Northwest Plumbing and
Pipefitting Industry
Health, Welfare, and Vacation Trust

ADMINISTERED BY:
Welfare & Pension Administration Service, Inc.
 

Northwest Ironworkers - Forms

Select from the above categories.

Where to send completed forms:

Medical claims for Active Members and Non-Medicare Retirees:

Premera Blue Cross
PO Box 91080
Seattle, WA 98111-9180

Medicare Retiree Medical claims:

Administration Office
P.O. Box 34464
Seattle, WA 98124-1464

Dental claims:

Administration Office
P.O. Box 34464
Seattle, WA 98124-1464

Retail Rx claims:

Administration Office
P.O. Box 34464
Seattle, WA 98124-1464

Time Loss claims and all other completed forms:

Administration Office
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.

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