Operating Engineers - Forms
Select from the above categories.
Where to send completed forms
- ACTIVE AND NON-MEDICARE RETIREES
- Medical and Vision Claims
- PPO Services Obtained in Oregon mail claims to:
Regence BlueCross BlueShield of Oregon
PO Box 30805
Salt Lake City, UT 84130-0805
- PPO Services Obtained in Washington & Alaska mail claims to:
Premera Blue Cross
PO Box 91080
Seattle, WA 98111-9180
- All Other Areas mail claims to:
Local BlueCard Plan
- Member Paid Claims, Dental Claims, and Time Loss Claims mail to:
AGC IUOE Local 701 H&W
PO Box 34687
Seattle, WA 98124-1687
- MEDICARE RETIREES
- Mail ALL claims to:
AGC IUOE Local 701 H&W
PO Box 34687
Seattle, WA 98124-1687
- ALL OTHER COMPLETED FORMS:
Administration Office
15 82nd Drive, Suite 200
Gladstone, OR 97027
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