Plan Information

Below you will find WCIF plan summaries, summary plan documents, and other plan information separated by carrier.  Scroll down to browse, or go directly to the section you're searching for with the quick link tool below.

 

Note: If your plan information is not listed below, please contact your WCIF Account Executive.

Medical Plans
Premera Blue Cross PPO Plans*		Group Health Options HMO Plans
Forms   |   Contact   |   Rates		Forms   |   Contact   |   Rates
Summaries		Summaries
2013		2013
•   WCIF 200		•   Options A
•   WCIF 500		•   Options 200
•   WCIF 750		•   Select 750
•   WCIF 3000		•   Options HDHP
•   WCIF HDHP		HSA Preventive Rx List >
HSA Preventive Rx List >
Qualified preventive care services >		Qualified preventive care services >
Prescription benefit information >		Prescription benefit information >
Specialty Drug List >		Health & wellness information >
Health & wellness information >
Summary of Benefits and Coverage		Summary of Benefits and Coverage
•   Premera WCIF 200 Plan		•   Group Health Options A Plan
•   Premera WCIF 500 Plan		•   Group Health Options 200 Plan
•   Premera WCIF 750 Plan		•   Group Health Select 750 Plan
•   Premera WCIF 3000 Plan		•   Group Health Options HDHP
•   Premera WCIF HDHP Plan
Summary Plan Documents		Medical Coverage Agreements
•   Premera WCIF 200 Plan		•   Options A -	Composite  |  4-Tier
•   Premera WCIF 500 Plan		•   Options 200 -	Composite  |  4-Tier
•   Premera WCIF 750 Plan		•   Select 750 -	Composite  |  4-Tier
•   Premera WCIF 3000 Plan
•   Premera WCIF HDHP Plan		Group Health Notice of Privacy Practices
Premera Notice of Privacy Practices
*  LifeWise of Washington for members whose       employer is located in Clark County
All active employees enrolled in WCIF medical plans have the following bundled benefits: »  Magellan Health Services Employee Assistance Program (EAP) »  The Standard Base Long Term Disability (LTD)
Dental Plans
Washington Dental Service (WDS)		Willamette Dental of Washington
Forms   |   Contact   |   Rates		Forms   |   Contact   |   Rates
Summaries		Summary
2013		2013
•   WDS Plan A		•   Plan I
•   WDS Plan B		Willamette Enrollment Brochure
•   WDS Plan C		Willamette Frequently Asked Questions
•   WDS Plan D
•   WDS Incentive
WDS MySmile Web Features
Coverage Booklets		Certificate of Coverage
•   WDS Plan A		•   Willamette Dental Plan I
•   WDS Plan B		includes Notice of Privacy Practices
•   WDS Plan C
•   WDS Plan D
•   WDS Incentive Plan
•   WDS DeltaCare
WDS Notice of Privacy Practices
Note: If your plan is not listed above please    contact your WCIF/WCIP Account Executive.
Vision Plans
Vision Service Plan (VSP)
Forms   |   Contact   |   Rates
Summaries
2013
•   VSP Extended Plan
•   VSP Standard Plan
•   VSP Budget Plan
Eye Health Management Program
Laser Vision Care
TruHearing Hearing Aid Discount Program
Certificate of Coverage
VSP Certificate of Coverage (All Plans)
+   Certificate Amendment, January 2008
VSP Notice of Privacy Practices
Life & AD&D Plans
The Standard Insurance Company  |  Life & AD&D
Forms   |   Contact   |   Rates
Summaries
for Basic Life information refer to the applicable summary plan document below
•   The Standard FrontierMedEx® Feature
•   The Standard Voluntary Term Life (VTL)
•   The Standard Voluntary Accidental Death & Dismemberment (VAD&D)
Certificates of Coverage
•   Basic Life  |  $12,000		•   Voluntary Term Life (VTL) Certificate
•   Basic Life  |  $15,000		•   Voluntary AD&D Certificate
•   Basic Life  |  $20,000		•   FrontierMEDEX Certificate
•   Basic Life  |  $24,000		Employer-Specific Plans
•   Basic Life  |  $36,000		•   Pend Oreille County Basic Life
•   Basic Life  |  $40,000		•   Stevens County Basic Life
•   Basic Life  |  $48,000		•   Whatcom County $49K Basic Life
•   Basic Life  |  1 x Annual Salary to $50K		•   Whatcom County $50K Basic Life
•   Basic Life  |  1 x Annual Salary to $100K		•   Whatcom County Voluntary Term Life
•   Basic Life  |  1 x Annual Salary to $150K
Disability Plans
The Standard Insurance Company  |  Disability
Forms   |   Contact   |   Rates
Summaries
•   The Standard Base Long Term Disability (LTD)
•   The Standard Voluntary Buy-Up Long Term Disability (LTD)
•   The Standard Voluntary Short Term Disability (VSTD)
Guide to the Taxation of Employee Disability Benefits
Certificates of Coverage
•   The Standard Long Term Disability  |  Base Plan Only
•   The Standard Long Term Disability  |  Base + Voluntary Buy-Up Plan
•   The Standard Voluntary Short Term Disability (90 day waiting period)
•   The Standard Voluntary Short Term Disability (180 day waiting period)
Employee Assistance Program
Magellan Health Services
Contact   |   Rates
Summaries
•   Magellan EAP Program
•   Magellan EAP Legal & Financial Services
•   Magellan EAP Online Resources
•   Magellan Member Discount Center
Health & wellness information >
Summary of Benefits & Coverage
• Employee Assistance Program
Consumer Driven Health Plans
Benefit Solutions, Inc. (BSI)
Forms   |   Contact   |   Rates
Flexible Spending Arrangement (FSA)		Health Savings Account (HSA)
Summaries
2013		2013
•  Employee       FSA Flyer		•  Employee       HSA Flyer
•  Employer       FSA Flyer		•  Employer       HSA Flyer
•  FSA Planning       Worksheet
•  FSA Debit Card       Substantiation       Requirements
List of qualifying expenses >  (click here for a printable (abbreviated) version)
Retiree Plans
see Retiree Plans >

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