Plan Administrators

  • Get Ready for Tax Season: Form 1095-B

    Under the Affordable Care Act, Premera Blue Cross will provide Form 1095-B to WEA enrollees. Form 1095-B is a health insurance tax form that reports the type of healthcare coverage a member had, dependents covered by their plan, and the period of coverage for the year.

    Here’s what you need to know:

    • Premera will send Form 1095-B by mail to WEA enrollees by Jan. 31, 2017. They can also find the form online by logging in to their member account on and choosing Form 1095 under Manage My Account.
    • Enrollees who receive the form should use it to file their taxes, but they do not need to submit the form with their 2016 tax return.
    • For more information on 1095-B, please visit the IRS website.

    Welcome new WEA Select Plan participants

    The WEA and Premera Blue Cross are pleased to welcome several school districts and employee groups that are participating on the WEA Select Medical Plans for the first time, or qualify for the 10% discounted rates this year. More than 90% of school districts and/or employee groups that offer the WEA Select Medical Plans do so by taking advantage of the 10% discount rates.

    • Ellensburg (Classified)
    • Hockinson (All Bargaining Units)
    • Lake Stevens (Administrators, Classified & Non-represented)
    • Lakewood (Administrators, Classified & Non-represented)
    • Sequim (Certificated & Non-represented)
    • University Place (All Bargaining Units)

  • These resources will help answer questions as you process your bill or your employees' WEA Select Medical and Vision Plans paperwork:

    Print Information
    WEA/APA Month-end Cut-off Calendar

    View cut-off dates for ancillary product billings and dues.

    WEA/APA Billing Guide Use this guide as you work on your district's monthly billing.
    Termination Notification Please complete if you have a subscriber termination outside of the regular billing, such as a reduction in force or layoffs.
    Open Enrollment Billing flyer Important open enrollment billing tips and reminders.
    The Center for Disease Control and Prevention's Healthier Worksite Initiative: Toolkits Find solutions to plan, implement and evaluate worksite wellness programs.

    Select “Medical” or “Vision” for additional materials, such as booklets and summaries. 

    District Forms and Information
    Participation Agreement Fill out all parts of the form, then print and sign. Return the original form to us by fax at 425-918-5057 or by mail to Premera Blue Cross, Attn: Public Sales and Marketing, MS 103, P.O. Box 327, Seattle, WA 98111-0327. If mailing, be sure to make a copy for your files and send us the original.
    Vision Summary of Benefits & Rates See an overview of the plans available to districts and bargaining units. For more information, please contact Aon Consulting at 206-467-4646.
    Supply Order Form You may fill out your order online for open enrollment supplies, print it and fax to 425-918-5057. Benefit books, summaries, provider directories, and preferred drug lists are online use the tabs on this page for links.
    Forms for Use with Employees
    COBRA Rates For WEA Select Medical and Vision plans.
    Declaration of Domestic Partnership For use with WEA Select Medical and Vision plans. This form should not be used to satisfy Aon Hewitt's Dependent Eligibility Verification Audit (DEVA).
    Unum Life Insurance Beneficiary Designation Form Employees should complete and return this form to their school district administrator as needed.
    Life Insurance Continuation Options Continuation of coverage options for WEA Select Group Term Life and AD&D Insurance, 9060, Plan 2.
    Benefits Information
    24-hour NurseLine flyer Information on the 24-hour NurseLine, staffed by registered nurses.