For enrollments in 2024, the WSHIP assessment report was due on March 1, 2025. Submissions are now closed.
Enrollees you need to report
In general, you'll need to report enrollees* in:
- Insurance policies under group or individual disability coverage
- Contracts with health care service contractors
- Agreements with health maintenance organizations (HMOs)
*Includes enrollees in plans sold inside and outside the Washington Health Benefit Exchange.
This also includes coverage under:
- Apple Health (Medicaid)
- Basic Health Plans and Basic Health Plan Plus
- Children's Health Insurance Program (CHIP)
- Individual health insurance
- Medicare Supplement coverage
- Small and large group health plans
- Stop-loss insurance
By law, this doesn't include:
- Accident coverage
- Auto medical payment coverage
- Coverage you issue as benefits payable with or without regard to fault, which need to be part of any liability insurance contract or equivalent self-insurance plan coverage by law
- Dental coverage
- Disability income contracts
- Exclusive pharmacy coverage
- Federal Employees Health Benefit Plan or TRICARE
- Fixed indemnity
- Limited benefit or credit insurance
- Short-term care or long-term care insurance
- Supplemental liability coverage
- Title XVIII of the Social Security Act (Medicare), including Medicare Advantage
- Vision coverage
-
Workers compensation or similar coverage
What WSHIP is
WSHIP and its members provide health insurance to all Washington state residents who other health insurers deny due to their medical status or who can't get comprehensive coverage.
Who is a WSHIP member
Washington state Health Insurance Pool (WSHIP) members are licensed or registered entities in the state of Washington, and organized as disability insurers, health care service contractors, health maintenance organizations, or issuers that are authorized to issue disability insurance, including stop-loss or health coverage.
WSHIP members are licensed or registered entities in the state of Washington, including those organized as:
- Disability insurers
- Health care service contractors
- Health maintenance organizations
- Authorized issuers of disability insurance, including stop-loss or health coverage
What WSHIP members need to report each year
If you're a member, you need to use our electronic form to report the following information from the last calendar year:
- Number of enrollees
- Premiums by month
Your assessment report ensures we have up-to-date information.
How we use the assessment report
We send this information to the state WSHIP Pool Administrator (Benefit Management, Inc.). They use it to determine your prorated assessment obligations for the current year under RCW 48.41.090.
If you don't have any activity to report
You might answer "No" to the first two questions on the electronic form. If so, you need to complete the rest of the assessment report with contact information and any other responses the instructions require.
If you can't find the NAIC company code
Contact our Company Supervision division to get access to the assessment report.
If you partially issue health coverage or stop-loss insurance
You need to report all eligible health coverage and stop-loss insurance for each month during the last calendar year. This includes coverage you partially issued.
If you're no longer licensed or registered
You still need to report all eligible health coverage and stop-loss insurance for each month during the last calendar year to determine your prorated assessment obligations.