Individual and Family

• Plan Information and Forms

  Virtual Plus Service Area Map (PDF)

  2021 Account Change Form (PDF)

  2021 Producer Reference Guide for Individual and Family Plans (PDF)

  Virtual Plus Overview for Consumers (PDF)

  2021 Affidavit of Non-Tobacco Use (PDF)

  2021 Pediatric Dental Attestation (PDF)

  2021 KPIF Enrollment Application (PDF)

  2021 Proof of Qualifying Life Event Form (PDF)

  2021 Special Enrollment Guide (PDF)

  2021 Enrollment Guide (PDF)

  Individual & Family and Medicare Sales Contact Sheet (PDF)

  2021 Individual & Family Service Area Map (PDF)

Small Group

• Plan Information and Forms

  Virtual Plus Overview for Consumers (PDF)

  2021 Underwriting Guidelines (PDF)

  Virtual Plus Service Area Map (PDF)

  Open Enrollment Guide Elect PPO (PDF)

  Virtual Plus 2021 B2B Highlights (PDF)

  Access PPO FAQ (PDF)

  Open Enrollment Guide Access PPO Puget Sound Region (PDF)

  Open Enrollment Guide Core Puget Sound Region (PDF)

  Quote Request Form (PDF)

  Combo notice of declining coverage and waiver form (PDF)

  Health Plans for Small Business (PDF)

  Small Group Rating Areas (PDF)

  Elect PPO FAQ (PDF)

  Elect PPO service area map (PDF)

  Group Master Application (PDF)

  Employee Enrollment and Change Form (PDF)

  Deductible & Out of Pocket Crediting Form (PDF)

  Disclosure Document (PDF)

  Small Group Census Template (XLS)

  Compare Your Options Plan Brochure (PDF)

Large Group

• Plan Information and Forms

  Summit PPO B2C Benefit Summary (PDF)

  Summit PPO B2B Plans (PDF)

  Service Area Map – Summit PPO (PDF)

  Virtual Plus Service Area Map (PDF)

  Virtual Plus Overview for Consumers (PDF)

  Virtual Plus Highlights for Large Groups (PDF)

  Health360 B2C Benefit Summary (PDF)

  Health360 B2B Slide Deck (PDF)

  Health360 B2B Sales Sheet (PDF)

  Employee Enrollment and Change Form (PDF)

  Getting Care with Access PPO Spokane Plans (PDF)

  Getting Care with Access PPO Plans (PDF)

  Getting Care with Access PPO Puget Sound Plans (PDF)

  HMO HealthPays HSA Benefits Grid (PDF)

  Access PPO Upfront Benefits Summary (PDF)

  Access PPO Basic Upfront (PDF)

Medicare Advantage

• Plan Information and Forms

  2021 Plans and Benefits Spokane (PDF)

  2021 Plans and Benefits North (PDF)

  2021 Plans and Benefits Puget Sound (PDF)

  Scope of Appointment Form (PDF)

  Star Rating Flyer (PDF)

  Summary of Benefits Basic (HMO) (PDF)

  KPIF and Medicare Sales Contact Sheet (PDF)

  Enrollment Form (PDF)

  Summary of Benefits Anchor (HMO) (PDF)

  Plan Summary Worksheet (PDF)

  2021 Pre-enrollment kit baseline cover letter (PDF)

  Medicare Advantage HMO Optional Dental Benefits (PDF)

  Service Area Map (PDF)

  Summary of Benefits Vital, Essential, Optimal (HMO) (PDF)

  Summary of Benefits Harbor (HMO) (PDF)

  Summary of Benefits Centennial and Columbia (HMO) (PDF)

  Summary of Benefits Key (HMO) (PDF)

  Silver&Fit Flyer (PDF)