WCIF Enrollment Forms

Valuable Websites

Employees can access the WCIF website that houses information on plans available, finding a provider, access to the Wellness portal and the Benefitshub Discount Center.

Creating a login(s) and portal(s) will allow you to look at your benefits, claims, find a network provider and check on your pharmacy benefits.

The Standard

Standard Plan Information
Travel Assistance (PDF)

VIMLY Link

Flexible Spending Arrangement (FSA) and Health Savings Account (HSA) information including Flyers, Overview, FAQs and Enrollment Forms.

HRA/VEBA

Formed in 1990, HRA VEBA Trust is a non-profit, multiple employer voluntary employees’ beneficiary association (VEBA) authorized under Internal Revenue Code 501(c)(9). HRA VEBA Trust offers a funded health reimbursement arrangement (HRA) plan available to certain governmental employers in the Northwest (Washington, Oregon, and Idaho).

HRA / VEBA Overview (PDF)

WCIF Enrollment Forms

  1. 2019 Group Benefit Enrollment and Change Form For all Active Employees (PDF)
  2. 2019 WCIF Demographic Change Form (PDF)
  3. Affidavit of Domestic Partnership (PDF)
  4. FSA - DCAP Enrollment (PDF)
  5. HSA Enrollment Form (PDF)
  6. Q and A Flexible Spending Account (PDF)
  7. Q and A Health Savings Account (PDF)
  8. Termination of Domestic Partnership (PDF)
  9. WCIF Medical Waiver Form (Includes Whitman County's Waiver Form) (PDF)
  10. WCIF Notice of Special Enrollment Rights and Consequences of Declining Coverage (PDF)

Teamsters Enrollment Form

  1. 2019 WA Teamsters Welfare Trust Participant Data Form (PDF)