Employee Benefit Plans

Vigilant Manufacturers’ Trust (VMT) provides high quality, affordable employee benefits programs to employers in the manufacturing industry, located in Washington State.

Groups may choose from several medical plan options underwritten by Premera Blue Cross. Optional ancillary benefits include dental coverage through Delta Dental of Washington, vision through VSP and Life/AD&D through LifeMap Assurance Company. Participating groups must elect a medical plan(s), which includes mandatory $10,000 Life/AD&D coverage, in order to elect optional dental, vision or buy-up life coverage.

Benefit Plan Documents & Forms

Enrollment Forms

• Group Master Application
• Employee Enrollment Form
• Census Enrollment Template

General Information

• Dual Choice Matrix
• Contact List
• New Business and Renewal Checklist
• Medicare Part D - Creditable Coverage Status Letter
• Non-Creditable Coverage Notice
• Summary Plan Description (SPD)
• Notice of Privacy Practices
• Premera Welcome Packet
• EFT Authorization Form

Medical Plan Highlights

Effective October 1, 2018 – September 30, 2019

Premera Blue Cross
80 Series, 70 Series, 50 Series, HSA Series

• 80 Series
  PPO 250
  PPO 350
  PPO 500
  PPO 750
  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000
  PPO 5000
• 70 Series
  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000
• 50 Series
  PPO 0
  PPO 500
  PPO 1000
• HSA Series
  HSA 1500
  HSA 2500
  HSA 3500
  HSA 5500

Medical Plan Summaries

Effective October 1, 2018 - September 30, 2019

Premera Blue Cross - Heritage Plus & Heritage Prime
80 Series, 70 Series, 50 Series, HSA Series

• 80 Series
  Premera Blue Cross (Prime & Plus Networks)
  PPO 250
  PPO 350
  PPO 500
  PPO 750
  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000
  PPO 5000
• 70 Series
  Premera Blue Cross (Prime & Plus Networks)
  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000
• 50 Series
  Premera Blue Cross (Prime & Plus Networks)
  PPO 50-50 0
  PPO 50-50 500
  PPO 50-50 1000
• HSA Series
  Premera Blue Cross (Prime & Plus Networks)
  HSA 1500
  HSA 2500
  HSA 3500
  HSA 5500

Medical Plan Booklets

Effective October 1, 2018 – September 30, 2019

Premera Blue Cross
80 Series, 70 Series, 50 Series, HSA Series

• 80 Series

  Prime

  PPO 250
  PPO 350
  PPO 500
  PPO 750
  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000
  PPO 5000

  Plus

  PPO 250
  PPO 350
  PPO 500
  PPO 750
  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000
  PPO 5000

• 70 Series

  Prime

  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000

  Plus

  PPO 1000
  PPO 1500
  PPO 2000
  PPO 2500
  PPO 3000
  PPO 4000

• 50 Series

  Prime

  PPO 50-0
  PPO 50-500
  PPO 50-1000

  Plus

  PPO 50-0
  PPO 50-500
  PPO 50-1000

• HSA Series

  Prime

  HSA 1500
  HSA 2500
  HSA 3500
  HSA 5500

  Plus

  HSA 1500
  HSA 2500
  HSA 3500
  HSA 5500

Dental Plan Summaries

Delta Dental of Washington

• Plan 1
• Plan 2
• Plan 3
• Plan 4

Vision Plan Summaries

VSP

• Basic
• Enhanced
• Exam Plus
• Preferred Plus

Life / AD&D Plan Summaries

Lifemap

• $10K Life/AD&D
• $15K Life/AD&D
• $25K Life/AD&D
• $50K Life/AD&D