Forms

Census template for submitting employee eligibility and COBRA administration data. Updated 4/10/26

Enrollment form to add, change, or decline coverage for employees and dependents. Updated 4/10/26

Agreement outlining employer terms, billing, and enrollment requirements with WG Health. Updated 4/10/26

Application for Western Growers Association membership for qualifying companies. Updated 1/25/26

Application for new and renewing groups covering eligibility, plans, and contributions. Updated 4/10/26

Brochure comparing Saver, Cedar, HSA, Spectrum, and Grow plans with benefit details. Updated 1/19/26

Form for multiple related business entities to consolidate under one billing umbrella. Updated 1/25/26

Proof of eligibility for owners not on payroll to qualify for WG Health coverage. Updated 3/30/26

Affidavit documenting agricultural affiliation to qualify for WG Health participation. Last Updated 12/19/25.

Renewal form for accepting current rates or requesting plan and contribution changes. Updated 4/10/26

Quote request form for a WG Health Specialty RSD for prospective group clients. Updated 3/30/26

Brochure covering WG Health services and coverage for agricultural businesses. Updated 1/19/26

Brochure detailing plan options, copays, and deductibles for the WG Health Saver Plans. Updated 1/19/26

Affidavit documenting agricultural affiliation to qualify for WG Health participation. Last Updated 12/19/25.

Application for new and renewing groups covering eligibility, plans, and contributions. Updated 4/10/26

Form for multiple related business entities to consolidate under one billing umbrella. Updated 1/25/26

Proof of eligibility for owners not on payroll to qualify for WG Health coverage. Updated 3/30/26

Agreement outlining employer terms, billing, and enrollment requirements with WG Health. Updated 4/10/26

Application for Western Growers Association membership for qualifying companies. Updated 1/25/26

Census template for submitting employee eligibility and COBRA administration data. Updated 4/10/26

Enrollment form to add, change, or decline coverage for employees and dependents. Updated 4/10/26

Renewal form for accepting current rates or requesting plan and contribution changes. Updated 4/10/26

Quote request form for a WG Health Specialty RSD for prospective group clients. Updated 3/30/26

Brochure covering WG Health services and coverage for agricultural businesses. Updated 1/19/26

Brochure detailing plan options, copays, and deductibles for the WG Health Saver Plans. Updated 1/19/26

Brochure comparing Saver, Cedar, HSA, Spectrum, and Grow plans with benefit details. Updated 1/19/26