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  • Regence Quote Request Form

Get Regence Quote Request Form

E send it to: Via: Email Seattle, Washington 98101 Company Contact Person Fax Producer Mail Please tell us about your company: Company Name Contact Person Type of Business SIC Code (if known) Number of Employees Street Address City State County Where Company is Located Phone Number Fax Number Email Address Do you have any employees in other states that are not listed? Percent of Premium Company Pays Employee Medical % Dependent Medical.

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How to fill out the Regence Quote Request Form online

This guide provides a step-by-step approach to completing the Regence Quote Request Form online. Whether you are seeking coverage for medical or dental services, this comprehensive overview will help ensure you fill out the form correctly and efficiently.

Follow the steps to complete your quote request form

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your preferred effective date for coverage in the designated field. Use the mm/dd/yyyy format for clarity.
  3. Provide your company’s address including the street address, city, state, county, and ZIP code to ensure accurate communication.
  4. Fill in the primary contact information, including the contact person's name, phone number, fax number, and email address.
  5. Indicate whether there are employees based in other states not listed in the form.
  6. Complete the section regarding the percentage of premiums your company will pay for employee and dependent medical and dental coverage.
  7. If applicable, disclose any affiliations with other companies and provide the name of the current carrier for medical and dental coverage.
  8. If Regence is your current carrier, include your group number and then provide details for your producer, if you have one.
  9. List the employees who will be covered under the policy. Include their names, dates of birth or ages, and specify if a spouse will be covered.
  10. For any additional employees beyond ten, attach separate sheets detailing their information.
  11. Review all entered information for accuracy and completeness before proceeding.
  12. Once satisfied with the form, you can save changes, download, print, or share the completed form as necessary.

Complete your Regence Quote Request Form online today for prompt assistance!

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Contact support

You can reach RGA customer service at 1-800-234-1234. The service representatives are available to assist you with any questions related to your health plan. For a more detailed exploration of your options, the Regence Quote Request Form can also provide helpful guidance.

Regence offers programs that may partially cover gym memberships as part of its wellness incentives. This can encourage you to stay active and healthy. To find out if a specific gym is included in your benefits, you can request additional details with the Regence Quote Request Form.

Yes, Regence provides options for vision and dental coverage depending on your selected plan. These benefits can help you maintain comprehensive health, making it easy for you to handle routine check-ups and treatments. You can learn more about these options through the Regence Quote Request Form.

Yes, Regence Blue Shield offers a mobile app that provides convenient access to health information and services. Users can manage their healthcare benefits, find doctors, and submit claims easily through this app. To streamline your experience even further, consider using the Regence Quote Request Form to explore insurance options that fit your lifestyle.

The parent company of Regence is Health Solutions. is focused on transforming healthcare by encouraging innovation and value-oriented services. By utilizing platforms like the Regence Quote Request Form, consumers can access personalized health insurance quotes, making it easier to find the right plan for their needs.

While Regence is a member of the Blue Cross Blue Shield network, they function as distinct entities. Regence provides specific regional services and insurance products, catering to the communities it serves. When you submit the Regence Quote Request Form, it’s vital to recognize these differences to find the right options for your healthcare needs.

Yes, Blue Cross Blue Shield is often referred to simply as 'Blue Cross' or 'BCBS.' This network includes multiple independent companies across the country. Understanding these names can be helpful, especially when filling out the Regence Quote Request Form, as it influences your choices for health insurance.

The timely filing limit for Regence claims is typically 180 days from the date of service. To ensure you submit your claims correctly, refer to your plan details or contact customer service. If you are unsure about any part of the submission process, the Regence Quote Request Form can clarify what you need.

Regence operates as a regional health insurance company, while Blue Cross refers to a larger network known as Blue Cross Blue Shield. Although Regence is associated with Blue Cross Blue Shield, they are not exactly the same. It’s essential to understand their distinctions, especially when completing the Regence Quote Request Form for accurate coverage information.

To contact Regence Washington, you can visit their official website or call their customer service number listed there. They provide options for direct support through phone, email, and online chat. If you need assistance with the Regence Quote Request Form, customer service representatives are knowledgeable and ready to help you navigate the process.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232