Meet Your Insurance Providers:

Vision Service Plans Is Our Dedicated Vision Provider

Quoting Forms - 2 to 99 enrolled employees

• RFP Form
• Census Form

Quote Requests

E-mail Address: quotes@wbacctrust.com

Fax Number: 206-812-7556

Additional information

• Broker Manual
• Sponsoring Chambers and Associations
• Restricted Industry list
• Micro-group Requirements
• RBS Cancellation Form
• ANH Cancellation Form

New Group Checklist

• Master Application
• Enrollment Forms
• Check Payable to WBACC
• Waivers*
• Micro-group Documentation*
• Domestic Partner Affidavit*
• Groups due by the 20th

* If applicable

Mail new group materials and check to:

DiMartino Associates

WBACC Trust

1501 4th Ave, Suite 2400

Seattle, WA 98101