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Please note: The state field refers to the location where your employer is headquartered.
| Title | Download | State |
|---|---|---|
| Agent Standard Commission Schedule - AK |
 Download Form (224.5 KB) |
AK |
| Agent Standard Commission Schedule - CA |
Download Form (230.62 KB) |
CA |
| Agent Standard Commission Schedule - MT, WY |
Download Form (206.81 KB) |
MT, WY |
| Agent Standard Commission Schedule - OR, ID, UT |
Download Form (233.93 KB) |
ID, OR, UT |
| Agent Standard Commission Schedule - WA |
Download Form (257.24 KB) |
WA |
| Find a Dentist |
Download Form (82.62 KB) |
AK, CA, ID, MT, OR, UT, WA, WY |
| Individual Critical Illness and Emergency Treatment Benefit Claim Form |
Download Form (877.17 KB) |
AK, CA, ID, MT, OR, UT, WA, WY |
| Individual Critical Illness Plus Application - ID |
Download Form (857.59 KB) |
ID |
| Individual Critical Illness Plus Application - OR |
Download Form (174.54 KB) |
OR |
| Individual Critical Illness Plus Application - WA |
Download Form (1.03 MB) |
WA |
| Individual Critical Illness Plus Beneficiary Form |
Download Form (83.93 KB) |
ID, OR, UT, WA |
| Individual Critical Illness Plus Enrollment Packet - UT |
Download Form (723.12 KB) |
UT |
| Individual Critical Illness Plus Flyer |
Download Form (112.64 KB) |
OR, UT, WA |
| Individual Critical Illness Plus Flyer - ID |
Download Form (113.27 KB) |
ID |
| Individual Dental Enrollment Packet - ID |
Download Form (914.11 KB) |
ID |
| Individual Dental Enrollment Packet - OR |
Download Form (1.13 MB) |
OR |
| Individual Dental Enrollment Packet - UT |
Download Form (921.42 KB) |
UT |
| Individual Dental Enrollment Packet - WA |
Download Form (1.22 MB) |
WA |
| Individual Dental Member Brochure - ID |
Download Form (193.48 KB) |
ID |
| Individual Dental Member Brochure - OR |
Download Form (2.2 MB) |
OR |
| Individual Dental Member Brochure - UT |
Download Form (193.42 KB) |
UT |
| Individual Dental Member Brochure - WA |
Download Form (2.2 MB) |
WA |
| Individual Dental Rates 1/1/2022 to 3/31/2022 - ID |
Download Form (327.65 KB) |
ID |
| Individual Dental Rates 1/1/2022 to 3/31/2022 - OR |
Download Form (221.31 KB) |
OR |
| Individual Dental Rates 1/1/2022 to 3/31/2022 - UT |
Download Form (333.42 KB) |
UT |
| Individual Dental Rates 1/1/2022 to 3/31/2022 - WA |
Download Form (328.38 KB) |
WA |
| Individual Dental Rates 10/1/2021 to 12/31/2021 - ID |
Download Form (327.39 KB) |
ID |
| Individual Dental Rates 10/1/2021 to 12/31/2021 - OR |
Download Form (221.34 KB) |
OR |
| Individual Dental Rates 10/1/2021 to 12/31/2021 - UT |
Download Form (333.15 KB) |
UT |
| Individual Dental Rates 10/1/2021 to 12/31/2021 - WA |
Download Form (328.15 KB) |
WA |
| Individual Short Term Medical Enrollment Packet - ID |
Download Form (324.86 KB) |
ID |
| Individual Short Term Medical Enrollment Packet - OR |
Download Form (498.14 KB) |
OR |
| Individual Short Term Medical Enrollment Packet - WA |
Download Form (491.59 KB) |
WA |
| Individual Short Term Medical Pharmacy Reimbursement Form |
Download Form (32.81 KB) |
ID, OR, UT, WA |
| Individual Short Term Medical Rates 1/1/2022 to 3/31/2022 - ID |
Download Form (168.19 KB) |
ID |
| Individual Short Term Medical Rates 1/1/2022 to 3/31/2022 - OR |
Download Form (461.23 KB) |
OR |
| Individual Short Term Medical Rates 1/1/2022 to 3/31/2022 - WA |
Download Form (464.55 KB) |
WA |
| Individual Short Term Medical Rates 10/1/2021 to 12/31/2021 - ID |
Download Form (451.22 KB) |
ID |
| Individual Short Term Medical Rates 10/1/2021 to 12/31/2021 - OR |
Download Form (459.83 KB) |
OR |
| Individual Short Term Medical Rates 10/1/2021 to 12/31/2021 - WA |
Download Form (463.38 KB) |
WA |
| Individual Vision Rider Reimbursement Form |
Download Form (143.95 KB) |
ID, OR, UT |
| LifeMap Advantages Member Flyer |
Download Form (885.84 KB) |
AK, CA, ID, MT, OR, UT, WA, WY |
| STM Authorization For Use and Disclosure of Protected Health Information |
Download Form (129.8 KB) |
ID, OR, UT, WA |