2026 PLANS

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

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

2026 PLANS

HHI PPO 1500 80/50 RX2

HHI PPO 2000 80/50 RX4

HHI PPO 2500 80/50 LXCP RX3

HHI PPO 3000 80/50 RX3

HHI PPO 4000 80/50 FF RX5

HHI PPO 5000 70/50 LXCP RX3

HHI PPO 5500 70/50 FF RX5

HHI PPO 6000 70/50 RX3

HHI PPO 7700 100/50 RX5

HHI PPO QHDHP 2500 80/50 TIF RX7

2026 Plans

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

2026 Plans

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)

2026 Plans

2026 Willamette Plan Comparison

2026 Benefit Summary – Willamette Dental LOW Option Plan 1

2026 Benefit Summary – Willamette Dental HIGH Option Plan 2

2026 Benefit Summary – Ameritas Dental

Ameritas Dental Claim Form (English)

Ameritas Dental Claim Form (Spanish)

Ameritas Dental Enrollment Waiver Form

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

2026 PLANS

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

Life Insurance Benefit Summary

Transamerica Basic Life Beneficiary Form

EAP Benefit Summary

Teladoc Benefit Summary

EAP Benefit Summary (Spanish)

Teladoc Benefit Summary (Spanish)

TransAmerica Death Claim Form

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