WEA Trust
WEA Trust
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    • HOME
    • LIFE, LTC & VISION PLANS
    • PROVIDERS
      • Information Requests
      • Submitting Claims
      • Provider Manual
      • Provider Contact Us
      • Provider News
      • No Surprises Act
    • MEMBERS
      • Information Requests
      • Plans and Policies
      • Member Contact Us
      • Forms
    • SECURE FILE UPLOAD
    • HOURS AND HOLIDAYS
    • PRIVACY PRACTICES
    • REPORTING FRAUD
  • HOME
  • LIFE, LTC & VISION PLANS
  • PROVIDERS
    • Information Requests
    • Submitting Claims
    • Provider Manual
    • Provider Contact Us
    • Provider News
    • No Surprises Act
  • MEMBERS
    • Information Requests
    • Plans and Policies
    • Member Contact Us
    • Forms
  • SECURE FILE UPLOAD
  • HOURS AND HOLIDAYS
  • PRIVACY PRACTICES
  • REPORTING FRAUD

Forms

Change Your Communication Preferences (pdf)Download
Member Reimbursement Claim Form (pdf)Download
COVID-19 Test Reimbursement Claim Form (pdf)Download
International Claim Form (pdf)Download
MedImpact Claim Form (pdf)Download
Designation of Health Insurance Representative (pdf)Download
End Designation of Health Insurance Representative (pdf)Download
Participant Request for Health Insurance Information (pdf)Download
WEA Grievance Procedure (pdf)Download
Authorization to Share Health Information with a Third Party (pdf)Download

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  • LIFE, LTC & VISION PLANS
  • SECURE FILE UPLOAD
  • HOURS AND HOLIDAYS
  • PRIVACY PRACTICES