Hospitality Health Insurance

Designed for our industry, by our industry.

 

Forms & Info

This website is for brokers. If you are an employer, please click here.

Broker Resource Guide

Broker Resource and UW Guidelines 2026

Benefits Buffet Flyer 2026

Quoting Forms

HHI Request for Proposal

Census Form

HHI Producer Profile

New Group Enrollment Forms

Enrollment Census Template

HHI 2026 Participation Agreement

Vimly Broker Setup ACH Form

Notice of Late Submission and Request for Processing Exception

SIMON Access Request Form

Eligibility Guidelines: 2025 Participation Rule

HHI Request for Proposal

Participation Requirements

Contact Information

Hospitality Health Insurance Trust: 866-897-0488

Kaiser Permanente Washington Customer Service: (888) 901-4636

Ameritas Customer Service: 800.487.5553

Willamette Customer Service: 855.433.6825

TransAmerica Customer Service: 800.797.2643

Teladoc Customer Service: 800.835.2362

ComPsych Customer Service: 877.357.4322

Vimly Benefit Solutions: 206-456-9940

Kaiser Permanente logo Aetna logo

For hospitality business owners, providing health insurance to employees is more than just a benefit—it’s a way to attract and retain top talent. Our Hospitality Health Insurance group health insurance plans are designed with flexibility and cost-effectiveness in mind.

 

Kaiser 2026 Plans

English

HHI Kaiser Rx Formulary for Jade, Topaz, Onyx, Virtual Plans

HHI Kaiser Rx Formulary for Sapphire, Emerald, Opal, HMO HSA, Pearl, Z2, Quartz, Zircon, Ruby, Diamond

HHI Kaiser Rx Formulary for Everyday Care Plan

Access PPO Diamond 500 Benefit Summary

Access PPO Diamond 500 SBC

Access PPO Emerald 1000 Benefit Summary

Access PPO Emerald 100 SBC

Access PPO Sapphire 1500 Benefit Summary

Access PPO Sapphire 1500 SBC

Access PPO Quartz 2500 Benefit Summary

Access PPO Quartz 2500 SBC

Access PPO Ruby 3000 Benefit Summary

Access PPO Ruby 3000 SBC

Access PPO Opal 5000 Benefit Summary

Access PPO Opal 5000 SBC

Core HMO Pearl 2500 Benefit Summary

Core HMO Pearl 2500 SBC

Core HMO Jade 2500 Benefit Summary

Core HMO Jade 2500 SBC

HSA Core HMO 2500 Benefit Summary

HSA Core HMO 2500 SBC

Core HMO Everyday Care Plan 4000 Benefit Summary

Core HMO Everday Care Plan 4000 SBC

Core HMO Onyx 5000 Benefit Summary

Core HMO Onyx 5000 SBC

Core HMO Topaz 5000 Benefit Summary

Core HMO Topaz 5000 SBC

Core HMO Zircon 5000 Benefit Summary

Core HMO Zircon 5000 SBC

Core HMO Z2 5000 Benefit Summary

Core HMO Z2 5000 SBC

Virtual Plus 1000 Benefit Summary

Virtual Plus 1000 SBC

Virtual Plus 3000 Benefit Summary

Virtual Plus 3000 SBC

Virtual Plus 5000 Benefit Summary

Virtual Plus 5000 SBC

Waiver of Health Coverage (English)

Waiver of Health Coverage (Español)

Domestic Partner Form

Spanish

Access PPO Diamond 500 Benefit Summary (spanish)

Access PPO Emerald 1000 Benefit Summary (spanish)

Access PPO Sapphire 1500 Benefit Summary (spanish)

Access PPO Quartz 2500 Benefit Summary (spanish)

Access PPO Ruby 3000 Benefit Summary (spanish)

Access PPO Opal 5000 Benefit Summary (spanish)

Core HMO Pearl 2500 Benefit Summary (spanish)

Core HMO Jade 2500 Benefit Summary (spanish)

HSA Core HMO 2500 Benefit Summary (spanish)

Core HMO Everyday Care Plan 4000 Benefit Summary (spanish)

Core HMO Onyx 5000 Benefit Summary (spanish)

Core HMO Topaz 5000 Benefit Summary (spanish)

Core HMO Zircon 5000 Benefit Summary (spanish)

Core HMO Z2 5000 Benefit Summary (spanish)

Virtual Plus 1000 Benefit Summary (spanish)

Virtual Plus 3000 Benefit Summary (spanish)

Virtual Plus 5000 Benefit Summary (spanish)

Aetna Member Flyers

Aetna Over the Counter Health Solutions – Quarterly $25

Aetna Over the Counter Health Solutions – Quarterly $25 (SPANISH)

 HHI Aetna Rx Formulary For All Plans

Aetna 2026 Plans

English

HHI PPO 1500 80/50 RX2

HHI PPO 1500 80/50 RX2 SBC

HHI PPO 2000 80/50 RX4

HHI PPO 2000 80/50 RX4 SBC

HHI PPO 2500 80/50 LXCP RX3

HHI PPO 2500 80/50 LXCP RX3 SBC

HHI PPO 3000 80/50 RX3

HHI PPO 3000 80/50 RX3 SBC

HHI PPO 4000 80/50 FF RX5

HHI PPO 4000 80/50 FF RX5 SBC

HHI PPO 5000 70/50 LXCP RX3

HHI PPO 5000 70/50 LXCP RX3 SBC

HHI PPO 5500 70/50 FF RX5

HHI PPO 5500 70/50 FF RX5 SBC

HHI PPO 6000 70/50 RX3

HHI PPO 6000 70/50 RX3 SBC

HHI PPO 7700 100/50 RX5

HHI PPO 7700 100/50 RX5 SBC

HHI PPO QHDHP 2500 80/50 TIF RX7

HHI PPO QHDHP 2500 80/50 TIF RX7 SBC

Spanish

HHI PPO 1500 80/50 RX2

HHI PPO 1500 80/50 RX2 SBC

HHI PPO 2000 80/50 RX4

HHI PPO 2000 80/50 RX4 SBC

HHI PPO 2500 80/50 LXCP RX3

HHI PPO 2500 80/50 LXCP RX3 SBC

HHI PPO 3000 80/50 RX3

HHI PPO 3000 80/50 RX3 SBC

HHI PPO 4000 80/50 FF RX5

HHI PPO 4000 80/50 FF RX5 SBC

HHI PPO 5000 70/50 LXCP RX3

HHI PPO 5000 70/50 LXCP RX3 SBC

HHI PPO 5500 70/50 FF RX5

HHI PPO 5500 70/50 FF RX5 SBC

HHI PPO 6000 70/50 RX3

HHI PPO 6000 70/50 RX3 SBC

HHI PPO 7700 100/50 RX5

HHI PPO 7700 100/50 RX5 SBC

HHI PPO QHDHP 2500 80/50 TIF RX7

HHI PPO QHDHP 2500 80/50 TIF RX7 SBC

 

Ameritas logo Willamette Dental logo

Hospitality Health Insurance offers comprehensive dental coverage that emphasizes preventive care while providing access to a wide range of services, including specialty and emergency care, with predictable out-of-pocket costs. Members can choose their providers, enjoy potential savings through network pricing, access their plan information easily, and receive timely care without restrictive limits or delays.

 

Ameritas Dental

Ameritas Dental Claim Form (English)

Ameritas Dental Claim Form (Spanish)

Ameritas Dental Enrollment Waiver Form

2026 Plans

English

2026 Benefit Summary – Ameritas Dental

Plan 1

Plan 2

Plan 3

Plan 4

Plan 5

Plan 6

Plan 7

*NEW* Plan 8

Plan 1 with ortho

Plan 2 with ortho

Plan 3 with ortho

Plan 4 with ortho

Plan 5 with ortho

Plan 6 with ortho

Plan 7 with ortho

*NEW* Plan 8 with ortho

Spanish

Plan 1

Plan 1 – ortho

Plan 2

Plan 2 – ortho

Plan 3

Plan 3 – ortho

Plan 4

Plan 4 – ortho

Plan 5

Plan 5 – ortho

Plan 6

Plan 6 – ortho

Plan 7

Plan 7 – ortho

*NEW* Plan 8

*NEW* Plan 8 – ortho

Willamette Dental 2026 Plans

2026 Willamette Plan Comparison

2026 Benefit Summary – Willamette Dental LOW Option Plan 1

2026 Benefit Summary – Willamette Dental HIGH Option Plan 2

Ameritas logo

Hospitality Health Insurance offers flexible vision coverage that lets members choose any vision provider, with reimbursement up to a set annual allowance that can be used for exams, lenses, and frames without frequency limits. Members also have the option to use a broad national network of chain and independent vision providers for convenient access to care.

 

Ameritas Vision 2026 Plans

English

HHI 2026 Benefit Summary – Vision Plans

Plan 1

Plan 2

Plan 3

Plan 4

Plan 5

Plan 6

Plan 7

Plan 8

Plan 9

Plan 10

VSP English Vision Claim Form

EyeMed English Vision Claim Form

Ameritas Vision Claim Form (English)

Ameritas Vision Claim Form (Spanish)

Ameritas Vision Enrollment Waiver Form

Spanish

Plan 1 (Spanish)

Plan 2 (Spanish)

Plan 3 (Spanish)

Plan 4 (Spanish)

Plan 5 (Spanish)

Plan 6 (Spanish)

Plan 7 (Spanish)

Plan 8 (Spanish)

Plan 9 (Spanish)

Plan 10 (Spanish)

ComPsych logo Teladoc logo TransAmerica logo

Hospitality Health Insurance offers a range of additional insurance services designed to support employees’ overall wellbeing and provide peace of mind for them and their families. These benefits include confidential support for personal, work, legal, and financial challenges; convenient 24/7 access to medical care and prescription support via telehealth; and dependable life insurance coverage with guaranteed enrollment, portability, and family options.

 

ComPsych EAP

EAP Benefit Summary

EAP Benefit Summary (Spanish)

Teladoc Telehealth

Teladoc Benefit Summary

Teladoc Benefit Summary (Spanish)

TransAmerica Life Insurance

Life Insurance Benefit Summary

Transamerica Basic Life Beneficiary Form

TransAmerica Death Claim Form

Get a Quote

This form is for brokers. If you are an employer, please click here.

Would you like a quote or a conversation with with one of our experts? Email hhi@tbsmga.com or fill out the form below and we will reach out to you.

Tatiana Schnadenberg
HHI Account Manager
425-354-3618
Email Tatiana

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