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Washington state health plan mapping hierarchy criteria
https://www.insurance.wa.gov/washington-state-health-plan-mapping-hierarchy-criteria
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For Insurers & Regulated Entities, Overview, The Office of the Insurance Commissioner (OIC) worked with the Washington state Health Benefit Exchange (HBE) to develop mapping criteria for qualified…, Questions, If you have questions about the number of enrollees that will be mapped to your company, please contact the Health Benefit Exchange ., Hierarchy, Washington Health Benefit Exchange's policy for with-in carrier QHP and QDP mapping (Excel, 39.45 KB) Mapping hierarchy for cross-carrier to qualified…, See also, What issuers need to know, Need more help?, Call us at 360-725-7111
Discontinuation and renewals for health plan year 2025
https://www.insurance.wa.gov/discontinuation-and-renewals-health-plan-year-2025
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Requirements and processes you need to know before submitting discontinuation and renewals notices., For Insurers & Regulated Entities, See also, Updated federal standard renewal and product discontinuation notices (PDF, 313 KB) Data calls and reporting Report errors in discontinuation and renewal…, Need more help?, Call us at 360-725-7111
When can I buy an individual health plan?
https://www.insurance.wa.gov/when-can-i-buy-individual-health-plan
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For Consumers, Important, : The 2025 annual open enrollment period will run from November 1, 2024 through January 15, 2025. During this time you can enroll, renew and make changes…, General special enrollment, If you have a qualifying event, you may get a special enrollment period (SEP) to buy an individual health plan. This means you can enroll in or change your…, Note, : You don't qualify for a SEP if you voluntarily cancel your health insurance or your insurer cancels you because you don't pay your premium. Effective…, Individual health plans, Qualifying events for SEPs include, but aren't limited to: Losing health coverage, including an employer plan or an individual policy. Losing Apple Health…, Individual health plans only inside the Exchange, See if you qualify for SEP for a health plan through the Exchange., Note:, The Exchange and the U.S. Department of Health and Human Services have the authority to create additional qualifying events for special enrollment periods…, Where to buy a plan, If you buy a plan: Outside the Exchange - contact an insurance agent or broker . Inside the Exchange - contact the Washington Healthplanfinder ., See also, Benefits health plans must cover under Washington state law Washington Healthplanfinder What to consider before buying health insurance, 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
Technical assistance advisories and emergency orders
https://www.insurance.wa.gov/technical-assistance-advisories-and-emergency-orders
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For Insurers & Regulated Entities Advisories, sometimes referred to as bulletins, are an interpretive policy statement released to advise the public of…, 2024, Memorandums, Aug. 30, 2024, memorandum regarding Aetna and Providence contract negotiations (PDF, 181.78 KB), Technical assistance advisories, 2024-02 The use of artificial intelligence systems in insurance (PDF, 345.79 KB) 2024-01: OIC's Interpretation of Chap. 48.200 RCW & RCW 48.43.731 -…, 2023, Emergency order 2023-01, 2023-01: Providing relief to Washington consumers from 2023 wildfires by addressing grace periods for nonpayment of premium and temporarily prohibiting…, Technical assistance advisories, 2023-04: Implementation of engrossed second substitute HB 1357 in the matter of modernizing the prior authorization process (PDF, 148.51 KB) 2023-03:…, 2022, Technical assistance advisories , 2022-02: Opioid reversal medication prescriptions in life insurance underwriting (PDF, 1.21 MB), 2021, Emergency Order 2021-02, 2021-02: Emergency order on coverage for COVID-19 vaccine counseling (PDF, 287KB), Emergency Order 2021-01, 2021-01: Emergency order opening a special enrollment (PDF, 1.35MB), Technical assistance advisories, TAA 2021-05: OIC's Implementation of the Federal No Surprises Act (PDF, 250.88 KB) TAA 2021-04: Access to Inpatient Substance Use Disorder Treatment Under…, 2020, Emergency Order 2020-06, 2020-06: Emergency order to insurers on surprise billing (PDF, 255.53KB), Emergency Order 2020-04, 2020-04: Emergency order on dental insurance and clarifying grace period payments (PDF, 229.53 KB), Emergency Order 2020-03, 2020-03: Emergency order to P&C insurers allow grace period (PDF, 197.58 KB), Emergency Order 2020-02, 2020-02: Emergency order to health insurers on telehealth, other coverage (PDF, 278.82, Frequently asked questions, FAQ on COVID testing and cost-sharing (PDF, 253KB) Frequently asked questions about Emergency Order 2020-1 and 2020-2 (PDF, 211.78 KB), Other advisories, Advisory notice regarding COVID-19 claims (PDF, 194.54 KB), 2018, 2018-01 Implementation credits as illegal inducement or rebate (PDF, 241.02 KB), 2017, 2017-01a Two-day Notification Requirement for Security Breaches (PDF, 346.97 KB) 2017-01 Two-day Notification Requirement for Security Breaches (PDF, 50KB), 2016, 2016-01 Student Health Plans, March 28, 2016 (PDF, 115.42 KB), 2015, 2015-01 Price Optimization, July 9, 2015 (PDF, 31.21 KB), See also, Legislation and rules News from the OIC, Need more help?, Call us at 800-562-6900, 8 a.m. to 5 p.m., Monday-Friday Contact Policy and Legislative Affairs
Registering as a health care benefit manager (HCBM)
https://www.insurance.wa.gov/registering-health-care-benefit-manager-hcbm
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For Insurers & Regulated Entities A health care benefit manager is any person or entity that provides services to or acts on behalf of a health carrier…, Recent changes to Washington's HCBM laws and rules, Effective June 6, 2024, E2SSB 5213 amended the definition of an HCBM. This revised definition excludes hospitals and any other entity, such as medical…, Technical assistance advisories, Technical assistance advisories (TAA), or bulletins, are interpretive policy statements from our office. TAA 2024-01: This advisory issued on 04/16/2024…, How to register as an HCBM, Registrations are valid from the certificate effective date to June 30. To register: Fill out the Account Creation and Request for Application form . We'll…, What to expect after you submit your application, We review applications on a first-in-first-out basis. Review times vary based on the number of pending applications. When we complete your application…, How to renew your HCBM registration, To continue operating as an HCBM in Washington, you need to renew your registration by March 1 of each year. Renewal registrations are valid for one fiscal…, Who needs to register as an HCBM?, You need to register with the OIC as an HCBM if the services you provide directly or indirectly impact patient access to health care services, drugs and…, Who doesn't need to register as an HCBM?, HCBMs providing services to or acting on behalf of these health plans do not need to register with the OIC: Self-insured health plans (unless the plan is…, See Also, Health care benefit managers - RCW 48.200 Health care benefit managers - WAC 284-180, Need more help?, Call 360-725-7219 Contact Company Supervision. Select company applications from the dropdown.
Current contracting opportunities
https://www.insurance.wa.gov/current-contracting-opportunities
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About OIC Connect with us Online services and tools Laws & Rules Washington state's Electronic Business Solution (WEBS) is the official notification…, Notice:, If you download documents from this website, you are responsible for checking this page to ensure you receive any amendments or bidder questions/agency…, Requests for proposals (RFP), S2408 Palliative care benefit work group, Requests for qualifications and quotations (RFQQ), No requests for qualifications and quotations are open at this time., Requests for information (RFI), No requests for information are open at this time., Work requests, No work request procurements are open at this time., See also, WEBS registration page Become an Office of Minority and Women's Business Enterprises (OMWBE)-certified vendor, Need more help?, Contact us about contracting opportunities Call us at 360-725-9604
S2408 Palliative care benefit work group
https://www.insurance.wa.gov/s2408-palliative-care-benefit-work-group
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Description, The purpose of this RFP is to solicit responses from individuals or Vendors interested in conducting an actuarial analysis and preparing a related report…, must, be conducted for fully insured health plans. Depending upon available funding and proposals received, the analysis and report may be expanded to include…, Minimum qualifications include:, 24 months of responsibilities substantially the same as, or very similar to, the Scope of Work Contractor must be or employ health economists or other…, Revisions to the RFP, If it becomes necessary to revise any part of this RFP, addenda will be published in the Washington Electronic Business Solution (des.wa.gov) (WEBS) and on…, Important dates, All times listed are Pacific Standard Time. 8/2/2024 by 11:59pm vendor questions due 8/9/2024 OIC issues Q&A addendum 8/22/2024 at 10:00 am Preproposal…, RFP Document, S2408 Palliative care benefit work group (PDF, 2.60 MB) S2408 Addendum 1 (PDF, 177.80 KB) S2408 Addendum 2 preproposal conference date change (PDF, 144.29…, SEE ALSO, Washington Electronic Business Solution (WEBS) Registration Page Become certified with the Office of Minority and Women's Business Enterprises (OMWBE)…, NEED MORE HELP?, Contact OIC Contracting Call an OIC Contracts Administrator at 360-725-9604
Community-based health providers working in a carceral setting liability market study work group
https://www.insurance.wa.gov/community-based-health-providers-working-carceral-setting-liability-market-study-work-group
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About OIC Connect with us Online services and tools Laws & Rules The Washington state Legislature has asked the Insurance Commissioner to study…, Work group meetings, Register in advance for work group meetings, Work group meeting agenda, materials, and recordings, August 20 and September 17 meetings The August and September work group meetings are canceled to allow for further research and interviews. July 16 meeting…, Work group members, Community-based health providers working in a carceral setting liability market study work group members Name Organization Bryon Welch Office of the…, Background information, Federal tort claim act health center policy manual HRSA health center program draft policy information notice PIN 2024-05 (PDF, 357.38 KB), Community-based health providers survey, Medical Malpractice survey for jails (PDF, 179.17 KB), Comments, To submit comments or questions contact policy and legislative affairs . Washington state health care authority seeks comments on draft pin 2024-05 (PDF,…, See also, Chapter 376, Laws of 2024, Section 142(29) Sign up to receive updates, Need more help or wish to submit a comment?, Contact Policy and Legislative Affairs
Fingerprint requirements
https://www.insurance.wa.gov/fingerprint-requirements
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For Producers Washington state requires resident applicants to submit their fingerprints electronically for a background check. Non-resident applicants do…, You are required to submit your application before you schedule your fingerprint appointment, per FBI guidelines. , We do not issue licenses until we receive the results of the background check., Questions, What is the process to have my fingerprints taken?, Complete any required exams for your license type. Submit your application prior to scheduling a fingerprint appointment per FBI requirement. Schedule an…, Where do I go to have my fingerprints taken?, Once you've submitted your insurance application, you'll need to have your fingerprints taken. You may visit an IdentoGO center at your convenience.…, Where do I send my completed fingerprints?, You don't have to send us anything. IdentoGO will transmit your fingerprints electronically. When you schedule your fingerprints with IdentoGO, please…, How much does it cost?, $49.25. This fee reflects the combined cost of the background check fee and IDEMIA IdentoGO's additional charge for providing the service, also known as a…, See also, Look up a company or agent, Need more help?, Call us at 360-725-7144, 8 a.m. to 5 p.m., Monday - Friday Contact Producer Licensing and Oversight
Health insurance plans and health care programs
https://www.insurance.wa.gov/health-insurance-plans-and-health-care-programs
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We've gathered a list of health insurance plans and programs for people who are considered low-income or who need additional help with health care costs., Health insurance plans, Health insurance plans for people who aren't covered by a group health plan. Health insurance plan name Description Washington Healthplanfinder Get help…, Note:, Apple Health for Kids and Medicaid have merged into "Apple Health" and serves all ages, not just kids., Health care programs, Health care programs for people considered low income or who need additional help with health care costs. Program named Description https://www.dshs.wa.gov…, Note:, Apple Health for Kids and Medicaid have merged into "Apple Health" and serves all ages, not just kids. You can now apply for Apple Health online through…, Note, : This program is part of the Apple Health program. Washington Connection Medicare beneficiaries may apply to see if they qualify to enroll in classic…, See also, Get free, unbiased health care coverage counseling in your local area, 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