---
title: BPJS Kesehatan Employee Enrollment Form Template for Indonesian Companies | Paperform
description: Complete BPJS Kesehatan enrollment form for Indonesian businesses with NIK validation, family member registration, and contribution class selection. Streamline mandatory health insurance compliance.
url: "https://paperform.co/templates/bpjs-kesehatan-employee-enrollment-form"
type: static
generatedAt: "2026-03-28T00:43:11.764Z"
---

[← Back to free form templates](/templates/)    ![BPJS Kesehatan Employee Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/bpjs-kesehatan-employee-enrollment-form.png)
    [Preview](https://_preview.paperform.co/ai-template/bpjs-kesehatan-employee-enrollment-form) [Use this template for free](/create?ai-template=bpjs-kesehatan-employee-enrollment-form)    [Human Resources Forms](/templates/category/hr/)[Legal & Compliance Forms](/templates/category/legal/) [Business](/templates/industry/business/)[Human Resources](/templates/industry/human-resources/) [Small Business Owner](/templates/role/small-business-owner/)[Office Manager](/templates/role/office-manager/)[HR Manager](/templates/role/hr-manager/)[Accountant](/templates/role/accountant/)     About this free form template
### Simplify BPJS Kesehatan Employee Enrollment for Indonesian Businesses

Managing employee health insurance registration in Indonesia requires careful attention to regulatory compliance and accurate data collection. This **BPJS Kesehatan Employee Enrollment Form** template helps Indonesian companies streamline the mandatory health insurance registration process for employees and their families, ensuring compliance with Indonesian social security regulations.

#### Built for Indonesian HR teams and small businesses

Whether you're an HR manager at a growing startup in Jakarta, a payroll specialist at a manufacturing company in Surabaya, or a business owner managing a small team in Bandung, this template handles the complete BPJS Kesehatan enrollment workflow. It captures essential information including NIK (Nomor Induk Kependudukan), employee details, family member information, and contribution class selection—all in one organized form.

The form is designed to work seamlessly with Indonesian identification systems and regulatory requirements, helping you avoid common errors in BPJS registration that can delay coverage or cause compliance issues.

#### Key features for compliance and efficiency

This template includes conditional logic to show family member sections only when needed, automatic calculation hints for contribution amounts, and structured fields that match BPJS Kesehatan's data requirements. The form validates NIK format, captures complete family details for dependent coverage, and allows employees to select their appropriate contribution class based on salary ranges.

**Integrate with Paperform's payment features** to collect monthly BPJS contributions directly through the form, or use **[Stepper](https://stepper.io)** to automatically send enrollment data to your HRIS system, notify payroll when deductions should begin, and trigger welcome emails with BPJS card information once registration is complete.

#### Secure, compliant, and ready to deploy

Built on Paperform's SOC 2 Type II certified platform, this form keeps sensitive employee data secure while remaining easy to customize for your company's specific needs. Embed it in your employee onboarding portal, share it via email during hiring, or use it as a standalone enrollment tool during open enrollment periods.

With Paperform's doc-style editor, you can easily adjust contribution classes, add your company branding, include custom instructions in Bahasa Indonesia, and modify the form as BPJS regulations evolve—all without technical skills.
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