Sales Collateral
Forms
- Individual Application + Supplement (2025)
- Individual Application + Supplement Spanish (2025)
- Large Employer Group Application (2025 | 2026)
- Small Employer Group Application (2025 | 2026)
- Continuity of Care Request Form
- Declination of Coverage
- eCheck Payment Authorization Form
- EFT Authorization Form
- HIPAA Authorization for Use or Disclosure
- Individual Termination Form
- Member Termination Form for Groups
- Non-Registered Domestic Partner Form
- Owner Statement
- Rate Filing Disclosure
- Rate Change Justification-Individual-Covered CA (English)
- Small Group Underwriting Guidelines
Member Benefit Information
- Advantage Referral
- Behavioral Health
- Complementary and Alternative Medicine (CAM)
- Convenient Care Options
- Digital Resources: Apps and Mobile
- Emergency Travel Assistance
- Family & Diversity Support Flyer
- Health Plan Basics: WHA FAQs
- HDHP: Considering an HSA-Compatible Plan
- HDHP: Managing Your HDHP + HSA
- HDHP: Considering an HSA-Compatible Plan (HealthEquity)
- HDHP: Managing Your HDHP + HSA (HealthEquity)
- Kaia Digital Pain Management
- Livongo for Hypertension Flyer
- Nutritional Counseling for Weight Management
- Parent Support (Small Group)
- Preferred Drug List (EHB)
- Preferred Drug List - Federal Employees Health Benefits (FEHB)
- Preferred Drug List - Premium
- Preferred Drug List - Premium + Infertility
- Prescription Benefits
- Virta Type 2 Diabetes Reversal
- Wellness Brochure (Large Group)
- Wellness Brochure (Small Group)
- Wellness Brochure (Individual)