Employers

Eligibility, Enrollment & Billing
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Eligibility, Enrollment & BillingDownload
Terms, Leave of Absence & Reinstatement
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Terms, Leave of Absence & ReinstatementDownload
Medical Plans
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3. Medical PlansDownload
3a. Premera Blue CrossDownload
3b. Kaiser PermanenteDownload
Live Well at WCIF
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4. Live Well at WCIFDownload
Disability Plans
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5. Disability PlansDownload
5a. Long Term DisabilityDownload
5b. Short Term DisabilityDownload
Employee Assistance Program
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6. Employees Assistance ProgramDownload
Dental Plans
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7. Dental PlansDownload
7a. Delta Dental of WADownload
7b. Willamette DentalDownload
Vision Plans
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8. Vision Service PlanDownload
Life and AD&D Plans
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9. Life and AD&DDownload
9a. Basic LifeDownload
9b Voluntary Term LifeDownload
9c. Voluntary Accidental Death & DismembermentDownload
CDHP
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10. CDHPDownload
10a. Flexible Spending AccountDownload
10b. Health Savings AccountDownload
10c. Health Reimbursement AccountDownload
Metlife Worksite Plans
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11. Metlife Worksite PlansDownload
11a. Accident InsuranceDownload
11b. Hospital Indemnity InsuranceDownload
11c. Critical Illness InsuranceDownload
Retiree Plans
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12. RetireesDownload
Legislative Compliance
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13. Legislative ComplianceDownload
13a. HIPAADownload
13b. COBRADownload
13c. CHIPRADownload
13d. PPACA Healthcare ReformDownload
13e. Other RequirementsDownload

Critical Incident Stress Management (CISM)

Tragedy has many faces, and each experience is unique. CISM is designed to support people through stressful events – no matter what the scope of those events. First Choice provides an annual block of CISM hours for use by WCIF member employers. If your group is in need of these hours, please contact your WCIF Account Executive. WCIF approves training requests on a needs and first come, first served basis.

 

Training

First Choice EAP provides an annual block of training hours for use by WCIF member employers. If your group is interested in using some of these hours, please contact your WCIF Account Executive. WCIF approves training requests on a needs and first come, first served basis.  To see what types of trainings are available through EAP, please reference their website. First Choice EAP.

Newest Benefit Blog Posts

Vimly Benefit Solutions is not just another third-party benefits administrator.  WCIF’s TPA is here for you each day with knowledge and experience in the healthcare industry, backed by innovative technology to make your life easier.

Employee User Guide Version 3.0
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2017-SIMON-3.0-Employee-UserGuide.pdfDownload
SIMON Employee Self Service (ESS) Instructions
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BSI-Simon-WCIF-Registration-Instructions-2017.pdfDownload
SIMON 3.0 User Guide
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SIMON-3.0-Employer-UserGuide.pdfDownload
WCIF – 2024 Billing & Premium Calendar
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WCIF - 2024 Billing CalendarDownload

    If you would like to demo the (ESS) Employee Self Service Module, please click below link.

    Access Password: BD1@lkt7

    The Standard: Guide to Taxation of Employee Disability Benefits
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    The Standard: Guide to Taxation of Employee Disability BenefitsDownload

    Plan Forms, Materials and Notifications for Administrators

    Below you will find WCIF plan forms and materials separated by carrier.  Most forms are available under the Employees Tab; however this page also offers additional forms, notifications and information that are for administrative use only. If you need copies mailed to you or cannot find what you are looking for, please contact Shawna Zusi-Cobb at shawna@wcif.net.

    2024 Group Master Application
    WCIF SIMON Access Request Form
    Demographic Change Form
    Group Benefit Enrollment & Change Form | Non-Medical
    Group Benefit Enrollment & Change Form | All Lines
      HIPAA Forms
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      HIPAA Authorization for Release of Personal Health Information (PHI)Download
      Waiver of Medical CoverageDownload
        Domestic Partnership Forms
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        Declaration of Termination of Domestic PartnershipDownload
        Affidavit of Domestic PartnershipDownload
          COBRA
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          Sample COBRA General Notice Download
          COBRA Notice to an Employer of a Qualifying EventDownload
          Sample HRA FSA COBRA General NoticeDownload

            Carrier Forms

            CDHP Forms
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            HRA Enrollment FormDownload
            FSA Enrollment FormDownload
            LPFSA Enrollment FormDownload
            CDH Commuter Benefits Enrollment FormDownload
            HSA Enrollment FormDownload
            Reading the 5498-SA Health Savings Account (HSA) Tax FormDownload
            Health Care Claim FormDownload
            Dependent Care Claim FormDownload
            Commuter Benefits Claim FormDownload
            MetLife Forms
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            2024 MetLife Legal Plan Enrollment FormDownload
            2024 MetLife Aura IF Protection Enrollment FormDownload
            2024 MetLife A-CI-H Combined Enrollment FormDownload
            Critical Illness Enrollment FormDownload
            Hospital Indemnity Enrollment FormDownload
            Accident Enrollment FormDownload
            All Lines Enrollment Form
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            All Lines Enrollment FormDownload
            Disabled Dependant FormDownload
            Basic & Voluntary Life Forms
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            Life Claim PacketDownload
            Beneficiary Designation & Change FormDownload
            Basic & Voluntary Life FormsDownload
            Accelerated Benefit Employee Claim Form.pdfDownload
            Accelerated Benefit Claim Form for Spouses / DependentsDownload
            Waiver of Premium Claim PacketDownload
            VTL Booklet (enrollment form attached)Download
            Group Life Portability ApplicationDownload
            Group Life Conversion MaterialsDownload
            Evidence of Insurability Form (Medical History Statement)Download
            Evidence of Insurability Online Submission Download
            Voluntary Accidental Death and Dismemberment Forms
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            VAD&D Claim PacketDownload
            VAD&D Booklet (Enrollment Form Attached)Download
            Long Term Disability Forms
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            2016 LTD Claim PacketDownload
            LTD Conversion FormDownload
            Buy-Up LTD Booklet (enrollment form attached)Download
            Buy-Up LTD Enrollment FormDownload
            Voluntary Short Term Disability Forms
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            VSTD Booklet (enrollment form attached)Download
            VSTD Claim PacketDownload

            No Events

            Plan Contacts

            The Standard plan administration is handled by WCIF. Please contact WCIF with questions regarding your coverage.

            (800) 777-4114 for all WCIF members and their households

            (855) 623-6334 or cobra@vimly.com for COBRA and Retirees Administration or (206) 859-2694 or wcif@vimly.com

            2024 Plan Information

            2024 Plan Information

            Claims & Payment
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            Sample ID CardDownload
            Preventive CareDownload
            Transition of CareDownload
            Notices
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            Premera Notice of Privacy PracticesDownload
            Premera Blue Cross Non-discrimination NoticeDownload
            WCIF 200
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            SummaryDownload
            SBCDownload
            WCIF 500
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            SummaryDownload
            SBCDownload
            WCIF 750
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            SummaryDownload
            SBCDownload
            WCIF 1250
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            SummaryDownload
            SBCDownload
            WCIF 2000
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            SummaryDownload
            SBCDownload
            WCIF 3000
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            SummaryDownload
            SBCDownload
            WCIF 5000
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            SummaryDownload
            SBCDownload
            WCIF HSA 1600
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            SummaryDownload
            SBCDownload
            WCIF HSA 3000
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            SummaryDownload
            SBCDownload
            WCIF 200
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            SummaryDownload
            SBCDownload
            WCIF HSA 5000
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            SummaryDownload
            SBCDownload
            WCIF Choice 2
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            SummaryDownload
            SBCDownload
            WCIF Choice 3
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            SummaryDownload
            SBCDownload
            WCIF Choice 5
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            SummaryDownload
            SBCDownload

            WCIF Premera medical plans have two separate networks, Heritage Plus and Prime.

            When choosing a provider, it is important the provider is in the member’s network.  Premera member ID cards will identify which network applies.  If unsure, please contact customer service at Premera.

            Member Resources

            Claims & Payment
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            Sample ID CardDownload
            Preventive CareDownload
            Transition of CareDownload
            Network and Provider
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            Find A ProviderDownload
            Virtual CareDownload
            Pharmacy
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            Find A ProviderDownload
            Mail Order PharmacyDownload
            Rx SearchDownload
            HSA PV Core Drug ListDownload
            Prescription Drug Reimbursement FormDownload

            2024 Plan Information

            Access PPO HSA 2500
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            SummaryDownload
            SBCDownload
            Access PPO HSA 5500
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            SummaryDownload
            SBCDownload
            Access PPO 2500
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            SummaryDownload
            SBCDownload
            Access PPO 1500
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            SummaryDownload
            SBCDownload
            Access Choice 5
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            SummaryDownload
            SBCDownload
            Access Choice 3
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            SummaryDownload
            SBCDownload
            Access Choice 2
            FileAction
            SummaryDownload
            SBCDownload
            Access PPO 200
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            SummaryDownload
            SBCDownload
            Access PPO 500
            FileAction
            SummaryDownload
            SBCDownload
            Access PPO 1000
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            SummaryDownload
            SBCDownload
            Access PPO 2000
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            SummaryDownload
            SBCDownload
            Access PPO 3000
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            SummaryDownload
            SBCDownload
            Access PPO 5000
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            SummaryDownload
            SBCDownload
            Access PPO HSA 1600
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            SummaryDownload
            SBCDownload
            Access PPO HSA 3500
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            SummaryDownload
            SBCDownload
            HMO 250
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            SummaryDownload
            SBCDownload
            HMO 500
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            SummaryDownload
            SBCDownload
            HMO 750
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            SummaryDownload
            SBCDownload
            HMO 2000
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            SummaryDownload
            SBCDownload

            Member Resources

            Claims and Payment
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            Sample ID Cards - Core HMODownload
            Sample ID Card - Access PPODownload
            Member ServicesDownload
            Preventive CareDownload
            Network and Provider
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            Find A ProviderDownload
            Virtual Care (CareNow)Download
            First Choice Health Network (Washington, Alaska, Idaho, Montana, Oregon)Download
            First Health Network (National)Download
            Pharmacy ServicesDownload
            Prescription Transfer FormDownload
            Rx Reimbursement FormDownload
            Additional Resources
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            Kaiser Permanente Terms of Use and Privacy PolicyDownload
            Kaiser Permanente Non Discrimination Notice and Language Access ServicesDownload
            Healthy Discounts and ExtrasDownload

            2024 Plan Information

            Basic Plan
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            SummaryDownload
            Voluntary (00478)
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            SummaryDownload
            Incentive (00501)
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            SummaryDownload
            Plan A (00498)
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            SummaryDownload
            Plan B (00498)
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            SummaryDownload
            Plan C (00497)
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            SummaryDownload
            Plan D (00497)
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            SummaryDownload
            Member Resources
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            Delta Dental of Washington Non-discrimination PolicyDownload
            Delta Dental of Washington Notice of Privacy PolicyDownload
            Find A ProviderDownload
            MySmile - Personal Benefits CenterDownload
            FAQDownload

            2024 Plan Information

            High Plan
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            SummaryDownload
            CertificateDownload
            Member Resources
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            Willamette Dental Notice of Non-discrimination PolicyDownload
            FAQDownload
            Find A ProviderDownload
            Group Dental Implant Surgery BenefitDownload

            2024 Plan Information

            EasyOptions
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            SummaryDownload
            FlierDownload
            Voluntary
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            SummaryDownload
            CertificateDownload
            Extended
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            SummaryDownload
            CertificateDownload
            Standard
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            SummaryDownload
            CertificateDownload
            Budget
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            SummaryDownload
            CertificateDownload
            Member Resources
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            Vision Service Plan Privacy NoticeDownload
            Vision Service Plan Non-discrimination StatementDownload
            TruHearing Discount ProgramDownload
            Special OffersDownload
            When You Are Double Covered – Coordination of Benefits InformationDownload

            2024 Special Open Enrollment (October 1 – December 1)

            2024 Special Open Enrollment
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            Special Open Enrollment FlyerDownload
            Special Open Enrollment - Voluntary Life FlyerDownload
            Special Open Enrollment - Voluntary Life PosterDownload
            Special Open Enrollment FormDownload

            Life Plans

            Voluntary Accidental Death & Dismemberment (VAD&D)
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            BookletDownload
            CertificateDownload
            Voluntary Term Life (VTL)
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            BookletDownload
            1x Annual Salary to $50,000
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            Benefit at a GlanceDownload
            CertificateDownload
            1x Annual Salary to $150,000
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            Benefit at a GlanceDownload
            CertificateDownload
            1x Annual Salary to $100,000
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            Benefit at a GlanceDownload
            CertificateDownload
            2x Annual Salary to $200,000
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            Benefits at a GlanceDownload
            CertificateDownload
            $12,000
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            Benefit at a GlanceDownload
            CertificateDownload
            $15,000
            FileAction
            Benefit at a GlanceDownload
            CertificateDownload
            $20,000
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            Benefit at a GlanceDownload
            CertificateDownload
            $24,000
            FileAction
            Benefit at a GlanceDownload
            CertificateDownload
            $36,000
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            Benefit at a GlanceDownload
            CertificateDownload
            $40,000
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            Benefit at a GlanceDownload
            CertificateDownload
            $48,000
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            Benefit at a GlanceDownload
            CertificateDownload
            $50,000
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            Benefit at a GlanceDownload
            CertificateDownload
            $100,000
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            Benefit at a GlanceDownload
            CertificateDownload

            Disability Plans

            Guide to Taxation of Employee Disability Benefits
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            Guide to Taxation of Employee Disability BenefitsDownload
            Voluntary Short Term Disability (VSTD)
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            BookletDownload
            Certificate - w/ Buy-Up LTDDownload
            Certificate - w/ Base LTDDownload
            Voluntary Buy-Up Long Term Disability (LTD)
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            BookletDownload
            CertificateDownload
            Base Long Term Disability (LTD)
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            Benefits at a GlanceDownload
            CertificateDownload
            Member Resources
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            Portability & Conversion OverviewDownload
            Travel Assistance FlyerDownload
            Life Services ToolkitDownload
            Minor Beneficiaries Payout OptionsDownload
            Waiver of Premium FAQDownload
            Legal Plan & Aura ID Theft Prevention Plan
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            Legal Plan Summary Download
            Legal Plan Certificate of CoverageDownload
            Legal Plan Enrollment FormDownload
            Aura Identity & Fraud Protection SummaryDownload
            Aura IF Protection Enrollment FormDownload
            Aura Identity Theft & Fraud Protection Plan Enrollment FormDownload
            Pet Insurance
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            Pet Insurance FAQDownload
            Sample Pet Insurance PolicyDownload
            MetLife Plan Information
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            MetLife Combined Product PacketDownload
            MyBenefits FlyerDownload
            Instructions for WCIF MyBenefits PortalDownload
            MetLife Privacy PolicyDownload
            Critical Illness Insurance
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            SummaryDownload
            OverviewDownload
            FAQDownload
            Certificate (Low Plan)Download
            Certificate (High Plan)Download
            Informational VideoDownload
            Hospital Indemnity Insurance
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            SummaryDownload
            OverviewDownload
            FAQDownload
            Certificate (Low Plan)Download
            Certificate (High Plan)Download
            Informational VideoDownload
            Accident Insurance
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            FAQDownload
            OverviewDownload
            SummaryDownload
            Certificate (Low Plan)Download
            Certificate (High Plan)Download
            Informational VideoDownload
            FSA
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            CDH FSA Account OverviewDownload
            CDH Advantages of the FSADownload
            2023 DFSA Handout (ER Specific)Download
            CDH Mobile AppDownload
            CDH Eligible Expenses (OTC)Download
            Healthcare FSA Tax Savings EstimatorDownload
            CDH FSA - Rollover FAQs Download
            CDH FSA - Grace Period FAQsDownload
            CDH Prepaid Benefits Card FAQsDownload
            Consumer Portal QuickStart Guide (Debit Card)Download
            HSA
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            5 Benefits of a HSADownload
            HSA - FAQ Download
            HSA - Fact SheetDownload
            HSA Consumer Portal Quickstart GuideDownload
            Reading the 5498-SA Health Savings Account (HSA) Tax Form Download
            HRA
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            CDH Prepaid Benefits Card FAQsDownload
            CDH Mobile AppDownload
            Consumer Portal QuickStart Guide (Debit Card)Download
            Consumer Portal QuickStart Guide (No Debit Card)Download
            First Choice Health EAP
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            EAP Program SummaryDownload
            EAP Member FAQDownload
            Home OwnershipDownload
            EldercareDownload
            Childcare and EducationDownload
            24/7 Telehealth FlyerDownload
            Betterhelp Use GuideDownload
            Betterhelp Online FAQDownload
            First Choice Health EAP Privacy PolicyDownload

            Administrator’s Committee for Excellence (ACE) & Insurance Advisory Committee (IAC)
            In order to encourage continued participation and to recognize and reward employers who offer the WCIF plans, WCIF will reimburse travel expenses incurred for attending ACE & IAC meetings as well as other WCIF administrative trainings. Travel expenses will be reimbursed in accordance with WCIF’s Travel Reimbursement Policy

            Loyalty Program
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            WCIF Travel Reimbursement FormDownload
            WCIF Travel Reimbursement PolicyDownload

              For WCIF participating employer groups offering WCIF medical plans
              The WCIF Loyalty Program will provide up to $600 per group annually to attend WCIF Meetings.

              For WCIF participating employer groups NOT offering WCIF medical plans
              The WCIF Loyalty Program will provide up to $300 per group annually to attend WCIF meetings.

              For all 2023 travel reimbursements, please use theWCIF Travel Reimbursement Form.

              Reimbursement requests should be directed to:

              WCIF | Attention: Accounting
              2620 RW Johnson BLVD Southwest, Suite 300
              Tumwater, Washington 98512
              fax: (360) 754-7859  |  accounting@wcif.net

              Please be sure to include your group name, payee name, receipts, and mailing address.

              Board Members
              Board meeting attendance, lodging and transportation costs are covered or reimbursable for WCIF board members through WCIF.

              Reimbursement requests should be directed to:

              WCIF | Attention: Accounting
              2620 RW Johnson BLVD Southwest, Suite 300
              Tumwater, Washington 98512
              fax: (360) 754-7859  |  accounting@wcif.net

              Please be sure to include your group name, payee name, receipts, and mailing address.

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