Voluntary Corporate Application

Corporate Policyholder Application Form 2025

IMPORTANT NOTE: Please complete and sign this form. Kaelo will only accept applications received by a broker. Applications received after the 15th of the current month will only activate the 1st of the following month.

Dedicated Kaelo Gap email address: kaelogap@kaelo.co.za.

Dedicated Western Gap email address: western@kaelo.co.za.

Dedicated Connectgap email address: connectgap@kaelo.co.za.

Supporting Documents Required:
ID document of principal member
Medical scheme Certificate of Membership

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