Individual and Family

• Plan Information and Brochures

  2020 Individual & Family Service Area Map (PDF)

  Individual & Family and Medicare Sales Contact Sheet (PDF)

  2020 Enrollment Guide (PDF)

  2020 Special Enrollment Guide (PDF)

  2020 Producer Reference Guide for Individual and Family Plans (PDF)

• Forms

  2020 Proof of Qualifying Life Event Form (PDF)

  2020 KPIF Enrollment Application (PDF)

  2020 Pediatric Dental Attestation (PDF)

  2020 Affidavit of Non-Tobacco Use (PDF)

  2020 Account Change Form (PDF)

Small Group

• Plan Information and Brochures

  Plan Value Brochure for businesses headquartered in Puget Sound (PDF)

  Elect PPO service area map (PDF)

  Elect PPO FAQ (PDF)

  Small Group Rating Areas (PDF)

  Health Plans for Small Business (PDF)

  Plan Value Brochure for businesses headquartered in all other WA counties (PDF)

  Getting Care Core Guide (PDF)

  Getting Care Access PPO Guide (PDF)

  Compare your plans options brochure (PDF)

  Access PPO FAQ (PDF)

• Forms

  Disclosure Document (PDF)

  Enrollment/Census Template (XLS)

  Deductible & Out of Pocket Crediting Form (PDF)

  Employee Enrollment and Change Form (PDF)

  Group Master Application (PDF)

  Employee Enrollment and Change Form (Spanish) (PDF)

  Declining Coverage and Waiver form (PDF)

  Quote Request Form (PDF)

Large Group

• Plan Information and Brochures

  Health360 B2B Sales Sheet (PDF)

  Health360 B2B Slide Deck (PDF)

  Health360 B2C Benefit Summary (PDF)

  Access PPO Upfront Benefits Summary (PDF)

  Access PPO Basic Benefits Summary (PDF)

  Access PPO Basic Upfront (PDF)

  HMO HealthPays HSA Benefits Grid (PDF)

  Standard Plan Rules (PDF)

  Getting Care with Access PPO Puget Sound Plans (PDF)

  Getting Care with Access PPO Spokane Plans (PDF)

  Getting Care with Access PPO Plans (PDF)

  Getting Care with Core/Kaiser Permanente Plans (PDF)

  Service Area Map - Core (PDF)

  Service Area Map - PPO (PDF)

  2020 Core Enrollment Guide (PDF)

• Forms

  Employee Enrollment and Change Form (PDF)

  Group Master Application (PDF)

  Health Equity - HSA and HRA Banking Arrangement (website)

  Census Template (XLS)

Medicare Advantage

• Forms and Websites

  Silver & Fit Flyer (PDF)

  Star Rating Flyer (PDF)

  KPIF and Medicare Sales Contact Sheet (PDF)

  Enrollment Form (PDF)

  Summary of Benefits Key (HMO) (PDF)

  Summary of Benefits Basic (HMO) (PDF)

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

  Summary of Benefits Harbor (HMO) (PDF)

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

  Scope of Appointment Form (PDF)

  Service Area Map (PDF)

  Medicare Advantage HMO Optional Dental Benefits (PDF)

Other

• Population Health Management
• Occupational Health Services
• Other Forms