Brokers
General Information & Forms
2021-2022 WFB Employee Application
2022-2023 WFB Employee Application
2021-2022 WFB Spanish Enrollment Form
2022-2023 WFB Spanish Enrollment Form
2021-2022 WFB Group Master Application
2022-2023 WFB Group Master Application
Census-Enrollment-Spreadsheet
WFBH-New-Group-Submission-Checklist
WFB Membership Application
Medical Plans
Upcoming Year
80% PPO Plans
01-PPO 80% Plan 250
02-PPO 80% Plan 500
03-PPO 80% Plan 750
04-PPO 80% Plan 1000
05-PPO 80% Plan 1500
06-PPO 80% Plan 2000
07-PPO 80% Plan 2500
08-PPO 80% Plan 3000
09-PPO 80% Plan 4000
10-PPO 80% Plan 5000
70% PPO Plans
11-PPO 70% Plan 1000
12-PPO 70% Plan 1500
13-PPO 70% Plan 2000
14-PPO 70% Plan 2500
15-PPO 70% Plan 3000
16-PPO 70% Plan 4000
17-PPO 70% Plan 5000
18-PPO 70% Plan 6000
100% and 50% PPO Plans
21-PPO 50% Plan 50-50
22-PPO 50% Plan 1000
23-PPO 50% Plan 2000
19-PPO 100% Plan 5500
20-PPO 100% Plan 8000
HSA Plans
24-HSA 1500
25-HSA 2500
26-HSA 3500
27-HSA 5500
Current Year
80% PPO Plans
01-PPO 80% Plan 250
02-PPO 80% Plan 500
03-PPO 80% Plan 750
04-PPO 80% Plan 1000
05-PPO 80% Plan 1500
06-PPO 80% Plan 2000
07-PPO 80% Plan 2500
08-PPO 80% Plan 3000
09-PPO 80% Plan 4000
10-PPO 80% Plan 5000
70% PPO Plans
11-PPO 70% Plan 1000
12-PPO 70% Plan 1500
13-PPO 70% Plan 2000
14-PPO 70% Plan 2500
15-PPO 70% Plan 3000
16-PPO 70% Plan 4000
17-PPO 70%Plan 5000
18-PPO 70% Plan 6000
100% and 50% PPO Plans
19-PPO 50% Plan 50-50
20-PPO 100% Plan 5500
21-PPO 50% Plan 1000
22-PPO 50% Plan 2000
23-PPO 100% Plan 8000
HSA Plans
24-HSA 1500
25-HSA 2500
26-HSA 3500
27-HSA 5500
Upcoming Enrollment Year
Prime Benefit – 80% PPO Plans
01-10 2022 – Heritage Prime PPO 80 250 Benefit Highlights
02-10 2022 – Heritage Prime PPO 80 500 Benefit Highlights
03-10 2022 – Heritage Prime PPO 80 750 Benefit Highlights
04-10 2022 – Heritage Prime PPO 80 1000 Benefit Highlights
05-10 2022 – Heritage Prime PPO 80 1500 Benefit Highlights
06-10 2022 – Heritage Prime PPO 80 2000 Benefit Highlights
07-10 2022 – Heritage Prime PPO 80 2500 Benefit Highlights
08-10 2022 – Heritage Prime PPO 80 3000 Benefit Highlights
09-10 2022 – Heritage Prime PPO 80 4000 Benefit Highlights
10-10 2022 – Heritage Prime PPO 80 5000 Benefit Highlights
Prime Benefit – 70% PPO Plans
11-10 2022 – Heritage Prime PPO 70 1000 Benefit Highlights
12-10 2022 – Heritage Prime PPO 70 1500 Benefit Highlights
13-10 2022 – Heritage Prime PPO 70 2000 Benefit Highlights
14-10 2022 – Heritage Prime PPO 70 2500 Benefit Highlights
15-10 2022 – Heritage Prime PPO 70 3000 Benefit Highlights
16-10 2022 – Heritage Prime PPO 70 4000 Benefit Highlights
17-10 2022 – Heritage Prime PPO 70 5000 Benefit Highlights
18-10 2022 – Heritage Prime PPO 70 6000 Benefit Highlights
Prime Benefit – 50 and 100% PPO Plans
19-10 2022 – Heritage Prime PPO 100 5500 Benefit Highlights
20-10 2022 – Heritage Prime PPO 100 8000 Benefit Highlights
21-10 2022 – Heritage Prime PPO 50 50-50 Benefit Highlights
22-10 2022 – Heritage Prime PPO 50 1000 Benefit Highlights
23-10 2022 – Heritage Prime PPO 50 2000 Benefit Highlights
Prime HSA Plans
24-10 2022 – Heritage Prime HSA 1500 Benefit Highlights
25-10 2022 – Heritage Prime HSA 2500 Benefit Highlights
26-10 2022 – Heritage Prime HSA 3500 Benefit Highlights
27-10 2022 – Heritage Prime HSA 5500 Benefit Highlights
Heritage HSA Plans
24-10 2022 – HSA 1500 Heritage Benefit Highlights
25-10 2022 – HSA 2500 Heritage Benefit Highlights
26-10 2022 – HSA 3500 Heritage Benefit Highlights
27-10 2022 – HSA 5500 Heritage Benefit Highlights
Heritage PPO 80 Plans
01-10 2022 – PPO 80 250 Heritage Benefit Highlights
02-10 2022 – PPO 80 500 Heritage Benefit Highlights
03-10 2022 – PPO 80 750 Heritage Benefit Highlights
04-10 2022 – PPO 80 1000 Heritage Benefit Highlights
05-10 2022 – PPO 80 1500 Heritage Benefit Highlights
06-10 2022 – PPO 80 2000 Heritage Benefit Highlights
07-10 2022 – PPO 80 2500 Heritage Benefit Highlights
08-10 2022 – PPO 80 3000 Heritage Benefit Highlights
09-10 2022 – PPO 80 4000 Heritage Benefit Highlights
10-10 2022 – PPO 80 5000 Heritage Benefit Highlights
Heritage PPO 70 Plans
11-10 2022 – PPO 70 1000 Heritage Benefit Highlights
12-10 2022 – PPO 70 1500 Heritage Benefit Highlights
13-10 2022 – PPO 70 2000 Heritage Benefit Highlights
14-10 2022 – PPO 70 2500 Heritage Benefit Highlights
15-10 2022 – PPO 70 3000 Heritage Benefit Highlights
16-10 2022 – PPO 70 4000 Heritage Benefit Highlights
17-10 2022 – PPO 70 5000 Heritage Benefit Highlights
18-10 2022 – PPO 70 6000 Heritage Benefit Highlights
Heritage PPO 50 & 100
22-10 2022 – PPO 50 1000 Heritage Benefit Highlights
23-10 2022 – PPO 50 2000 Heritage Benefit Highlights
21-10 2022 – PPO 50 50-50 Heritage Benefit Highlights
19-10 2022 – PPO 100 5500 Heritage Benefit Highlights
20-10 2022 – PPO 100 8000 Heritage Benefit Highlights
Current Year
Plus Benefit – 80% PPO Plans
01-10 2021 – PPO 80 250 Plus Benefit Highlights
02-10 2021 – PPO 80 500 Plus Benefit Highlights
03-10 2021 – PPO 80 750 Plus Benefit Highlights
04-10 2021 – PPO 80 1000 Plus Benefit Highlights
05-10 2021 – PPO 80 1500 Plus Benefit Highlights
06-10 2021 – PPO 80 2000 Plus Benefit Highlights
07-10 2021 – PPO 80 2500 Plus Benefit Highlights
08-10 2021 – PPO 80 3000 Plus Benefit Highlights
09-10 2021 – PPO 80 4000 Plus Benefit Highlights
10-10 2021 – PPO 80 5000 Plus Benefit Highlights
Prime Benefit – 80% PPO Plans
01-10 2021 – Prime PPO 80 250 Benefit Highlights
02-10 2021 – Prime PPO 80 500 Benefit Highlights
03-10 2021 – Prime PPO 80 750 Benefit Highlights
04-10 2021 – Prime PPO 80 1000 Benefit Highlights
05-10 2021 – Prime PPO 80 1500 Benefit Highlights
06-10 2021 – Prime PPO 80 2000 Benefit Highlights
07-10 2021 – Prime PPO 80 2500 Benefit Highlights
08-10 2021 – Prime PPO 80 3000 Benefit Highlights
09-10 2021 – Prime PPO 80 4000 Benefit Highlights
10-10 2021 – Prime PPO 80 5000 Benefit Highlights
Plus Benefit – 70% PPO Plans
11-10 2021 – PPO 70 1000 Plus Benefit Highlights
12-10 2021 – PPO 70 1500 Plus Benefit Highlights
13-10 2021 – PPO 70 2000 Plus Benefit Highlights
14-10 2021 – PPO 70 2500 Plus Benefit Highlights
15-10 2021 – PPO 70 3000 Plus Benefit Highlights
16-10 2021 – PPO 70 4000 Plus Benefit Highlights
17-10 2021 – PPO 70 5000 Plus Benefit Highlights
18-10 2021 – PPO 70 6000 Plus Benefit Highlights
Prime Benefit – 70% PPO Plans
11-10 2021 – Prime PPO 70 1000 Benefit Highlights
12-10 2021 – Prime PPO 70 1500 Benefit Highlights
13-10 2021 – Prime PPO 70 2000 Benefit Highlights
14-10 2021 – Prime PPO 70 2500 Benefit Highlights
15-10 2021 – Prime PPO 70 3000 Benefit Highlights
16-10 2021 – Prime PPO 70 4000 Benefit Highlights
17-10 2021 – Prime PPO 70 5000 Benefit Highlights
18-10 2021 – Prime PPO 70 6000 Benefit Highlights
Plus Benefit – 50 and 100% PPO Plans
19-10 2021 – PPO 100 5500 Plus Benefit Highlights
20-10 2021 – PPO 100 8000 Plus Benefit Highlights
21-10 2021 – PPO 50 50-50 Plus Benefit Highlights
22-10 2021 – PPO 50 1000 Plus Benefit Highlights
23-10 2021 – PPO 50 2000 Plus Benefit Highlights
Prime Benefit – 50 and 100% PPO Plans
19-10 2021 – Prime PPO 100 5500 Benefit Highlights
20-10 2021 – Prime PPO 100 8000 Benefit Highlights
21-10 2021 – Prime PPO 50 50-50 Benefit Highlights
22-10 2021 – Prime PPO 50 1000 Benefit Highlights
23-10 2021 – Prime PPO 50 2000 Benefit Highlights
Plus HSA Plans
24-10 2021 – HSA 1500 Plus Benefit Highlights
25-10 2021 – HSA 2500 Plus Benefit Highlights
26-10 2021 – HSA 3500 Plus Benefit Highlights
27-10 2021 – HSA 5500 Plus Benefit Highlights
Prime HSA Plans
24-10 2021 – Prime HSA 1500 Benefit Highlights
25-10 2021 – Prime HSA 2500 Benefit Highlights
26-10 2021 – Prime HSA 3500 Benefit Highlights
27-10 2021 – Prime HSA 5500 Benefit Highlights
Current Year
Plus Benefit – 80% PPO Plans
01-2021 WFB PPO 80% Plan 250 Heritage
02-2021 WFB PPO 80% Plan 500 Heritage
03-2021 WFB PPO 80% Plan 750 Heritage
04-2021 WFB PPO 80% Plan 1000 Heritage
05-2021 WFB PPO 80% Plan 1500 Heritage
06-2021 WFB PPO 80% Plan 2000 Heritage
07-2021 WFB PPO 80% Plan 2500 Heritage
08-2021 WFB PPO 80% Plan 3000 Heritage
09-2021 WFB PPO 80% Plan 4000 Heritage
10-2021 WFB PPO 80% Plan 5000 Heritage
Prime Benefit – 80% PPO Plans
01-2021 WFB PPO 80% Plan 250 Heritage Prime
02-2021 WFB PPO 80% Plan 500 Heritage Prime
03-2021 WFB PPO 80% Plan 750 Heritage Prime
04-2021 WFB PPO 80% Plan 1000 Heritage Prime
05-2021 WFB PPO 80% Plan 1500 Heritage Prime
06-2021 WFB PPO 80% Plan 2000 Heritage Prime
07-2021 WFB PPO 80% Plan 2500 Heritage Prime
08-2021 WFB PPO 80% Plan 3000 Heritage Prime
09-2021 WFB PPO 80% Plan 4000 Heritage Prime
10-2021 WFB PPO 80% Plan 5000 Heritage Prime
Plus Benefit – 70% PPO Plans
11-2021 WFB PPO 70% Plan 1000 Heritage
12-2021 WFB PPO 70% Plan 1500 Heritage
13-2021 WFB PPO 70% Plan 2000 Heritage
14-2021 WFB PPO 70% Plan 2500 Heritage
15-2021 WFB PPO 70% Plan 3000 Heritage
16-2021 WFB PPO 70% Plan 4000 Heritage
17-2021 WFB PPO 70% Plan 5000 Heritage
18-2021 WFB PPO 70% Plan 6000 Heritage
Prime Benefit – 70% PPO Plans
11-2021 WFB PPO 70% Plan 1000 Heritage Prime
12-2021 WFB PPO 70% Plan 1500 Heritage Prime
13-2021 WFB PPO 70% Plan 2000 Heritage Prime
14-2021 WFB PPO 70% Plan 2500 Heritage Prime
15-2021 WFB PPO 70% Plan 3000 Heritage Prime
16-2021 WFB PPO 70% Plan 4000 Heritage Prime
17-2021 WFB PPO 70% Plan 5000 Heritage Prime
18-2021 WFB PPO 70% Plan 6000 Heritage Prime
Plus Benefit – 50 and 100% PPO Plans
19-2021 WFB PPO 100% Plan 5500 Heritage
20-2021 WFB PPO 100% Plan 8000 Heritage
21-2021 WFB PPO 50% 50-50 Plan Heritage
22-2021 WFB PPO 50% Plan 1000 Heritage
23-2021 WFB PPO 50% Plan 2000 Heritage
Prime Benefit – 50 and 100% PPO Plans
19-2021 WFB PPO 100% Plan 5500 Heritage Prime
20-2021 WFB PPO 100% Plan 8000 Heritage Prime
21-2021 WFB PPO 50% 50-50 Plan Heritage Prime
22-2021 WFB PPO 50% Plan 1000 Heritage Prime
23-2021 WFB PPO 50% Plan 2000 Heritage Prime
Plus HSA Plans
24-2021 WFB HSA 1500 Plan Heritage
25-2021 WFB HSA 2500 Plan Heritage
26-2021 WFB HSA 3500 Plan Heritage
27-2021 WFB HSA 5500 Plan Heritage
Prime HSA Plans
24-2021 WFB HSA 1500 Plan Heritage Prime
25-2021 WFB HSA 2500 Plan Heritage Prime
26-2021 WFB HSA 3500 Plan Heritage Prime
27-2021 WFB HSA 5500 Plan Heritage Prime
Dental Plans
Upcoming Year
Delta Dental of Washington
WFB Plan 1 00085 2022-2023
WFB Plan 2 00086 2022-2023
WFB Plan 3 00087 2022-2023
WFB Plan 4 00088 2022-2023
WFB Plan 5 00089 Vol 2022-2023
WFB Plan 6 00097 Vol 2022-2023
Delta Dental of Washington – Plans 1 -4 – With Ortho
WFB Plan 1 00085 Ortho 2022-2023
WFB Plan 2 00086 Ortho 2022-2023
WFB Plan 3 00087 Ortho 2022-2023
WFB Plan 4 00088 Ortho 2022-2023
Current Year
Delta Dental of Washington
00085 Washington Farm Bureau Plan 1 2021-22
00086 Washington Farm Bureau Plan 2 2021-22
00087 Washington Farm Bureau Plan 3 2021-22
00088 Washington Farm Bureau Plan 4 2021-22
00089 Washington Farm Bureau Vol Plan 5 2021-22
00097 Washington Farm Bureau Vol Plan 6 2021-22
Delta Dental of Washington – Plans 1 -4 – With Ortho
00085 Washington Farm Bureau Plan 1 Ortho 2021-22
00086 Washington Farm Bureau Plan 2 Ortho 2021-22
00087 Washington Farm Bureau Plan 3 Ortho 2021-22
00088 Washington Farm Bureau Plan 4 Ortho 2021-22
Vision Plans
Current Year
Exam Plus – VSP Vision Plan
Exam Plus 0121
Exam Plus 0121 Spanish
Basic – VSP Vision Plan
Basic 0121
Basic 0121MBS- Spanish
Preferred – VSP Vision Plan
Preferred 0121
Preferred 0121 MBS- Spanish
Enhanced – VSP Vision Plan
Enhanced 0121
Enhanced 0121 MBS- Spanish
Life Plans
LifeMap Life AD&D $10k
$10k Life/AD&D Summary (Spanish)
$10k Life/ AD&D Summary
$10k Life/AD&D Certificate + Dependant Life
LifeMap Life AD&D $15k
$15k Life/AD&D Summary (Spanish)
$15k Life/AD&D Summary
$15k Life/AD&D Certificate + Dependent
LifeMap Life AD&D $25k
$25k Life/AD&D Summary (Spanish)
$25k Life/AD&D Summary
$25k Life/AD&D Certificate + Dependant Life
LifeMap Life AD&D $50k
$50 Life/AD&D Summary (Spanish)
$50k Life/AD&D Summary
W$50k Life/AD&D Certificate + Dependent Life
LifeMap $10k Certificate of Coverage
$10k Life and AD&D Benefit
WFB-Healthcare-LifeMap-Life-ADD-Plan-1-
LifeMap $15k Certificate of Coverage
$15k Life and AD&D Benefit
WFB-Healthcare-LifeMap-Life-ADD-Plan-2-
LifeMap $25 Certificate of Coverage
$25k Life and AD&D Benefit
WFB-Healthcare-LifeMap-Life-ADD-Plan-3-
LifeMap $50k Certificate of Coverage
W$50k Life and AD&D Benefit
WFB-Healthcare-LifeMap-Life-ADD-Plan-4