To view, fill out and print the forms on this page, you will need the latest version of Adobe Acrobat Reader, which can be downloaded. However, Adobe Acrobat Reader does not allow you to save your completed, or partially completed, forms to a disk or on your computer. For that expanded capability you will need to have the complete Adobe Acrobat software package, version 5.0 or later.
Enrollment/change of status/waiver of coverage forms
Oregon small groups
Choose your small group plan:
Oregon large groups
Choose your large group plan:
- 2020 Choice, HSA, Option Advantage Base, Option Advantage Plus (A), Option Advantage B (Premium), or Integrated HSA plans (PDF)
- 2020 Connect plans (PDF)
- 2020 Choice, HSA, Option Advantage Base, Option Advantage Plus (A), Option Advantage B (Premium), or Integrated HSA plans – Spanish (PDF)
- 2020 Connect plans – Spanish (PDF)
Forms for all groups
Oregon small-group forms
View 2019 forms ›
Change forms for individual and family insurance plans
2020 Oregon plans
2019 Oregon plans
The Special Enrollment Period for 2019 is closed.
The only qualifying events left for 2019 coverage are birth, adoption, placement for adoption, foster care of a child or a court order. Use the link below to access the online and paper change forms to make changes applicable to these qualifying events.
2020 Washington plans
For changes to current 2020 coverage, visit WaHealthPlanFinder.org.
Enrollment forms for individual and family plans
Secret shopper surveillance tools
Health information disclosure forms for all groups