As Washington’s source for employee benefits, Business Health Trust (BHT) helps Washington’s business community thrive by providing the high-quality, affordable employee benefits growing companies need to be competitive.
 


FORMS LIBRARY

This section will allow you to access forms including Enrollment Forms, Claim Forms, Administrative Forms, and other forms.
Please choose a year or industry below to find information for various Trust Forms.

If you have any questions, please contact the Trust Program Managers:

Nathan Edmondson at 206-602-3558 or 
Nathan.Edmondson@advprofessionals.com

Paul Baker at 206-899-1895 or Paul.Baker@advprofessionals.com




Approved Census Enrollment Form (Vimly)

  • Census Import - Template Industry Health Trust (Download)
  • Census Import - Template Kaiser Permanente and Non-Medical (Download)

 

Enrollment Forms: Industry Specific
(Premera, Kaiser Permanente)

Enrollment Forms: Business Health Trust
(Kaiser Permanente Small Group Medical / BHT Non-Medical)

 


  Premera Medical  
Industry Health Trust Enrollment Form
  Aerospace Download
  Agriculture Download
  Business Services Download
  Community Service Org. Download
  Construction Download
  End-Line Manufacturing Download
  Healthcare Download
  Information Technology Download
  Media Download
  Retail Download
  Tourism Download
  Transportation Download
  Wholesaling Download

 

 

  Premera Medical  
Industry Health Trust Enrollment Form
  Aerospace Download
  Agriculture Download
  Business Services Download
  Community Service Org. Download
  Construction Download
  End-Line Manufacturing Download
  Healthcare Download
  Information Technology Download
  Media Download
  Retail Download
  Tourism Download
  Transportation Download
  Wholesaling Download

 

Kaiser Permanente AHP - Medical  
Industry Health Trust Enrollment Form
  Aerospace Download
  Agriculture Download
  Business Services Download
  Community Services Org. Download
  Healthcare Download
  Information Technology Download
  Media Download
  Retail Download
  Tourism Download
  Transportation Download
  Wholesaling Download

 

2019 Plan Year: Jan. 1, 2019 - Dec. 31, 2019

  Kaiser Permanente Small Group Medical / BHT Non-Medical  
Trust Enrollment Form
  Business Health Trust Download

 

 

Insurance Carrier Forms

 

Other Forms


Approved Census Enrollment Form (BSI)

  • Census Import Template - Industry Health Trust (Download)
  • Census Import Template - Kaiser Permanente and Non-Medical (Download)


2018-2019 Industry Specific Enrollment Forms

Plan Year: Jan. 1, 2018 - Dec. 31, 2018

  Premera Medical  
Industry Health Trust Enrollment Form
  Agriculture Download
  Business Services Download
  Community Service Organization Download
  Construction Download
  End-Line Manufacturing Download
  Information Technology Download
  Retail Download
  Wholesaling Download



Plan Year: Jul. 1, 2018 - Jun. 30, 2019

  Premera Medical  
Industry Health Trust Enrollment Form
  Aerospace Download
  Healthcare Download
  Media Download
  Tourism Download
  Transportation Download



Plan Year: Jan. 1, 2018 - Dec. 31, 2018

  Kaiser Permanente and Non-Medical  
Trust Enrollment Form
  Business Health Trust Download

 

 

 

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