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Business-entity licensees - complying with other Washington state agencies
https://www.insurance.wa.gov/business-entity-licensees-complying-other-washington-state-agencies
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For Producers If you're obtaining an insurance license for your business entity, anticipate interacting with more than one state agency in order to comply…, Starting an insurance agency?, You may need to file or register with: Department of Revenue's Business Licensing Service Department of Licensing Office of the Secretary of State Internal…, If your insurance agency is hiring employees, There may be federal- or state-employment applications required by: Department of Revenue Department of Labor & Industries Employment Security…, Tax and wage reports, Find out if quarterly tax and wage reports are required by: Department of Revenue Labor & Industries Employment Security Department Office of the…, See also, Business-licensee compliance Individual-licensee compliance Compliance laws, rules and guidelines, Need more help?, Call us at 360-725-7144, 8 a.m. to 5 p.m., Monday - Friday Contact Producer Licensing and Oversight
Insurer Holding Company Act (R 2024-04)
https://www.insurance.wa.gov/insurer-holding-company-act-r-2024-04
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About OIC Connect with us Online services and tools Laws & Rules SB 6027 (2023-24) was passed to align Washington's Insurer Holding Company Act (Ch. 48…, Adopted rule filed Sept. 17, 2024, CR 103 to R 2024-04 (PDF, 168.96 KB) Concise explanatory statement for Insurer Holding Company Act R2024-04 (PDF, 221.63 KB), Public hearing on Sept. 12, 2024, The public hearing was held Sept. 12, 2024 at 9:00am PST, Proposed rulemaking filed Aug. 05, 2024, CR 102 to R 2024-04 (PDF, 264.50 KB) The comment period for the CR-102 ended Sept. 13, 2024. No comments were submitted for the CR-102., Notice to start rulemaking filed June 04, 2024, CR-101 for R 2024-04 (PDF, 109.54 KB) The comment period for the CR-101ended July 19, 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
Comments on R 2024-02
https://www.insurance.wa.gov/comments-r-2024-02
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The following comments were submitted on the CR-101 for R2024-02 (PDF, 114.23 KB) CR-101 comments on R 2024-02 Organization Submitted by Association of…, SEE ALSO, Regulations - Washington Administrative Code (WAC) Laws - Revised Code of Washington (RCW) Recently adopted rules, NEED MORE HELP?, Contact the rules coordinator
Medicare and people with End Stage Renal Disease (ESRD)
https://www.insurance.wa.gov/medicare-and-people-end-stage-renal-disease-esrd
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For Consumers This information is for people who are eligible for Medicare solely because they have ESRD (permanent kidney failure) and are enrolled in…, Medicare eligibility and applying, I have ESRD. Am I eligible for Medicare?, You can get Medicare, no matter how old you are, if your kidneys no longer work, you need regular dialysis or you had a kidney transplant, and one of these…, If I'm eligible due to ESRD, should I apply for Medicare?, Medicare enrollment can save you money on out-of-pocket costs, but it may not be right for everyone. We recommend you consult a social worker or the ESRD…, How do I apply for Medicare?, You must file an application and meet any deadlines or waiting periods that apply. Contact your local Social Security Administration (SSA) office to make…, Medicare services, What services does Medicare cover?, Medicare helps pay for kidney dialysis and kidney transplant services. Medicare has two parts:, 1. Part A (Hospital insurance), helps pay for: Inpatient hospital care Some skilled nursing facility care Hospice care Some home health care, 2. Part B (Medical insurance), helps pay for: Doctors' services Outpatient hospital care Some other medical services that Part A doesn't cover, such as home health care You'll need both…, Part B Immunosuppressive Drug benefit, In 2023, Medicare started offering Part B-ID, a special benefit covering immunosuppressive (anti-rejection) drugs for those who: Had a successful…, Medicare costs, How much does Medicare cost?, Medicare costs include premiums, deductibles and copayments/coinsurances . Each year the costs may change. You're responsible for paying your monthly…, Can I get help with Medicare costs?, In some circumstances, if you have health insurance in addition to Medicare, your insurance carrier may offer to pay the costs of your Medicare premium.…, Medicare Savings Program, - may cover Medicare Parts A and B premiums, copays and deductibles, Medicare Part D prescription Extra Help savings, - covers prescription drug premiums, deductibles, some copay costs and donut hole/coverage gap costs, What should I know about my costs?, Contact your insurance company to find out what your portion of costs might be for health services. Sometimes there's a difference between what your health…, When to join or drop Medicare, When does Medicare coverage start?, When you first enroll in Medicare based on ESRD and you receive dialysis at an inpatient or outpatient dialysis facility, your Medicare coverage usually…, When does Medicare coverage end?, If you have Medicare only because of kidney failure, your Medicare coverage will end due to one of the following: 12 months after the month you stop…, Medicare and other health insurance, Do I have to give up my other health insurance coverage if I have Medicare?, Technically, no. However, be sure to read the rest of the information in this FAQ and talk with your non-Medicare health plan benefits administrator., Can I apply for health insurance through the Washington Health Benefit Exchange (also called Washington Healthplanfinder)?, If you're already enrolled in Medicare coverage, you cannot buy a qualified health plan sold through Washington Healthplanfinder . If you're enrolled in a…, Important:, When your Medicare Part A coverage starts you will lose your eligibility for premium tax credits and cost-sharing reductions for your qualified health plan., What does "coordination of benefits" mean?, If you have Medicare and other health coverage, each type of coverage is called a "payer." When there's more than one payer, coordination of benefits rules…, What should I know about my doctor?, It's important to find out if your provider is in- or out-of-network, or a participating provider with your health insurance company. Your costs for care…, Contact information, Who do I contact for questions?, To discuss how Medicare due to ESRD might work for you, consult a social worker or the ESRD Network at 800-262-1514. Call your local SHIBA at 800-562-6900…, Disclaimer:, This is general information about ESRD and Medicare. For personalized help, contact Medicare, Social Security, your insurer, and/or your local ESRD Network…, See also, Social Security office locator (www.ssa.gov) Medicare coverage of kidney dialysis & kidney transplant services (PDF, 4MB) (www.medicare.gov), Need more help?, Statewide Health Insurance Benefits Advisors (SHIBA) offers free, unbiased Medicare counseling. Call SHIBA at 800-562-6900 Contact the Washington state…
Ground ambulance advisory group
https://www.insurance.wa.gov/ground-ambulance-advisory-group
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About OIC Connect with us Online services and tools Laws & Rules We were directed by the legislature to work with the Department of Health and the…, Advisory group and report, Presentation to the Washington State Senate Health & Long Term Care Committee - October 30, 2023 (PDF, 907.37 KB) Ground Ambulance Advisory Group…, Advisory Group meetings, August 10 meeting materials, August 10 meeting agenda (PDF, 200.50 KB), Comments on policy options , Northwest Health Law Advocates ground ambulance billing recommendations letter (PDF, 775.62 KB) Washington Ambulance Association ground ambulance balance…, July 26 meeting materials, Northwest project presentation (PDF, 221.63 KB) Provider and carrier survey results presentation (PDF, 405.67 KB) Value and systems science lab…, June 15 meeting materials, The No surprises act and state action to address ground ambulance bills presentation (PDF, 703.63 KB), May 4 meeting materials, May 4 meeting agenda (PDF, 126.77 KB) APCD analysis presentation (PDF, 1.60 MB), March 31 meeting materials, March 31 meeting agenda (PDF, 180.94 KB) Health Care Authority presentation (PDF, 639.95 KB) Office of Insurance Commissioner presentations (PDF, 856.40 KB…, February 27 meeting materials, February 27 meeting agenda (PDF, 163.82 KB) Washington Ambulance Association presentation (PDF, 3.50 MB) Department of Health presentation (PDF, 910.96 KB…, January 20 meeting materials, Jan. 20 meeting agenda (PDF, 182.57 KB) Ground ambulance balance billing presentation (PDF, 498.15 KB), See also, Ground ambulance services and surprise billing Balance Billing Protection Act, Need more help?, Contact Policy and Legislative Affairs
Public records request process
https://www.insurance.wa.gov/public-records-request-process
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About OIC Connect with us Online services and tools Laws & Rules To obtain public records from our office, please submit a public records request .…, Provide the requested documents, Typically, we provide documents at no charge electronically by a file transfer site, email or CD. It is our priority to provide agency records in a timely…, Give you a reasonable estimate of when records will be available, The estimated response time is based on the current volume of requests being processed and the amount of documents involved. In some circumstances, it will…, Make the records available for inspection or copying, You must make arrangements in advance with the Public Records Office to inspect documents in person. The assembled records must be claimed or reviewed…, Deny the request , We will deny your request if: The Washington state Office of the Insurance Commissioner does not collect or maintain the requested information. It is for a…, Requests can also be filed by:, Mail: Office of the Insurance Commissioner Information Governance Unit PO Box 40255 Olympia, WA 98504-0255 Public Records Officer: Kelly Cairns Phone: 360-…, Information we don't collect or maintain, The Office of the Insurance Commissioner does not collect or store records on individual policyholders. , See also, Privacy policy, Need more help?, Submit a public records request
Tribal members
https://www.insurance.wa.gov/tribal-members
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For Consumers Learn about some of your options for health care in Washington if you're a tribal member of a federally recognized tribe or a shareholder in…, Washington Healthplanfinder, If you're under age 65, not on Medicare, and you're a tribal member of a federally recognized tribe or a shareholder in an Alaska Native Corporation, you…, Indian Health Service (IHS), IHS is a federal program that provides health services for federally recognized: American Indians Alaska natives It also may provide health services to:…, IHS and Medicare, IHS is not insurance. However, if you're an enrolled tribal member and you're on Medicare and use IHS pharmacies, you're protected from the Part D penalty…, IHS contact information, For more information and to find the nearest office, call the Portland service area office (which serves Washington, Oregon, and Idaho) at 503-414-5555 ., Tribal clinics, Tribal clinics offer health care to tribal members and their families. In some smaller rural communities, tribal clinics may serve non-native people in…, 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…, See also, Locate Indian Health Service health care in your area When can I buy an individual health plan?, 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
Comments on R 2024-01
https://www.insurance.wa.gov/comments-r-2024-01
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The following comments were submitted on the CR-101 (PDF, 60.78 KB) CR-101 comments on R 2024-01 Organization Submitted by Association of Washington…, See also, Regulations - Washington State Administrative Code (leg.wa.gov) Laws - Revised Code of Washington (leg.wa.gov) Recently adopted rules, need more help?, Contact the rules coordinator
How do insurance companies set auto premiums?
https://www.insurance.wa.gov/how-do-insurance-companies-set-auto-premiums
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For Consumers Insurance companies determine your auto premiums by starting with the base rate and adjusting it based on rating factors specific to you and…, Driving factors, The make, model, and year of your car determine how expensive it would be to repair or replace. Check with your insurance company or agent before you buy a…, Non-driving factors, Companies can use your age, credit history, education, gender, marital status, employment status and occupation as rate factors., Why does auto insurance cost so much?, Insurance premiums go up when costs to repair or replace vehicles go up. As more technology is integrated into vehicles, repairs become more expensive and…, How to save money on your premiums, Shop around for lower premiums and ask your agent or company if they offer special discounts. Consider a policy with higher collision and comprehensive…, See also, Choosing an insurance agent or broker Answering questions about your auto insurance, Need more help?, Call us at 800-562-6900, 8 a.m. to 5 p.m., Monday - Friday Live chat, 10 a.m. to 12 p.m. and 2 p.m. to 4 p.m., Monday - Friday Contact us to ask an…
Mapping hierarchy for cross-carrier to qualified health plans
https://www.insurance.wa.gov/mapping-hierarchy-cross-carrier-qualified-health-plans
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For Insurers & Regulated Entities Washington state Qualified Health Plan auto-reenrollment mapping hierarchy for Plan Year 2025., Hierarchy one: priority enrollment, First, the Health Benefit Exchange will determine an enrollee's mapped Qualified Health Plan (QHP) based on the following criteria: If there , is more than one Cascade or Cascade Select plan available at the enrollee's same metal level, , the Exchange will then map to the Cascade or Cascade Select plan with the lowest annualized premium. If there , is one Cascade or Cascade Select plan available at the enrollee's same metal level, , map to that plan. , Hierarchy two, If there, are no Cascade or Cascade Select plans available at the enrollee's same metal level,, map the non-standard QHP with the lowest annualized premium. If there, are no QHPs in the same metal level, , the Health Benefit Exchange will map the enrollee to the Cascade or Cascade Select plan with the lowest annualized premium either one metal lower or one…, See also, What issuers need to know, Need more help?, Call us at 360-725-7111