Instructions
Print application(s), WSHIP Health Questionnaire, and complete by hand.
Hints
- Enrolling other family members? All family members can use the same application if they are enrolling on the same plan. Complete a separate health questionnaire for each person.
- Select the deductible you want.
- Non-smoker? You might be eligible for a discount, so be sure to complete the certification statement on your application.
- Answer all questions so we can process your application without delay.
Where to mail application forms
Regence BlueShield
PO Box 1107
1602 21st Avenue
Lewiston ID 83501
In most cases, an approved application received in our office by 5:00 p.m. on the last business day of the month will be considered for an effective date of the first of the following month.
