How to request your 1095-C form

Active employees, former employees and any covered or previous covered individuals under an employee plan may request the 1095-C form from Willamette Dental’s Benefit team.

• Email your request to benefits@willamettedental.com
• Submit your request in writing to 6950 NE Campus Way, Hillsboro, OR 97124, attention Willamette Dental Benefits team
• Call the Benefits team at 503.952.2132