AGC Health Plan for Washington State

 

 

Broker Documents and Forms

 

General Forms and Documents

 

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2008 Underwriting Guidelines

Medicare Secondary Payer / TEFRA Explanation

AGC Association Membership Information

AGC of Washington Chapter (Western and Central WA) Membership Fact Sheet

AGC Inland Northwest Chapter (Eastern WA) Membership Fact Sheet

 

Enrollment Form

Approved SIC Codes

 

Medical Plan Comparison

Medical Plan Price Points

Program Highlights

Proposal Booklet

 

New Group Submission Forms

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New Group Submission Forms

New Group Checklist

Master Application

Individual Health Statements (Groups under 21)

 

EFT Form

COBRA Agreement (Groups of 20+)

 

Proposal Request Forms

 

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RFP  Form

Group Census Form

 

Group Health Risk Questionnaire

Individual Health Statements

 

 

Renewal Forms

 

 

2008 Renewal Application

 

 

 

Flex Plan (Offered through TASC)

 

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For help, please contact:

Don Klippenes

(877)886-1467

donk@tasconline.com

 

Employer Forms:

Fee Schedule

Plan Application