Search
Housing providers using housing trust fund insurance market study work group
https://www.insurance.wa.gov/housing-providers-using-housing-trust-fund-insurance-market-study-work-group
File Format:
About OIC Connect with us Online services and tools Laws & Rules The Washington state Legislature has determined that housing providers receiving…, Work group meetings, There are no meetings currently scheduled. Please check back for updates on future meetings., Work group meeting agenda, materials, and recordings, October 23 meeting, Davies Group presentation (PDF, 856.11 KB) Oct. 23 meeting recording ., August 13 and September 10 meetings, The August and September work group meetings are canceled to allow for further research and interviews., July 9 meeting, July 9, 2024 meeting agenda (PDF, 249.22 KB) July 9, 2024 meeting recording Office of the insurance commissioner, David Forte insurance update presentation…, June 11 meeting, June 11, 2024 meeting agenda (PDF, 215.48 KB) June 11, 2024 meeting recording Catholic services housing presentation (PDF, 3.41 MB) Tacoma housing…, Work group members, Housing providers using housing trust fund insurance market study work group members Name Organization Bryon Welch Office of the Insurance Commissioner…, Background information, Commerce housing authority plan 2023-2028 ., Housing provider surveys, Washington housing provider survey (PDF, 249.84 KB) Housing provider insurance survey (PDF, 275.54 KB), Housing provider work group data call, Pursuant to Chapter 74, Laws of 2024 , Commissioner Kreidler issued a data call to specifically identified insurance related entities that may have…, Comments, To submit comments or questions contact policy and legislative affairs, See also, Washington housing trust fund Chapter 74, Laws of 2024 Sign up to receive updates, Need more help or wish to submit a comment?, Contact Policy and Legislative Affairs
Appeals information for Medicare and other plans not subject to Office of the Insurance Commissioner regulations
https://www.insurance.wa.gov/appeals-information-medicare-and-other-plans-not-subject-office-insurance-commissioner-regulations
File Format:
For Consumers Some health plans are not required to meet state or federal requirements. If you're appealing a health insurance denial from one of these…, Medicare plans, Where you can find appeals information for Medicare plans Medicare plans Where to look for appeal information Original Medicare On the back of your…, Non-Medicare plans, Where you can find appeals information for non-Medicare plans Non-Medicare plans Where to look for appeal information Apple Health (Medicaid for kids and…, See also, File a complaint or check your complaint status How to appeal a health care insurance decision: A guide for consumers in Washington state (PDF, 2.04 MB), Need more help?, Call us at 800-562-6900, 8 a.m. to 5 p.m., Monday - Friday Live chat with us Contact us to ask an insurance question
About the contracting process
https://www.insurance.wa.gov/about-contracting-process
File Format:
About OIC Connect with us Online services and tools Laws & Rules The Office of the Insurance Commissioner (OIC) complies with Enterprise Services…, Procurement forecast, OIC forecasts known procurement needs on an annual basis. The forecasted needs include competitive procurements, anticipated sole source procurements,…, When are procurements issued?, We issue procurements when a purchase exceeds the Office of the Insurance Commissioner (OIC)'s direct buy limit of $30,000. The buy limit increases to $40,…, How do I learn about available procurements?, Washington's Electronic Business Solution (WEBS) is the official notification tool used by state agencies for all competitive procurements. We encourage…, How do I respond to a procurement?, Download the procurements document(s) using Washington's Electronic Business Solution (WEBS) . Doing so will ensure notification of any amendments to the…, How is the successful vendor selected?, A scoring team of at least three people will review the responses received and score them against the criteria in the procurement. Follow-up or clarifying…, See also, WEBS registration page Become an Office of Minority and Women's Business Enterprises (OMWBE)-certified vendor, Need more help?, Have a complaint about the procurement process? Contact us about contracting opportunities Call us at 360-725-9604
Tribal relations
https://www.insurance.wa.gov/tribal-relations
File Format:
About OIC Connect with us Online services and tools Laws & Rules The Washington state Office of the Insurance Commissioner (OIC) is dedicated to…, The 1989 Centennial Accord , This relationship is established to enhance and improve communication and to facilitate issue resolution. The accord also commits the parties to tasks…, Government-to-government relationship with Indian tribes, Chapter 43.376 RCW requires us to: Make reasonable efforts to collaborate with tribes in development of policies, agreements, and program implementation…, Policy 5, OIC Tribal consultation and collaborative process, This policy, established based on the Centennial Accord and Chapter 43.376 RCW, provides general requirements and specific procedures for engaging with…, Requirements for health insurance issuers, In Washington state, health insurance issuers must comply with all state and federal laws governing their business practices and the health benefits they…, Contact information for agency Tribal Liaison, Todd Dixon, Deputy Commissioner for Consumer Protection, Call, : 360-725-7262, Email:, OIC Tribal Liaison, see also, The Governor's Office of Indian Affairs American Indian Health Commission for Washington State, Need more help?, Ask an insurance expert
Relating to health care benefit managers (R 2024-02)
https://www.insurance.wa.gov/relating-health-care-benefit-managers-r-2024-02
File Format:
About OIC Connect with us Online services and tools Laws & Rules E2SSB 5213 (Chapter 242, Laws of 2024) amends state law concerning the business…, Public hearing on Nov. 26, 2024, When: November 26, 2024, at 11:00 a.m. Pacific Time Zone Where: Virtual Meeting Register in advance for this meeting . After registering, you will…, Proposed rulemaking filed Oct. 23, 2024, CR-102 for R2024-02 (PDF, 480.91 KB) The comment period for the CR-102 begins on October 23, 2024, ending November 26, 2024 at 2 p.m. Pacific Time Zone , Second prepublication draft released Sept. 6, 2024, The comment period for the second prepublication draft ended on , Sept. 16, 2024, . Second prepublication draft for R 2024-02 (PDF, 535.38 KB), Prepublication draft released July 12, 2024, The comment period for the prepublication ended , July 26, 2024. , View previously submitted comments, ., Prepublication draft for R 2024-02 (PDF, 419.31 KB), Notice to start rulemaking filed May 21, 2024, CR-101 for R 2024-02 (PDF, 114.23 KB) Comments for the CR-101 closed June 20, 2024. View previously submitted comments View previously submitted comments , SEE ALSO, Regulations - Washington Administrative Code Laws - Revised Code of Washington Sign up to receive updates, NEED MORE HELP?, Contact the rules coordinator
Implementation of SSB 5986 and updates to the Balance Billing Protection Act (BBPA) (R 2024-01)
https://www.insurance.wa.gov/implementation-ssb-5986-and-updates-balance-billing-protection-act-bbpa-r-2024-01
File Format:
About OIC Connect with us Online services and tools Laws & Rules SSB 5986 (PDF, 171 KB) adds ground ambulance balance billing protections to the…, Public hearing is scheduled for Nov. 26, 2024 , When: 9:00 am Where: virtual, please register in advance, Proposed rulemaking filed Oct. 22, 2024, CR 102 to R 2024-01 (PDF, 457.09 KB) The comment period for the CR 102 begins on October 23, 2024 and closes at 12:00 pm on November 26, 2024., Comments on prepublication draft , The comment period for the second prepublication draft period ended on Sept. 11, 2024 The comment period for the first prepublication draft ended July 31,…, Second prepublication draft released Aug. 27, 2024, Second prepbulication draft for R 2024-01 (PDF, 375.95 KB), First prepublication draft released July 17, 2024, Prepublication draft for R 2024-01 (PDF, 475.16 KB), Notice to start rulemaking filed May 21, 2024, CR-101 for R 2024-01 (PDF, 60.78 KB), Comments, Comments for the CR-101 closed June 21, 2024 View previously submitted comments, SEE ALSO, Regulations - Washington Administrative Code Laws - Revised Code of Washington Sign up to receive updates, NEED MORE HELP?, Contact the rules coordinator
2025 Individual and family health plans
https://www.insurance.wa.gov/2025-individual-and-family-health-plans
File Format:
For Consumers, Get ready for open enrollment, Open enrollment starts Nov. 1 and ends Jan. 15 each year. You can purchase a plan for yourself or your family inside the Exchange at Washington…, Asuris Northwest Health, Phone: 888-427-0470 2025 plan rates (PDF, 496.12 KB) Adams, Asotin, Benton, Chelan, Columbia, Douglas, Ferry, Franklin, Garfield, Grant, Kittitas, Lincoln…, BridgeSpan Health Company, Phone: 855-857-9944 2025 plan rates (PDF, 494.98 KB) Benton, Clark, Columbia, Franklin, King, Kitsap, Klickitat, Pierce, Skagit, Snohomish, Spokane,…, Community Health Plan of Washington, Phone: 800-440-1561 2025 plan rates (PDF, 393.60 KB) Adams, Asotin, Benton, Chelan, Clallam, Columbia, Douglas, Ferry, Franklin, Grant, Jefferson, King,…, Coordinated Care Corporation, Phone: 877-644-4613 2025 plan rates (PDF, 1.22 MB) Adams, Asotin, Benton, Chelan, Clallam, Clark, Columbia, Cowlitz, Douglas, Ferry, Franklin, Garfield,…, Kaiser Foundation Health Plan of the Northwest, Phone: 800-488-3590 2025 plan rates (PDF, 433.54 KB) Clark, Cowlitz Inside Exchange Outside Exchange, Kaiser Foundation Health Plan of Washington, Phone: 800-488-3590 2025 plan rates (PDF, 521.43 KB) Benton, Columbia, Franklin, Island, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane,…, Lifewise Health Plan of Washington, Phone: 800-817-3056 2025 plan rates (PDF, 948.56 KB) Adams, Asotin, Benton, Chelan, Clark, Columbia, Cowlitz, Douglas, Ferry, Garfield, Grant, Grays…, Molina Healthcare of Washington, Phone: 855-542-1900 2025 plan rates (PDF, 450.17 KB) Benton, Clark, Cowlitz, Ferry, Franklin, King, Kitsap, Klickitat, Lewis, Lincoln, Mason, Pend Oreille…, Premera Blue Cross, Phone: 800-607-0546 2025 plan rates (PDF, 168.62 KB) Franklin, Grays Harbor, King, Kitsap, Pacific, Pierce, Spokane, Yakima Inside Exchange , Providence Health Plan, Phone: 800-878-4445 2025 plan rates (PDF, 343.86 KB) Benton, Clark, Franklin, Spokane, Thurston, Walla Walla Outside Exchange, Regence BlueCross BlueShield of Oregon, Phone: 888-734-3623 2025 plan rates (PDF, 349.89 KB) Clark Inside Exchange Outside Exchange, Regence BlueShield, Phone: 888-367-2112 2025 plan rates (PDF, 1.21 MB) Clallam, Columbia, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Mason,…, UnitedHealthcare of Oregon, Phone: 877-856-2429 2025 plan rates (PDF, 656.42 KB) Adams, Clallam, Jefferson, King, Kittitas, Lincoln, Mason, Pierce, Whitman, Yakima Inside Exchange …, See Also, When can I buy an individual health plan? Who sells health insurance Benefits health plans must cover under Washington state law, Need more help?, Call us at 800-562-6900, 8 a.m. to 5 p.m., Monday - Friday Live chat with us Contact us to ask an insurance question
Essential health benefits benchmark plan
https://www.insurance.wa.gov/essential-health-benefits-benchmark-plan
File Format:
About OIC Connect with us Online services and tools Laws & Rules A new law ( SSB 5338 ) directs the Office of the Insurance Commissioner (OIC) to…, Defining Washington state's EHB-benchmark health plan , The Affordable Care Act requires certain benefits, items and services be covered by all individual and small employer health plans. These are called…, Option 1:, Select another state's entire EHB benchmark, , Option 2, : Replace a category of benefits in the current benchmark with the same category of benefits used in another state's EHB plan, or , Option 3, : Select a set of benefits to become part of the your state's EHB plan. States that want to make changes are required by Federal law to have an…, Essential health benefits benchmark plan update approved by Centers for Medicare & Medicaid Services (CMS), Essential Health Benefits benchmark approval letter (PDF, 254.24 KB) Appendix B - Washington Essential Health Benefits Benchmark Plan (PDF, 723.58 KB)…, Opportunity for public comment on the State's selection of an EHB-benchmark plan, per 45 CFR 156.111, Benefits for Health Care Coverage - Washington Benchmark Plan (PDF, 1.19 MB) Appendix A - Confirmations on the State EHB-Benchmark Plan (Excel, 56.33 KB)…, 2023 essential health benefits report and presentation, 2023 Essential Health Benefits Report & Presentation (PDF, 1.84 MB), How to get involved, Submit your comments to the rules coordinator. Subscribe to get updates via email or text alerts about the EHB-benchmark plan ., Public comments, PANDAS/PANS Network comments submitted by Sarah Lemley (PDF, 16.88 MB), Past meetings, Dec. 13, 2023, Wakely essential health benefit update (PDF, 937.53 KB), Oct. 20, 2023, Wakely Washington EHB Benchmark Plan overview and potential changes (PDF, 705.78 KB), Sept. 12, 2023 , Wakely essential health benefits overview and application process presentation (PDF, 1.98 MB), June 12, 2023 , SSB 5338 -Essential Health Benefits benchmark plan update (PDF, 730.70 KB), State and federal EHB information , Washington state: EHB statute: RCW 48.43.715 EHB rules: WAC 284-43-5602 , WAC 284-43-5622 and WAC 284-43-5642 SSB 5338 2023 Fertility treatment benefit:…, SEE ALSO, Benefits health plans must cover under Washington state law What health insurance plans must cover 2022 Mandated health benefits report (PDF, 292.90 KB), NEED MORE HELP?, Contact Policy and Legislative Affairs
2025 Medicare Advantage and Special Needs Plans (SNPs)
https://www.insurance.wa.gov/2025-medicare-advantage-and-special-needs-plans-snps
File Format:
Washington state consumers can find more information about Medicare Advantage plans and SNPs, including prices, by looking for plans in their county., All Counties, 2025 Medicare Landscape All Counties (Excel, 96.51 KB), Adams, 2025 Medicare Advantage plans and Special Needs Plans, Adams County (PDF, 202.32 KB), Asotin, 2025 Medicare Advantage plans and Special Needs Plans, Asotin County (PDF, 201.03 KB), Benton, 2025 Medicare Advantage plans and Special Needs Plans, Benton County (PDF, 215.49 KB), Chelan, 2025 Medicare Advantage plans and Special Needs Plans, Chelan County (PDF, 207.55 KB), Clallam, 2025 Medicare Advantage plans and Special Needs Plans, Clallam County (PDF, 209.10 KB), Clark, 2025 Medicare Advantage plans and Special Needs Plans, Clark County (PDF, 241.66 KB), Columbia, 2025 Medicare Advantage plans and Special Needs Plans, Columbia County (PDF, 204.76 KB), Cowlitz, 2025 Medicare Advantage plans and Special Needs Plans, Cowlitz County (PDF, 261.85 KB), Douglas, 2025 Medicare Advantage plans and Special Needs Plans, Douglas County (PDF, 205.59 KB), Ferry, 2025 Medicare Advantage plans and Special Needs Plans, Ferry County (PDF, 200.86 KB), Franklin, 2025 Medicare Advantage plans and Special Needs Plans, Franklin County (PDF, 207.35 KB), Garfield, 2025 Medicare Advantage plans and Special Needs Plans, Garfield County (PDF, 200.12 KB), Grant, 2025 Medicare Advantage plans and Special Needs Plans, Grant County (PDF, 202.78 KB), Grays Harbor, 2025 Medicare Advantage plans and Special Needs Plans, Grays Harbor County (PDF, 226.00 KB), Island, 2025 Medicare Advantage plans and Special Needs Plans, Island County (PDF, 246.42 KB), Jefferson, 2025 Medicare Advantage plans and Special Needs Plans, Jefferson County (PDF, 208.10 KB), King, 2025 Medicare Advantage plans and Special Needs Plans, King County (PDF, 231.50 KB), Kitsap, 2025 Medicare Advantage plans and Special Needs Plans, Kitsap County (PDF, 228.48 KB), Kittitas, 2025 Medicare Advantage plans and Special Needs Plans, Kittitas County (PDF, 234.79 KB), Klickitat, 2025 Medicare Advantage plans and Special Needs Plans, Klickitat County (PDF, 190.52 KB), Lewis, 2025 Medicare Advantage plans and Special Needs Plans, Lewis County (PDF, 251.55 KB), Lincoln, 2025 Medicare Advantage plans and Special Needs Plans, Lincoln County (PDF, 204.78 KB), Mason, 2025 Medicare Advantage plans and Special Needs Plans, Mason County (PDF, 248.93 KB), Okanogan, 2025 Medicare Advantage plans and Special Needs Plans, Okanogan County (PDF, 202.34 KB), Pacific, 2025 Medicare Advantage plans and Special Needs Plans, Pacific County (PDF, 198.88 KB), Pend Oreille, 2025 Medicare Advantage plans and Special Needs Plans, Pend Oreille County (PDF, 204.87 KB), Pierce, 2025 Medicare Advantage plans and Special Needs Plans, Pierce County (PDF, 263.85 KB), San Juan, 2025 Medicare Advantage plans and Special Needs Plans, San Juan County (PDF, 203.86 KB), Skagit, 2025 Medicare Advantage plans and Special Needs Plans, Skagit County (PDF, 267.57 KB), Skamania, 2025 Medicare Advantage plans and Special Needs Plans, Skamania County (PDF, 243.89 KB), Snohomish, 2025 Medicare Advantage plans and Special Needs Plans, Snohomish County (PDF, 233.87 KB), Spokane, 2025 Medicare Advantage plans and Special Needs Plans, Spokane County (PDF, 229.88 KB), Stevens, 2025 Medicare Advantage plans and Special Needs Plans, Stevens County (PDF, 206.60 KB), Thurston, 2025 Medicare Advantage plans and Special Needs Plans, Thurston County (PDF, 228.72 KB), Wahkiakum, 2025 Medicare Advantage plans and Special Needs Plans, Wahkiakum County (PDF, 239.62 KB), Walla Walla, 2025 Medicare Advantage plans and Special Needs Plans, Walla Walla County (PDF, 211.13 KB), Whatcom, 2025 Medicare Advantage plans and Special Needs Plans, Whatcom County (PDF, 247.45 KB), Whitman, 2025 Medicare Advantage plans and Special Needs Plans, Whitman County (PDF, 197.49 KB), Yakima, 2025 Medicare Advantage plans and Special Needs Plans, Yakima County (PDF, 242.22 KB), SEE ALSO, Dual-eligible Special Needs Plans (D-SNP), NEED MORE HELP?, Statewide Health Insurance Benefits Advisors (SHIBA) offers free, unbiased Medicare counseling. Call us at 800-562-6900, 8 a.m. to 5 p.m., Monday - Friday
Self-funded group health plans and surprise billing
https://www.insurance.wa.gov/self-funded-group-health-plans-and-surprise-billing
File Format:
For Consumers The Federal No Surprises Act protects consumers with self-funded group health plans (SFGHPs) from surprise billing. This includes any…, New ground ambulance services protections and attestation, During the 2024 legislative session, Second Substitute Senate Bill (SSB) 5986 was enacted to add ground ambulance services balance billing protections to…, new attestation by Dec. 31, 2024., If we do not receive the attestation by that date, we will need to disenroll your plan from the opt-in to BBPA consumer protections, beginning Jan. 1, 2025, . Attest to the full suite of protections under the BBPA , How to opt-in to the Balance Billing Protection Act, A self-funded group health plan must notify the Office of the Insurance Commissioner at least 15 days before it intends to participate in the Balance…, SEE ALSO, Balance Billing Protection Act Rule implementing the Balance Billing Protection Act, NEED MORE HELP?, Contact us with your self-funded group health plan opt-in questions