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Northwest Ironworkers - FormsSelect from the above categories. Documents on this website are formatted in Adobe's Portable Document Format (PDF). To view these documents, you need the FREE Adobe Acrobat Reader. If you do not already have Acrobat, click on the icon below to download it.
Where to send completed forms:
Medical claims for Active Members and Non-Medicare Retirees: PO Box 91080 Seattle, WA 98111-9180
Medicare Retiree Medical claims: P.O. Box 34464 Seattle, WA 98124-1464
Dental claims: P.O. Box 34464 Seattle, WA 98124-1464
Retail Rx claims: P.O. Box 545 Deerfield, IL 60015
Time Loss claims and all other completed forms: P.O. Box 34203 Seattle, WA 98124-1203 Pre-Authorization: Required for inpatient and/or outpatient chemical dependency and before hospital admission or within 48 hours of emergency admission. Call First Choice at 1-800-231-6935. Protected Health Information Notices and Forms can be found on the Privacy page. To access personal information online or reset your personal access number, please use the PIN Request Form.
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