AWB Member Advantage/Benefit Programs

Note: Please familiarize yourself with the "Terms & Conditions of Use" before using this Web site. Link is provided above.

In order to provide information on the AWB HealthChoice program, we must have the following information. Complete the form below and press "Submit."

Yes No Is your company currently a member of AWB?

Company / Organization:
Contacts Name:
Mailing Address:
City:
State:
Zip:
Phone:
Fax:
Email:
# Of Employees:

Please check the appropriate boxes below:

Our company currently offers health care benefits Carrier: Renewal Date:

Our company currently does not offer health care benefits

My current insurance agent is: Name: Agency:

I do not have an insurance agent

Name and Title of Benefits Manager Contact (if applicable)

Benefits Mgr.:

Questions/Comments:




For more information or assistance, please call 1-866-448-9577. AWB HealthChoice is sponsored by the Association of Washington Business.