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CONTACT US | LIFEWISE ASSURANCE COMPANY Physical address. LifeWise Assurance Company 7001 220th St. S.W., Building 2 Mountlake Terrace, Washington 98043 Mailing address. P.O. Box 2272 Seattle, Washington 98111-2272 Telephone. 425-918-4575 Toll free 800-258-0394 Fax. 425-918-4485 Toll free 800-628-2380 Email LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONS LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.comMETALLIC M4
054567 (05-27-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 06-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
CONTACT US | LIFEWISE ASSURANCE COMPANY Physical address. LifeWise Assurance Company 7001 220th St. S.W., Building 2 Mountlake Terrace, Washington 98043 Mailing address. P.O. Box 2272 Seattle, Washington 98111-2272 Telephone. 425-918-4575 Toll free 800-258-0394 Fax. 425-918-4485 Toll free 800-628-2380 Email LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONS LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.comMETALLIC M4
054567 (05-27-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 06-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP StudentsSTOP-LOSS COVERAGE
Benefits that may be included in LifeWise Assurance Stop Loss: Deductible levels ranging from $20,000 to $500,000 based on group size and needs, subject to state requirements. Aggregate stop-loss coverage from 120% to 200% of expected claims, subject to state requirements. Standard stop-loss contract basis of 12/12 first year, which wouldrenew
LIFEWISE ASSURANCE COMPANY Member benefit booklets, summary of coverage Sign in to check member eligibility online and use the booklets below for more coverage details. If you have questions, call 800-971-1491. COVID Endorsement All plans UW International Student Health Insurance Plan (ISHIP) LIFEWISE ASSURANCE COMPANY Use the app to find care options anytime or anywhere. Locate nearby in-network doctors, hospitals, urgent care facilities, and more. Or schedule a call or video consultation with a doctor. View your claims. Use the app from anywhere to view detailed claims info for you and your dependents. You'll see when LifeWise receives a claim, when wepay
EMPLOYERS FAQ
Your partner in self-funded coverage. LifeWise Assurance Company provides self-insured employers the security they need. As a member of the Premera family of companies, we can offer you the security and resources of a major regional carrier and the dedicated, individualized service of a local company. LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 800-842-5357 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940. Claims Submission. PO Box 91059 Seattle, WA 98111-9159. Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays.Browser Support
LIFEWISE ASSURANCE COMPANY Call 800-971-1491. Mail billing and claims submissions to: LifeWise Assurance Company. PO Box 91059. Seattle, WA 98111-9159. LIFEWISE ASSURANCE COMPANY Allow access to notes made by medical professionals providing psychiatric or psychological services. Complaint and Appeal Information (.pdf) View LifeWise’s complaint and appeal process. Member Appeal and Authorization (.pdf) Request an appeal of a decision and give your permission for another person to submit an appeal onyour behalf.
GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (08-03-2020) LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company considers mental health and chemical addiction or dependency treatment as specialty care. Contact us, using the number on the back of your member ID card, if you can't get an appointment with a behavioral health provider within 15 business days. and providers in your network. Get started with a therapist. CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONS LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.com HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more.LOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company LifeWise Student Insurance response to COVID-19. LifeWise is waiving cost shares for all COVID-19 related testing and treatment. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONS LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.com SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 10/01/2020 – 09/30/2021 LifeWise Assurance Company: UW GAIP + Vision/Dental Coverage for: Individual or Family | Plan Type: PPO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (08-03-2020)METALLIC M4
054567 (05-27-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 06-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more.LOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company LifeWise Student Insurance response to COVID-19. LifeWise is waiving cost shares for all COVID-19 related testing and treatment. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONS LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.com SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 10/01/2020 – 09/30/2021 LifeWise Assurance Company: UW GAIP + Vision/Dental Coverage for: Individual or Family | Plan Type: PPO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (08-03-2020)METALLIC M4
054567 (05-27-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 06-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers.STOP-LOSS COVERAGE
Benefits that may be included in LifeWise Assurance Stop Loss: Deductible levels ranging from $20,000 to $500,000 based on group size and needs, subject to state requirements. Aggregate stop-loss coverage from 120% to 200% of expected claims, subject to state requirements. Standard stop-loss contract basis of 12/12 first year, which wouldrenew
LIFEWISE ASSURANCE COMPANY Member benefit booklets, summary of coverage Sign in to check member eligibility online and use the booklets below for more coverage details. If you have questions, call 800-971-1491. COVID Endorsement All plans UW International Student Health Insurance Plan (ISHIP) LIFEWISE ASSURANCE COMPANY People without internet access can call DOH at 800-525-0127, press #, or 888-856-5816. Again, be patient, because at times the phone lines have been flooded with calls. To get on a wait list at MultiCare, call its automated line at 833-770-0530. You can also get on Virginia Mason's wait list and fill LIFEWISE ASSURANCE COMPANY Call 800-971-1491. Mail billing and claims submissions to: LifeWise Assurance Company. PO Box 91059. Seattle, WA 98111-9159. LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 800-842-5357 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940. Claims Submission. PO Box 91059 Seattle, WA 98111-9159. Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays.Browser Support
SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 10/01/2020 – 09/30/2021 LifeWise Assurance Company: UW GAIP + Vision/Dental Coverage for: Individual or Family | Plan Type: PPO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. LIFEWISE ASSURANCE COMPANY Enrollment. I have a TA/RA/SA appointment. Where do I get information regarding my appointment)? The UW Benefits Office is the plan contact at the University of Washington and can handle questions regardingyour appointment.
GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (09-01-2019) STUDENT INSURANCE OTHER COVERAGE QUESTIONNAIRE ENROLLMENT 023071 (01-2015) student.lifewiseac.com Other Coverage Questionnaire Enrollment Customer Service: 800-971-1491 Hearing Impaired: 800-842-5357
HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. “GAIP” GRADUATE APPOINTEE INSURANCE PROGRAM GAIP UW C (10-2020) 3 Diagnostic X-ray, Lab and Imaging After $1,000 Hall Health Maximum Benefit, benefits then: • 0% coinsurance, Preventive care screening and tests 0% coinsurance,METALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students PRE-SERVICE/ PRIOR AUTHORIZATION REVIEW REQUEST Note: Unless specifically requested elsewhere in this do cument, do not send a DNA or other genetic sample, or the results of any genetic typing, test, or analysis, including DNA. Confidentiality Notice: The information contained in this fax message i s privileged or confidential and intended only for the individual or entity namedabove.
HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. “GAIP” GRADUATE APPOINTEE INSURANCE PROGRAM GAIP UW C (10-2020) 3 Diagnostic X-ray, Lab and Imaging After $1,000 Hall Health Maximum Benefit, benefits then: • 0% coinsurance, Preventive care screening and tests 0% coinsurance,METALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students PRE-SERVICE/ PRIOR AUTHORIZATION REVIEW REQUEST Note: Unless specifically requested elsewhere in this do cument, do not send a DNA or other genetic sample, or the results of any genetic typing, test, or analysis, including DNA. Confidentiality Notice: The information contained in this fax message i s privileged or confidential and intended only for the individual or entity namedabove.
ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
CONTACT US | LIFEWISE ASSURANCE COMPANY Physical address. LifeWise Assurance Company 7001 220th St. S.W., Building 2 Mountlake Terrace, Washington 98043 Mailing address. P.O. Box 2272 Seattle, Washington 98111-2272 Telephone. 425-918-4575 Toll free 800-258-0394 Fax. 425-918-4485 Toll free 800-628-2380 EmailLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , orSTOP-LOSS COVERAGE
Benefits that may be included in LifeWise Assurance Stop Loss: Deductible levels ranging from $20,000 to $500,000 based on group size and needs, subject to state requirements. Aggregate stop-loss coverage from 120% to 200% of expected claims, subject to state requirements. Standard stop-loss contract basis of 12/12 first year, which wouldrenew
FRAUD AND ABUSE
At LifeWise, it’s critical that we do all we can to prevent, detect, and investigate healthcare fraud and abuse by providers, producers, employer groups or members. LifeWise has a Special Investigations Unit to look into suspected instances of fraud. We also have a Fraud Hotline you can call anytime (800-360-9535) to report fraud. LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 800-842-5357 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940. Claims Submission. PO Box 91059 Seattle, WA 98111-9159. Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays.Browser Support
LIFEWISE ASSURANCE COMPANY People without internet access can call DOH at 800-525-0127, press #, or 888-856-5816. Again, be patient, because at times the phone lines have been flooded with calls. To get on a wait list at MultiCare, call its automated line at 833-770-0530. You can also get on Virginia Mason's wait list and fill SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 10/01/2020 – 09/30/2021 LifeWise Assurance Company: UW GAIP + Vision/Dental Coverage for: Individual or Family | Plan Type: PPO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. LIFEWISE ASSURANCE COMPANY Need help? Give us a call. Contracted providers: Call Physician and Provider Relations at 877-342-5258, option 4 Non-contracted providers: Call Customer Service at 877-342-5258, option 2 For payment questions, call Customer Service at 877-342-5258, option 2 For technical support managing your OneHealthPort account, call 800-973-4797. GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (08-03-2020) HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. “GAIP” GRADUATE APPOINTEE INSURANCE PROGRAM GAIP UW C (10-2020) 3 Diagnostic X-ray, Lab and Imaging After $1,000 Hall Health Maximum Benefit, benefits then: • 0% coinsurance, Preventive care screening and tests 0% coinsurance,METALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students PRE-SERVICE/ PRIOR AUTHORIZATION REVIEW REQUEST Note: Unless specifically requested elsewhere in this do cument, do not send a DNA or other genetic sample, or the results of any genetic typing, test, or analysis, including DNA. Confidentiality Notice: The information contained in this fax message i s privileged or confidential and intended only for the individual or entity namedabove.
HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. “GAIP” GRADUATE APPOINTEE INSURANCE PROGRAM GAIP UW C (10-2020) 3 Diagnostic X-ray, Lab and Imaging After $1,000 Hall Health Maximum Benefit, benefits then: • 0% coinsurance, Preventive care screening and tests 0% coinsurance,METALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students PRE-SERVICE/ PRIOR AUTHORIZATION REVIEW REQUEST Note: Unless specifically requested elsewhere in this do cument, do not send a DNA or other genetic sample, or the results of any genetic typing, test, or analysis, including DNA. Confidentiality Notice: The information contained in this fax message i s privileged or confidential and intended only for the individual or entity namedabove.
ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
CONTACT US | LIFEWISE ASSURANCE COMPANY Physical address. LifeWise Assurance Company 7001 220th St. S.W., Building 2 Mountlake Terrace, Washington 98043 Mailing address. P.O. Box 2272 Seattle, Washington 98111-2272 Telephone. 425-918-4575 Toll free 800-258-0394 Fax. 425-918-4485 Toll free 800-628-2380 EmailLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , orSTOP-LOSS COVERAGE
Benefits that may be included in LifeWise Assurance Stop Loss: Deductible levels ranging from $20,000 to $500,000 based on group size and needs, subject to state requirements. Aggregate stop-loss coverage from 120% to 200% of expected claims, subject to state requirements. Standard stop-loss contract basis of 12/12 first year, which wouldrenew
FRAUD AND ABUSE
At LifeWise, it’s critical that we do all we can to prevent, detect, and investigate healthcare fraud and abuse by providers, producers, employer groups or members. LifeWise has a Special Investigations Unit to look into suspected instances of fraud. We also have a Fraud Hotline you can call anytime (800-360-9535) to report fraud. LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 800-842-5357 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940. Claims Submission. PO Box 91059 Seattle, WA 98111-9159. Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays.Browser Support
LIFEWISE ASSURANCE COMPANY People without internet access can call DOH at 800-525-0127, press #, or 888-856-5816. Again, be patient, because at times the phone lines have been flooded with calls. To get on a wait list at MultiCare, call its automated line at 833-770-0530. You can also get on Virginia Mason's wait list and fill SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 10/01/2020 – 09/30/2021 LifeWise Assurance Company: UW GAIP + Vision/Dental Coverage for: Individual or Family | Plan Type: PPO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. LIFEWISE ASSURANCE COMPANY Need help? Give us a call. Contracted providers: Call Physician and Provider Relations at 877-342-5258, option 4 Non-contracted providers: Call Customer Service at 877-342-5258, option 2 For payment questions, call Customer Service at 877-342-5258, option 2 For technical support managing your OneHealthPort account, call 800-973-4797. GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (08-03-2020) HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. “GAIP” GRADUATE APPOINTEE INSURANCE PROGRAM GAIP UW C (10-2020) 3 Diagnostic X-ray, Lab and Imaging After $1,000 Hall Health Maximum Benefit, benefits then: • 0% coinsurance, Preventive care screening and tests 0% coinsurance,METALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students PRE-SERVICE/ PRIOR AUTHORIZATION REVIEW REQUEST Note: Unless specifically requested elsewhere in this do cument, do not send a DNA or other genetic sample, or the results of any genetic typing, test, or analysis, including DNA. Confidentiality Notice: The information contained in this fax message i s privileged or confidential and intended only for the individual or entity namedabove.
HOME | LIFEWISE ASSURANCE COMPANY Welcome. LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. Learn more. ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , or LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANY LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. “GAIP” GRADUATE APPOINTEE INSURANCE PROGRAM GAIP UW C (10-2020) 3 Diagnostic X-ray, Lab and Imaging After $1,000 Hall Health Maximum Benefit, benefits then: • 0% coinsurance, Preventive care screening and tests 0% coinsurance,METALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students PRE-SERVICE/ PRIOR AUTHORIZATION REVIEW REQUEST Note: Unless specifically requested elsewhere in this do cument, do not send a DNA or other genetic sample, or the results of any genetic typing, test, or analysis, including DNA. Confidentiality Notice: The information contained in this fax message i s privileged or confidential and intended only for the individual or entity namedabove.
ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
CONTACT US | LIFEWISE ASSURANCE COMPANY Physical address. LifeWise Assurance Company 7001 220th St. S.W., Building 2 Mountlake Terrace, Washington 98043 Mailing address. P.O. Box 2272 Seattle, Washington 98111-2272 Telephone. 425-918-4575 Toll free 800-258-0394 Fax. 425-918-4485 Toll free 800-628-2380 EmailLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , orSTOP-LOSS COVERAGE
Benefits that may be included in LifeWise Assurance Stop Loss: Deductible levels ranging from $20,000 to $500,000 based on group size and needs, subject to state requirements. Aggregate stop-loss coverage from 120% to 200% of expected claims, subject to state requirements. Standard stop-loss contract basis of 12/12 first year, which wouldrenew
FRAUD AND ABUSE
At LifeWise, it’s critical that we do all we can to prevent, detect, and investigate healthcare fraud and abuse by providers, producers, employer groups or members. LifeWise has a Special Investigations Unit to look into suspected instances of fraud. We also have a Fraud Hotline you can call anytime (800-360-9535) to report fraud. LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 800-842-5357 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940. Claims Submission. PO Box 91059 Seattle, WA 98111-9159. Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays.Browser Support
LIFEWISE ASSURANCE COMPANY People without internet access can call DOH at 800-525-0127, press #, or 888-856-5816. Again, be patient, because at times the phone lines have been flooded with calls. To get on a wait list at MultiCare, call its automated line at 833-770-0530. You can also get on Virginia Mason's wait list and fill SUMMARY OF BENEFITS AND COVERAGE: WHAT THIS PLAN COVERS Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 10/01/2020 – 09/30/2021 LifeWise Assurance Company: UW GAIP + Vision/Dental Coverage for: Individual or Family | Plan Type: PPO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. LIFEWISE ASSURANCE COMPANY Need help? Give us a call. Contracted providers: Call Physician and Provider Relations at 877-342-5258, option 4 Non-contracted providers: Call Customer Service at 877-342-5258, option 2 For payment questions, call Customer Service at 877-342-5258, option 2 For technical support managing your OneHealthPort account, call 800-973-4797. GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (08-03-2020) ABOUT US | LIFEWISE ASSURANCE COMPANYLIFEWISE DENTAL INSURANCELIFEWISE HEALTHLIFEWISE NETWORK PROVIDERS LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , orFRAUD AND ABUSE
At LifeWise, it’s critical that we do all we can to prevent, detect, and investigate healthcare fraud and abuse by providers, producers, employer groups or members. LifeWise has a Special Investigations Unit to look into suspected instances of fraud. We also have a Fraud Hotline you can call anytime (800-360-9535) to report fraud. LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANYLIFEWISE ASSURANCE COMPANY STUDENT INSURA…LIFEWISE STUDENT INSURANCELIFEWISE INSURANCE WASHINGTON STATELIFEWISE ASSURANCE PROVIDERLIFEWISE ASSURANCELIFEWISE HEALTHINSURANCE
LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. LIFEWISE ASSURANCE COMPANY Imaging (CT scan, echocardiography, MRI, MRA, nuclear cardiology, PET scan) Radiation oncology. Sleep study. View the code list (.pdf) to see which codes require review. View AIM Clinical Appropriateness Guidelines. To request a prior authorization , register with AIM and then submit your request online or by phone at 866-666-0776. LIFEWISE ASSURANCE COMPANYLIFEWISE ASSURANCE PROVIDERLIFEWISE ASSURANCE COMPANY SEATTLELIFEWISE ASSURANCE COMPANY CUSTOMER SERV…LIFEWISE ASSURANCE COMPANY STUDENT INSURA…LIFEWISE PROVIDER LINELIFEWISE INSURANCE People without internet access can call DOH at 800-525-0127, press #, or 888-856-5816. Again, be patient, because at times the phone lines have been flooded with calls. To get on a wait list at MultiCare, call its automated line at 833-770-0530. You can also get on Virginia Mason's wait list and fill CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONSCLAIMS REIMBURSEMENT AND REPORTING SYSTEMCRRS CLAIMS REIMBURSEMENTEDUCATION CLAIMS AND REIMBURSEMENTMEDICAL REIMBURSEMENT CLAIM FORM LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.com ABOUT US | LIFEWISE ASSURANCE COMPANYLIFEWISE DENTAL INSURANCELIFEWISE HEALTHLIFEWISE NETWORK PROVIDERS LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 711 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940 . Claims Submission. PO Box 91059 Seattle, WA 98111-9159 . Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdaysLOG IN
× Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , orFRAUD AND ABUSE
At LifeWise, it’s critical that we do all we can to prevent, detect, and investigate healthcare fraud and abuse by providers, producers, employer groups or members. LifeWise has a Special Investigations Unit to look into suspected instances of fraud. We also have a Fraud Hotline you can call anytime (800-360-9535) to report fraud. LIFEWISE ASSURANCE COMPANY Benefits and Using Your Plan. COVID-19 Vaccine, Care and Coverage. NEW Mobile App. Plan Information. Pharmacy. Find a Doctor, Hospital, Clinic or Other Provider. Access Your Claims. Find a Form. LIFEWISE ASSURANCE COMPANYLIFEWISE ASSURANCE COMPANY STUDENT INSURA…LIFEWISE STUDENT INSURANCELIFEWISE INSURANCE WASHINGTON STATELIFEWISE ASSURANCE PROVIDERLIFEWISE ASSURANCELIFEWISE HEALTHINSURANCE
LifeWise is waiving member cost shares including copays, deductible, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, FDA-approved medications administered inpatient for both in- and out-of-network providers. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company. Notification: If you are having difficulties with the enrollment tool and need to enroll a dependent, please contact customer service for assistance at 800-971-1491. LIFEWISE ASSURANCE COMPANY Imaging (CT scan, echocardiography, MRI, MRA, nuclear cardiology, PET scan) Radiation oncology. Sleep study. View the code list (.pdf) to see which codes require review. View AIM Clinical Appropriateness Guidelines. To request a prior authorization , register with AIM and then submit your request online or by phone at 866-666-0776. LIFEWISE ASSURANCE COMPANYLIFEWISE ASSURANCE PROVIDERLIFEWISE ASSURANCE COMPANY SEATTLELIFEWISE ASSURANCE COMPANY CUSTOMER SERV…LIFEWISE ASSURANCE COMPANY STUDENT INSURA…LIFEWISE PROVIDER LINELIFEWISE INSURANCE People without internet access can call DOH at 800-525-0127, press #, or 888-856-5816. Again, be patient, because at times the phone lines have been flooded with calls. To get on a wait list at MultiCare, call its automated line at 833-770-0530. You can also get on Virginia Mason's wait list and fill CLAIMS REIMBURSEMENT AND REPORTING INSTRUCTIONSCLAIMS REIMBURSEMENT AND REPORTING SYSTEMCRRS CLAIMS REIMBURSEMENTEDUCATION CLAIMS AND REIMBURSEMENTMEDICAL REIMBURSEMENT CLAIM FORM LifeWise Assurance Company PO Box 2272 Seattle, WA 98111-2272 Phone: 425-918-4575 800-258-0394 Fax: 425-918-4485 800-628-2380 Email: LWACStopLossClaims@LifeWiseAC.com ABOUT US | LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company is your source for flexible, reliable stop-loss coverage, user-friendly online tools, and unsurpassed support. We provide stop-loss insurance programs to employers in the following states: Alaska. Oregon. Washington. Over the past quarter-century, we’ve built and maintained solid relationships withthousands of
CONTACT US | LIFEWISE ASSURANCE COMPANY Physical address. LifeWise Assurance Company 7001 220th St. S.W., Building 2 Mountlake Terrace, Washington 98043 Mailing address. P.O. Box 2272 Seattle, Washington 98111-2272 Telephone. 425-918-4575 Toll free 800-258-0394 Fax. 425-918-4485 Toll free 800-628-2380 EmailSTOP-LOSS COVERAGE
Benefits that may be included in LifeWise Assurance Stop Loss: Deductible levels ranging from $20,000 to $500,000 based on group size and needs, subject to state requirements. Aggregate stop-loss coverage from 120% to 200% of expected claims, subject to state requirements. Standard stop-loss contract basis of 12/12 first year, which wouldrenew
LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company LifeWise Student Insurance response to COVID-19. LifeWise is waiving cost shares for all COVID-19 related testing and treatment. LIFEWISE ASSURANCE COMPANY LifeWise Assurance Company considers mental health and chemical addiction or dependency treatment as specialty care. Contact us, using the number on the back of your member ID card, if you can't get an appointment with a behavioral health provider within 15 business days. and providers in your network. Get started with a therapist. LIFEWISE ASSURANCE COMPANY Call 800-971-1491. Mail billing and claims submissions to: LifeWise Assurance Company. PO Box 91059. Seattle, WA 98111-9159. LIFEWISE ASSURANCE COMPANY Customer Service. 800-971-1491 TDD / TTY: 800-842-5357 5 a.m. to 8 p.m. Pacific, Monday to Friday. Mailing Address. LifeWise Assurance Company PO Box 33940 Seattle, WA 98133-0940. Claims Submission. PO Box 91059 Seattle, WA 98111-9159. Office Location. 7001 – 220th St SW, Building 1 Mountlake Terrace, WA 98043 8 a.m. to 5 p.m. weekdays.Browser Support
LOG OUT - STUDENT.LIFEWISEAC.COM × Uh-oh, looks like your browser needs an update. This site has been developed and optimized to render on the latest version of Internet Explorer, Google Chrome , orMETALLIC M4
054567 (05-04-2021) Metallic M4 - List of Covered Drugs (Formulary) Effective Date: 05-01-2021 The Metallic M4 Formulary is used by these plans: University of Washington ISHIP Students GOLD + VISION/DENTAL “ISHIP” INTERNATIONAL STUDENT HEALTH INSURANCE PLAN Gold + Vision/Dental 023423 (09-01-2019)Menu
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