Welcome to AGC Health Benefit Trust – Washington Chapter

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SIMON Account Login 
Online Administration for Billing & Enrollment

AGC of Washington Website
Inland Northwest AGC Website 

Customer Service 
p: 503.450.9796
f: 503.459.4555
e: service@agchealthplansnw.com

Program Overview:

  • Overview
  • Product Grid
  • Underwriting Guidelines
  • Member Contact Information
  • Vimly Administration Guide

Quoting & Submission Materials

Quoting Materials

  • Quote Request Form
  • Census Template

Submission Materials

  • Submission Checklist
  • Employer Application
  • Employee Enrollment Form
  • Enrollment Census Template
  • SBC Acknowledgement Form
  • Late Submission Letter
  • EFT Authorization Form
  • Vimly COBRA Administrative Agreement

“Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.”

“Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.”

  • “Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.”

Medical/RX – United Healthcare

Links, Forms & Helpful Information

  • UHC Website
  • Welcome to myUHC

SBC’s

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Benefit Summaries

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Dental – Delta Dental

Links, Forms & Helpful Information

  • Delta Dental Website
  • Delta Dental Provider Lookup
  • Dental Claim Form

Benefit Summaries

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Vision – Standard

Links, Forms & Helpful Information

  • Standard Website
  • Provider Lookup
  • Vision Claim Form

Benefit Summaries

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Certificates

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Ancillary Benefits & Programs

Ancillary Benefits & Programs

  • United Healthcare Life/AD&D Benefit Overview
  • Life/AD/&D Benefit Summaries $10k, $20k, $30k, $40k, $50k
  • Life/AD&D Certificate (All Increments of Coverage)
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