Annual Renewal Information

Renewal Information

If your child is currently enrolled in the Healthy Kids Gold or Silver program and this is the only program he/she is enrolled in, please use the following application for your yearly renewal of your child's health coverage: Renewal Application. La aplicacion de renovacion tambien se encuentra disponible en Español.

If your child is enrolled in any other programs such as food stamps or cash assistance, you must use a different form for your yearly renewal.

Renewal Forms

Renewal Application - English
This application is used to complete your annual renewal for Healthy Kids Gold or Healthy Kids Silver.

Aplicacion de renovacion - Español
Esta aplicacion es usada para completar su renovacion anual de Healthy Kids Gold o Healthy Kids Silver.

Employment Verification Form
This form can be filled out by an employer as a verification of wages earned.

Self Employment Form
This form can be used to report income if you are self employed.

Identification Form for Children Under 16
This form can be completed by your child’s school or day care to prove identity.  

*Note: Children 16 or older need to send a photo ID.