Recommended Broker: Green Financial 1-800-877-8019  
TempBenefits.com
  Home Medical Dental Life 401KRollovers About Us  
Medical
Overview
Benefit Summary
Rates
How to Enroll
HSA Benefit Summary
HSA Calculator
Exclusions/Limits
Pre-Existing Condition
Providers
Instant Quote Individual Plans
 
 

  
Enrollment Instructions - Two Ways to Enroll

1. The fastest way to enroll is to apply online:

Click on the "Get Quotes and Apply Online" link. This will take you through a paperless enrollment process.

2. Or apply via mail by completing the enrollment application and standard health questionnaire (SHQ).  One SHQ is required for each family member.  Mail all items to Green Financial. Do not send any money with the application.  Once approved, you will be billed on a monthly basis.

Enrollment Forms:

Part 1 - Print & Complete an Enrollment Application


Part 2 - Print & Complete a Standard Health Questionnaire - PDF Form


(This is multiple pages so if you prefer, simply call us and we will gladly mail)

Remember, one health questionnaire for each family member.  Although this form has 280 questions it is much easier to complete than it appears.  There are only 13 main sections (A through M). Answering "no" to any of the main questions allows you to skip the questions in that particular section.


Mail all forms to: Or Deliver all forms to:
Green Financial
PO Box 8036
Kirkland, WA  98034		 Green Financial
11930 Slater Ave NE, Ste 100
Kirkland, WA  98034

 

Effective Date Information:

Effective dates are either the 1st or the 15th of the month. LifeWise applications received in our office, completed online or postmarked by the 14th of the month will be effective on the 15th of that month. Applications received in our office, completed online or postmarked by the last day of the month will be effective on the 1st of the following month.

If you prefer we can fax, mail, or e-mail these forms to you.  Either call us at 800-877-8019 or go to Home, Contact us and request. You'll need Acrobat Reader to display the PDF files.  If you don't have that program, you can download it free from Adobe.

Please call if any questions: 1-800-877-8019
  Tell A Friend © Copyright Temp Benefits, All rights reserved.