WMI Forms & Updates
To Get a Health Insurance Quote:
For businesses interested in
health insurance
health insurance
If you are a business interested in obtaining a quote
for group health insurance, the employer will need to
fill out:
Employer Application
Group Eligibility Form
Employers are also required to submit a payroll report
for all employees
Each employee to be covered on the plan needs to
complete both of the following:
Health Statement
Enrollment Card
If "yes" is answered to any of the health questions,
please make sure details are provided in the
appropriate section
Please remember that employers are required to
pay a minimum of 75% of the single rate.
After all information is complete, please mail to our
office at 2602 Highway 2 East, Kalispell, MT 59901
for group health insurance, the employer will need to
fill out:
Employer Application
Group Eligibility Form
Employers are also required to submit a payroll report
for all employees
Each employee to be covered on the plan needs to
complete both of the following:
Health Statement
Enrollment Card
If "yes" is answered to any of the health questions,
please make sure details are provided in the
appropriate section
Please remember that employers are required to
pay a minimum of 75% of the single rate.
After all information is complete, please mail to our
office at 2602 Highway 2 East, Kalispell, MT 59901
* Don't Forget
All clients using Western
Mutual Insurance will be
accessing Health Info Net
as their primary PPO
provider. Please call our
office for a list of providers
or you can go to
www.healthinfonetmt.com
for the most updated
information.
Mutual Insurance will be
accessing Health Info Net
as their primary PPO
provider. Please call our
office for a list of providers
or you can go to
www.healthinfonetmt.com
for the most updated
information.
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| Claims Forms Insurance claims for WMI require forms to be filled out in certain situations. The first claim of every year, you will be required to fill out a Coordination of Benefits Form If your claim is due to an accident or WMI requests the information, you will need to fill out an Accident Form |
2602 Hwy 2 East~Kalispell, MT 59901 Ph: 406-257-7680 Fax: 406-257-7685