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FORMS LIBRARY | This section will allow you to access forms including Enrollment Forms, Claim Forms, Administrative Forms, and other forms. If you have any questions, please contact Omnitrade Sales: Nathan Edmondson at 206.602.3558 or Nathan.Edmondson@advprofessionals.com Tara Reynolds at 253-541-6538 or Tara.Reynolds@advprofessionals.com |
2025 Trust Industries Enrollment Forms
Effective Plan Year: January 1, 2025 - December 31, 2025
Industry | Enrollment Forms | Census Import Template (Enrollment Spreadsheet) |
CleanTech Alliance Health Trust | Click Here | Click Here |
Life Science Washington Health Trust | Click Here | |
Omnitrade Non-Medical | Click Here |
2024 Trust Industries Enrollment Forms
Effective Plan Year: January 1, 2024 - December 31, 2024
Industry | Enrollment Forms | Census Import Template (Enrollment Spreadsheet) |
CleanTech Alliance Health Trust | Click Here | Click Here |
Life Science Washington Health Trust | Click Here | |
Omnitrade Non-Medical | Click Here |
2023 Trust Industries Enrollment Forms
Effective Plan Year: January 1, 2023 - December 31, 2023
Industry | Enrollment Forms | Census Import Template (Enrollment Spreadsheet) |
CleanTech Alliance Health Trust | Click Here | Click Here |
Life Science Washington Health Trust | Click Here | |
Omnitrade Non-Medical | Click Here |
2022 Trust Industries Enrollment Forms
Effective Plan Year: January 1, 2022 - December 31, 2022
Industry | Enrollment Forms | Census Import Template (Enrollment Spreadsheet) |
CleanTech Alliance Health Trust | Click Here | Click Here |
Life Science Washington Health Trust | Click Here | |
Omnitrade Non-Medical | Click Here |
[AP-Standardized] Life Beneficiary Enrollment Census (Download)
Insurance Carrier Forms
Medical |
Dental |
Life |
Vision |
Other Forms
- Premera Blue Cross Provider Fax Form
- COBRA Waiver Form
- Late Submission Form
- Vimly EFT Authorization Form
- Life/AD&D and EAP Form
- Simon Access Form
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