Washington - Idaho Operating Engineers Trust Funds



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• Claim Forms
  • Medical Time Loss Claim Form
  • Dental Claim Form
  • Vision Reimbursement Claims Form
  • Optum RX - PDP Prescription Reimbursement Request
  • Optum Rx - Prescription Reimbursement Request
  • Appeal Claim Form
• Enrollment Forms
  • Enrollment Form
• Disclosure and Privacy
  • Notice of Privacy Practices
  • Authorization to Disclose Protected Health Information
  • Revocation of Protected Health Information