Instructions for Submitting New Business

Below you will find an easy checklist of documents required by the AI Trusts to process New Business. Each of these items is further explained in the instructions following.

Mandatory Forms:

• Group Master Application (submitted through AP Connect)
• Employee Enrollment/Waiver Forms
• Premium Check for first month's premium
• Appropriate micro group documents if enrolling a 2-4 employee group in Medical
• Associated Industries Membership Application and Payment Verification.
   - Membership App: AI Basic
   - Membership App: AI Executive
• New Group Late Submission Form - This form is required for new groups submitted after the 15th of the month for coverage effective the first day of the following month. Groups submitted after the 15th of the month are considered a late submission, which may cause a delay in the issuance of member ID cards and eligibility of benefits.

Optional Forms:

• COBRA Carryover Form
• Regence Domestic Partner Affidavit
• Asuris Domestic Partner Affidavit

Instructions

Mandatory Forms: The following forms are required to be included with every New Group Submission. If any of the items are not included, the group will be pended back to the Producer and processing will be delayed.

1. Group Master Application – Submitted through AP Connect. Please be sure to select the GMA that corresponds with the name of the Trust that was quoted. (See the header located on your current proposal for the appropriate Trust.)

2. Completed Employee Enrollment/Waiver Forms – These forms are located in the Forms Library.  Please be sure to select the Enrollment Form that corresponds with the name of the Trust that was quoted. (See the header located on your current proposal for the appropriate Trust.) An Enrollment Spreadsheet is an option for enrollment.

3. Premium Check – Please make all checks payable to one of the following Trusts (please see header located on your current proposal for the appropriate Trust.):

• • Washington Commercial Construction Health Trust
  • Washington Retail Health Trust
  • Washington Manufacturing Health Trust
  • Washington Health Industry Health Trust
  • Washington Business Services Health Trust

4. Associated Industries Membership Application and Payment Verification – Please click the link below for the Associated Industries Membership form. 

• • Associated Industries Membership Application
    • AI Basic
    • AI Executive

Please be advised that the group needs to complete this form and submit it, along with their membership dues to Associated Industries. (Checks can be made payable to: Associated Industries).

Mail To:
Associated Industries
1206 North Lincoln St., Ste. 200
Spokane, WA 99201-2559

P: 509.326.6892
TF: 800.274.5309
F: 509.777.2690

Please make a copy of the groups Membership Application and check and submit it along with the New Business paperwork.

5. First Sold AI Trusts Case? – Please contact Program Manager Paul Baker at (206) 899-1895 or Paul.Baker@advprofessionals.com if you have any questions regarding New Business Submissions or if this is your first sold case.

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