington/get-care/traveling?kp_shortcut_referrer=kp.org/travel" title="Care Away From Home - sp" target="_blank" rel="noopener">Espa&ntilde;ol</a></p>
<p style="text-align: center;">&nbsp; &nbsp;</p>
<p style="text-align: center;"><strong>FREQUENTLY ASKED QUESTIONS</strong><br />- &nbsp;<a href="https://healthy.kaiserpermanente.org/oregon-washington/support" target="_blank" title="FAQs - Eng" rel="noopener">English</a></p>
<p style="text-align: center;"><span class="styling-2 -book"><strong>PREGUNTAS M&Aacute;S COMMUNES</strong><br /></span>-&nbsp; <a href="https://espanol.kaiserpermanente.org/es/oregon-washington/support" target="_blank" rel="noopener">Espa&ntilde;ol</a></p>
<p style="text-align: center;">&nbsp; &nbsp; &nbsp; &nbsp;</p>
<p style="text-align: center;"><strong><span style="background-color: #f1c40f;">MEMBER SERVICES<br /></span>1-800-813-2000<span style="background-color: #f1c40f;"><br /></span></strong></p>
<p style="text-align: center;"><strong><span style="background-color: #f1c40f;">SERVICIO AL CLIENTE<br /></span>1-800-324-8010</strong></p>
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<p style="text-align: center;"><strong>PLAN ADMINISTRATION:</strong></p>
<p style="text-align: center;"><a href="https://thequintanagroup.sharefile.com/d-s65a696853c254b9c9344299d9cf76dfd" target="_blank" rel="noopener">Kaiser Member Cancellation</a></p>
<p style="text-align: center;"><a href="https://account.kp.org/static/bcssp/pdfs/shared/nw/ever/KP_NW_LG_Administrative_Guide.pdf" target="_blank" rel="noopener">Kaiser Administrative Guide</a></p>
<p style="text-align: center;"><a href="https://account.kp.org/broker-employer/resources/employer?pfUrl=https://fam.kp.org/as/2JnII/resume/as/authorization.ping&amp;region=NW" target="_blank" rel="noopener">account.kp.org</a>&nbsp;<br /><a href="https://www.hr360.com/login/" target="_blank" rel="noopener">www.hr360.com</a></p>
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<p style="text-align: center;">Please protect your confidential data<br />by using this&nbsp;<span style="color: #e03e2d;"> <a href="https://thequintanagroup.sharefile.com/share/getinfo/r183bca69f7241e6b" target="_blank" data-link="webAddress" rel="noopener"></a><a style="color: #e03e2d;" href="https://thequintanagroup.sharefile.com/r-r183bca69f7241e6b">SECURE LINK</a><br /></span>when <span style="font-size: 1rem;">emailing documents with personal information.</span></p>
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<p style="text-align: center;">Is something missing?&nbsp; Not working?<br />Please let us know!&nbsp;&nbsp;<br /><span style="color: #3598db;"><a style="color: #3598db;" title="email" href="mailto:mail@thequintanagroup.com" target="_blank" rel="noopener">Send us a Note!</a></span></p>
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<p style="text-align: center;">Your Agent:<br />Donna Quintana<br />The Quintana Group<br />503-699-7770<br /><span style="color: #3598db;"><a href="mailto:donna@thequintanagroup.com?cc=mail@thequintanagroup.com&amp;subject=" target="undefined" data-link="emailAddress" style="color: #3598db;">donna@thequintanagroup.com</a></span></p>
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<p>&nbsp;</p>
<p><strong>NOTE:&nbsp;</strong> Although your group contract renews November 1st each year, your personal deductible and out-of-pocket maximum accumulate on a calendar year basis.</p>
<p>&nbsp;</p>
<p>Deductible and out-of-pocket maximum accumulations from January 1, 2022 through November 1, 2022 will be credited to your plan through the end of December, 2022.</p>
<p>&nbsp;</p>
<p>Your deductible and out-of-pocket maximum reset each January 1st.</p>
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<p>This also applies to dental.</p>
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<h5 style="text-align: center;">Want to Learn More?</h5>
<p style="text-align: center;"><strong>Talk to a Kaiser Permanente enrollment specialist</strong></p>
<p style="text-align: center;">about specialty care, extra features and more.&nbsp;</p>
<p style="text-align: center;">Call <strong>1-800-514-0985</strong> Monday through Friday, 7am to 6pm.</p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong>Kaiser New Member Welcome Desk<br /></strong>1-888-491-1124</p>
<p>&nbsp;</p>
<p style="text-align: center;"><strong>Kaiser New Member Pharmacy Services<br /></strong>1-888-572-7231</p>
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