| To apply for any of the plans
shown, see the instructions below.
Lifewise of
Washington
Regence Blue Shield
KPS Health Plans of Washington
Assurant Insurance
You may also simply contact our office at 1-866-527-1910
(PST).
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Lifewise of Washington |
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Apply Online Now! You
may apply directly online by following the link above to our
safe and secure online application process. We recommend this online process, it is
safe, fast and secure and will enable the completion of your
application in a much shorter amount of time.
However if you wish to apply by mail you may download an
application by following the link below. Be sure to
complete a separate "Standard Health Questionnaire" for each
person applying. |
Lifewise Individual Application
- Download Now
| To print an application
simply click on the link above and then print, or you
may choose to apply online. You must complete a
separate Standard Health
Questionnaire for each person applying for coverage
unless you meet one of the exclusionary
requirements as outlined on the application. |
You can choose from two
effective dates – the 1st or 15th of the month. For a 1st of
the month effective date, applications must be postmarked by
the 20th of the previous month. For a 15th of the month
effective date, applications must be postmarked by the 5th
of the same month.
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Request
an
instant
health
insurance
quote
now >>
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Please do not send a rate payment with your application. You will receive a
statement from Regence BlueShield upon acceptance of your application.
The mailing address to send your completed application directly the insurance
company is shown on the application after you print it out.
Please note: All COMPLETED
enrollment materials should postmarked prior to the 20th of the of the month for
which coverage to
become effective for.
Request
an
instant
health
insurance
quote
now >> Back To Top |
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KPS Health
Plans of Washington |
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KPS
Health Plan Application
- Download Now
To print
an application simply click on the link above and then
print.
You will need to complete a
Standard Health
Questionnaire for each person applying for coverage
unless you meet one of the exclusionary requirements
as outlined on the application.
The mailing address to send your completed
application directly the insurance company is shown on the
application after you print it out.
Please note: All COMPLETED
enrollment materials should postmarked prior to the 20th of the of the month for
which coverage to
become effective for.
Request
an
instant
health
insurance
quote
now >> Back To Top |
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Assurant
Health Insurance |
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Apply Online Now!
You may apply directly securely
online by clicking on the link above, or print out and
complete the enrollment forms provided below. We
recommend the online process, it is safe, secure, accurate
and allows the completion of your application much quicker
than by mail. |
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Assurant Application
- Download Now
Standard Health
Questionnaire
To apply for coverage please print
out one application by clicking on the following line.
For each applicant applying a separate health questionnaire
must be completed, which may printed out from the following
link; Standard Health
Questionnaire.
If you are applying for a HSA with
Assurant this
supplement application should be completed and returned
along with the Application and Health Questionnaires'.
HSA Supplement Application
Assurant Health
an application must be completed along with a Standard
Health Questionnaire for each person applying must be
completed and accompany the application. The
application should be mailed directly to our General Agents
mailing address of;
Westcoast Agencies Inc
PO Box 2168
Battle Ground, WA 98604
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For questions or help with any of these
plans please
Contact Us. |
