WMI Forms & Updates
To Get a Health Insurance Quote:
For businesses interested in
health insurance
If you are a business interested in obtaining a quote
for group health insurance, the employer will need to
fill out:
employer application
group eligibility form
Employers are also required to submit a payroll report
for all employees

Each employee to be covered on the plan needs to
complete both of the following:
health statement
enrollment card
If "yes" is answered to any of the health questions,
please make sure details are provided in the
appropriate section

Please remember that employers are required to
pay a minimum of 75% of the single rate.

After all information is complete, please mail to our
office at 112 Cooperative Way, Suite A, Kalispell, MT  
59901
* Don't Forget
All clients using Western
Mutual Insurance will be
accessing Health Info Net
as their primary PPO
provider.  Please call our
office for a list of providers
or you can go to
www.healthinfonetmt.com
for the most updated
information.
Claims Forms
Insurance claims for
Western Mutual
Insurance require
forms to be filled out
in certain situations.
The first claim of every
year, you will be
required to fill out a
coordination of
benefits form


If your claim is due to
an accident or
Western Mutual
requests the
information, you will
need to fill out an
accident form
2602 Hwy 2 East~Kalispell, MT 59901 Ph: 406-257-7680 Fax: 406-257-7685