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Health insurance Washington state Office of the

Details: Health insurance helps pay your medical bills when you seek medical care. Knowing your options can help save you time, money and frustration. Learn how health insurance works. Individuals & families. Small business owners. For medical providers. Dental insurance. Veterans. Tribal members.

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› Url: https://www.insurance.wa.gov/health-insurance Go Now

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Health insurance plans and health care programs

Details: Health insurance plan name. Description. Washington Healthplanfinder (www.wahealthplanfinder.org) Get help paying for your insurance rates when you buy a health plan in our state's health insurance Exchange through the Washington Healthplanfinder. The 2020 annual open enrollment period is closed, unless you qualify for Apple Health.

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› Url: https://www.insurance.wa.gov/health-insurance-plans-and-health-care-programs Go Now

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Individuals & families Washington state Office of the

Details: Individuals & families. If you don’t have health insurance through an employer, you can buy an individual health plan during the annual open enrollment period. You can either buy a plan directly from an insurer or through Washington state’s health Exchange, the Washington Healthplanfinder.

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› Url: https://www.insurance.wa.gov/individuals-families Go Now

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Long-term care insurance Washington state Office of the

Details: Long-term care insurance helps with many medical, personal and social services for people with prolonged illnesses or disabilities. It can include home health care, adult day care, nursing home care and group living facility care. What qualifies as long-term care insurance? Long-term care insurance companies approved to sell in Washington state.

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› Url: https://www.insurance.wa.gov/long-term-care-insurance Go Now

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Get licensed Washington state Office of the Insurance

Details: Health carrier admissions; P&C, life, disability and title company admissions; Registering as a pharmacy benefit manager (PBM) Registering as a health care benefit manager (HCBM) Registering as a direct primary health care practice; Registering as a captive insurer; Credit for reinsurance; Charitable gift annuity; Service contract provider

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› Url: https://www.insurance.wa.gov/get-licensed Go Now

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About SHIBA services Washington state Office of the

Details: Statewide Health Insurance Benefits Advisors (SHIBA) Washington state's SHIBA provides free, unbiased and confidential help with Medicare to people of all ages and backgrounds. Our volunteer advisors, located around the state, can help you: Assess your health care coverage needs. Determine your general eligibility for health care coverage programs.

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› Url: https://www.insurance.wa.gov/about-shiba-services Go Now

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Individual license Washington state Office of the

Details: Health carrier admissions; P&C, life, disability and title company admissions; Registering as a pharmacy benefit manager (PBM) Registering as a health care benefit manager (HCBM) Registering as a direct primary health care practice; Registering as a captive insurer; Credit for reinsurance; Charitable gift annuity; Service contract provider

› Verified 7 days ago

› Url: https://www.insurance.wa.gov/individual-license Go Now

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Complaints & appeals Washington state Office of the

Details: Health carrier admissions; P&C, life, disability and title company admissions; Registering as a pharmacy benefit manager (PBM) Registering as a health care benefit manager (HCBM) Registering as a direct primary health care practice; Registering as a captive insurer; Credit for reinsurance; Charitable gift annuity; Service contract provider

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› Url: https://www.insurance.wa.gov/complaints-appeals Go Now

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IN THE MATTER OF THE MARKET CONDUCT EXAMINATION …

Details: IN THE MATTER OF THE MARKET CONDUCT EXAMINATION OF THE MEGA LIFE AND HEALTH INSURANCE COMPANY, MID-WEST NATIONAL LIFE INSURANCE COMPANY OF TENNESSEE, AND THE CHESAPEAKE LIFE INSURANCE COMPANY REGULATORY SETTLEMENT AGREEMENT Page 3 D.5. On March 15, 2005, the States of Washington and Alaska issued a call letter to

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/RSA05292008Final.pdf Go Now

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Benefit Marketing Solutions, Benefit Services Association

Details: 9 Articles of Amendment - America's Health Care Consmner 3 Corporation 10 Articles of Amendment - Name change to Benefit Services 3 Association 11 Bylaws of Amercia's Health Care Consumer Association 17 12 Amended. Order to Cease and Desist 3 13 Demand for Administrative Hearing 1 14 Second Amended Notice of Request for Hearing and 6

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/14-0082-rac-bms-witness-exhibit-list.pdf Go Now

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Appealing a health insurance denial Washington state

Details: Appealing a health insurance denial. When your health insurer says no to a treatment or a bill dispute, that doesn't have to be the final word. You can appeal to your insurer. If the answer is still no, you can appeal to an independent review organization. In addition to appealing a denial, you can also file a complaint with us. What is a

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› Url: https://www.insurance.wa.gov/appealing-health-insurance-denial Go Now

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Get help paying for coverage Washington state Office of

Details: Financial aid through the Exchange. If you buy a health plan through the Exchange, you may qualify for financial assistance that would lower your plan's premiums and out-of-pocket costs. The premium tax credit (www.healthcare.gov) is based on income estimates and household information. Income between 100% and 400% of the Federal Poverty Level

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› Url: https://www.insurance.wa.gov/get-help-paying-coverage Go Now

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Advocate for consumers Washington state Office of the

Details: We protect consumers by empowering and educating the public about insurance issues and health care access. Consumer Advocacy. Criminal Investigations Unit (CIU) Statewide Health Insurance Benefits Advisors (SHIBA)

› Verified 7 days ago

› Url: https://www.insurance.wa.gov/advocate-consumers Go Now

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What is health insurance

Details: Health insurance helps pay your medical bills when you need care. Knowing what options are available can help save you time, money and frustration. There are four ways you can get your health insurance: 1. The most common way people get their health insurance is through a group sponsor, such as: Employer. Fraternal organization.

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› Url: https://www.insurance.wa.gov/what-health-insurance Go Now

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Laws and rules for companies in 2021 Washington state

Details: Health Care Benefit Managers (2020-04) Increasing allowable amount for risk reduction goods and services (R 2020-01) Life insurance - behavioral change incentives (R 2020-09) Medicare Part D (R 2020-12) Mitigating inequity in the health insurance market (R 2020-14) Network access and notice requirements (R 2019-05)

› Verified 8 days ago

› Url: https://www.insurance.wa.gov/laws-and-rules-companies-2021 Go Now

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When can I buy an individual health plan

Details: Important: The 2021 annual open enrollment period to buy an individual and family health plan is closed. If you missed open enrollment, you can buy a plan directly through the Washington Health Benefit Exchange during a special enrollment period that runs through Aug. 15, 2021.

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› Url: https://www.insurance.wa.gov/when-can-i-buy-individual-health-plan Go Now

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Registering as a health care benefit manager (HCBM

Details: A health care benefit manager is any person or entity that provides services to or acts on behalf of a health carrier or employee benefits program. HCBMs directly or indirectly impact the determination or use of benefits for or patient access to health care services, drugs and supplies.

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› Url: https://www.insurance.wa.gov/registering-health-care-benefit-manager-hcbm Go Now

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Regence BlueShield

Details: Plans and premiums. Regence BlueShield 2021 individual health plans and premiums (PDF, 1.14 MB) *It's always a good idea to double-check with your plan to make sure your providers are part of the plan's network before you sign up. Warning: The plans included …

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› Url: https://www.insurance.wa.gov/rates/regence-blueshield-2021-premiums Go Now

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Health Entities: HCSC, HMO, & MEWA only

Details: 11 Accident & Health Policy Experience Exhibit 0 EO xxx 4/1 NAIC 12 Actuarial Opinion 0 EO xxx 3/1 Company 13 Life Supplemental Data due March 1 0 EO xxx 3/1 NAIC 14 Life Supplemental Data due April 1 0 EO xxx 4/1 NAIC 15 Life Supp Statement non-guaranteed elements – …

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/health-filing-requirements-updated-1-2021.pdf Go Now

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Can't afford coverage Washington state Office of the

Details: With rising health care costs, here are some options you and your family may qualify for to help pay for health care services. Health insurance plans and programs Direct health care practices

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› Url: https://www.insurance.wa.gov/cant-afford-coverage Go Now

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Health savings accounts Washington state Office of the

Details: Health savings accounts What is an HSA? Internal Revenue Service (IRS) rules may allow you to pay for your current health care expenses and save for future qualified health expenses on a tax-free basis through a health savings account (HSA).

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› Url: https://www.insurance.wa.gov/health-savings-accounts Go Now

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Benefits health plans must cover under Washington state

Details: There are essential health benefits that must be covered under the Affordable Care Act.Under Washington state law, certain individual/family and group plans must also offer the following benefits. Note: Health plans are required to include these benefits. However, your medical services, supplies and prescription drugs are still subject to the plan’s medical necessity criteria.

› Verified 8 days ago

› Url: https://www.insurance.wa.gov/benefits-health-plans-must-cover-under-washington-state-law Go Now

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Patient Bill of Rights Washington state Office of the

Details: The Patient Bill of Rights is a state law (leg.wa.gov) guarantees health insurance consumers have access to quality health care.. Your benefit rights. Some health benefits are required by either state or federal law — or both — and must be in all health insurance plans.. Before you even sign up or your employer enrolls you in a plan, the plan must tell you the following:

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› Url: https://www.insurance.wa.gov/patient-bill-rights Go Now

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Producer (full and limited lines) Washington state

Details: Producer (full and limited lines) A producer is a person licensed to sell, solicit, or negotiate insurance. See RCW 48.17.010 (leg.wa.gov). In Washington state, the health line of authority is referred to as "disability." The following terms all mean the same thing: See RCW 48.17.170 (b) (leg.wa.gov). Follow the steps below to complete the

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Discontinuation and renewals for health plan year 2021

Details: Health care and disability filings. Association Health Plans - Review and Regulation (PDF, 43.51 KB) OIC RFPN PY2022 Filing Webinar – April 6, 2021 (PDF, 2.29 MB) Discontinuation and renewals for health plan year 2021. Small group and individual templates; What issuers need to know; Washington state health plan mapping hierarchy criteria

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› Url: https://www.insurance.wa.gov/discontinuation-and-renewals-health-plan-year-2021 Go Now

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How Medicare and Medicaid work together in Washington state

Details: Statewide Health Insurance Benefits Advisors (SHIBA) How Medicare and Medicaid work together in Washington state •Review of SHIBA scope •Classic Medicaid •Dual eligibles •Medically Needy and Spenddown •Extra Help •Action steps for SHIBA volunteers. February 2019 .

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› Url: https://insurance.wa.gov/sites/default/files/documents/how-medicare-medicaid-work-together-wa-state.pdf Go Now

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What you need to know about short-term medical plans

Details: Drop all of the 10 essential health benefits (www.healthcare.gov) except they must cover mental health services and prescriptions for mental health treatment. Per RCW 48.44.341 (leg.wa.gov), short term medical plans issued or renewed on or after Jan. 1, 2021, must cover mental health treatment.

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› Url: https://www.insurance.wa.gov/what-you-need-know-about-short-term-medical-plans Go Now

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Health Alliance Northwest Health Plan

Details: Health Alliance Northwest Health Plan 2021 individual health plans and premiums (PDF, 425.11 KB) *It's always a good idea to double-check with your plan to make sure your providers are part of the plan's network before you sign up.

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› Url: https://www.insurance.wa.gov/rates/health-alliance-northwest-health-plan-2021-premiums Go Now

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Health insurance options for people with disabilities

Details: medical, dental, vision and mental health coverage. Enrollment is open all year long. To find out if you qualify, go to www.wahealthplanfinder.org or call 1-855-923-3633. Community health centers These community health centers offer health services for the entire community on …

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/options-disability-booklet_1.pdf Go Now

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Choosing an insurance agent or broker Washington state

Details: Ask your friends, neighbors, co-workers and family about their experiences with their insurance agent or broker. Check out potential licensed agents or brokers before you decide to buy – it’s your right. We can tell you: How many complaints consumers have filed against an agent or broker. Whether they’ve faced disciplinary action in the past.

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› Url: https://www.insurance.wa.gov/choosing-insurance-agent-or-broker Go Now

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Questions to ask when comparing health plans Washington

Details: What does the plan pay for and what does it exclude? Due to health reform, most health plans must include a standard set of benefits, also known as essential health benefits (www.healthcare.gov).. They include services, such as maternity and newborn care, preventive services and …

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Adult dental/Washington Apple Health (Medicaid)

Details: Washington Apple Health (Medicaid) Starting January 1, 2014 Client Handout The Washington Apple Health (Medicaid) resumed covering dental services for all adults with Medicaid (clients 21 years of age and older) Includes people who already have Medicaid AND people who are eligible for “Expanded Medicaid,” part of health care reform.

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/adult-dental-apple-health.pdf Go Now

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When health insurers can ask you about your health

Details: Under health reform, health insurance companies can't make you answer health questions to buy health insurance. They also can't require a pre-existing condition waiting period for claims you submit. However, once you're on a health plan, they can ask you questions to find out if you qualify for one of the following programs:

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› Url: https://www.insurance.wa.gov/when-health-insurers-can-ask-you-about-your-health Go Now

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Providence Health Plans

Details: Plans and premiums. Providence Health Plan 2021 individual health plans and premiums (PDF, 250.82 KB) *It's always a good idea to double-check with your plan to make sure your providers are part of the plan's network before you sign up. Warning: The plans included above only apply to people who do not qualify for Medicare.

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› Url: https://www.insurance.wa.gov/rates/providence-health-plans-2021-premiums Go Now

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Long-term care insurance companies approved to sell in

Details: Note to consumers: Washington state laws took effect Jan. 1, 2009, to further protect consumers who buy long-term care insurance. Before selling long-term care policies in Washington state, insurers must submit their policies to our office to make sure they meet the requirements of the laws.

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› Url: https://www.insurance.wa.gov/long-term-care-insurance-companies-approved-sell-washington-state Go Now

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Learn how health insurance works Washington state Office

Details: Health insurance helps pay your medical bills when you seek care. Knowing what your options are can help save you time, money and frustration.

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› Url: https://www.insurance.wa.gov/learn-how-health-insurance-works Go Now

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Kreidler fines OneShare Health LLC $150,000 for selling

Details: A legitimate health care sharing ministry is a nonprofit organization whose members have shared a common set of ethical or religious beliefs since 1999 and share medical expenses consistent with those beliefs. Health care sharing ministries often provide limited coverage and exclude pre-existing medical conditions.

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› Url: https://www.insurance.wa.gov/news/kreidler-fines-oneshare-health-llc-150000-selling-illegal-insurance Go Now

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Market information reports Washington state Office of

Details: Market information reports. The Office of the Insurance Commissioner (OIC) is required by state law to report each year on the state's largest insurance companies by market share, statistical information and companies' financial statements and transactions. The OIC collects the information from the National Association of Insurance

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› Url: https://www.insurance.wa.gov/market-information-reports Go Now

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WASHINGTON STATE Health Care Sharing Ministries …

Details: Health care sharing ministries shall timely reply in writing to an inquiry of the commissioner regarding their compliance with RCW 48.43.009, and any potential violations of RCW 48.05.030(1) and RCW 48.15.020(1), and any related regulations including this regulation. A timely response is one that is received by the commissioner

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/r-2021-17-stakeholder-draft.pdf Go Now

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Health insurance rate frequently asked questions

Details: Anytime a health insurer requests a rate change, it must back up its request with data. We create a summary for each request to help you understand why your company believes it needs a rate change. Each one-page summary includes: The average percentage change the company is requesting.

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Eligibility overview for Washington Apple Health (Medicaid

Details: Health Insurance Plan) that covers the Categorically Needy (CN) and Medically Needy (MN) programs. Washington Apple Health is an umbrella term or “brand name” for all Washington State medical assistance programs, including Medicaid. The brand name may be shortened to “Apple Health.” The Health Care Authority (HCA) administers

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› Url: https://www.insurance.wa.gov/sites/default/files/documents/eligibility-overview-apple-health-medicaid-programs.pdf Go Now

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Washington State Health Insurance Pool (WSHIP) (R 2021-18

Details: Washington State Health Insurance Pool (WSHIP) (R 2021-18) Health care sharing ministries (R 2021-17) Implementation of E2SHB 1477 and consolidated health care rulemaking (R 2021-16) FAIR Plan committee members (R 2021-15) Health insurance discrimination and gender affirming treatment (R 2021-14) Student Health Plans (R 2021-13)

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› Url: https://www.insurance.wa.gov/washington-state-health-insurance-pool-wship-r-2021-18 Go Now

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Exam content outlines Washington state Office of the

Details: Exam content outlines. PSI Services, LLC (PSI), a Washington state insurance licensing exam provider, develops content outlines to help you study as you prep for your exam. There are 12 outlines available for the following exams: You may obtain exam outlines from PSI's website (PDF, 382KB) (www.psiexams.com) or call them at 800-733-9267 for

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2021 financial filing checklists Washington state Office

Details: The National Association of Insurance Commissioners (NAIC) requires insurance companies and health carriers to submit financial statements and related filings. Fraternal Beneficial Societies. Filing checklist (PDF, 656.02 KB) Use of remote online notary (PDF, 123.19 KB)

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Health information and your privacy Washington state

Details: Health information and your privacy. Important! You have the right to have your personal health information sent to you instead of the person who pays for your health insurance plan. You must let your health insurance company know where to send this information or they’ll send it to the address on file. To make this request, print, complete

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› Url: https://www.insurance.wa.gov/health-information-and-your-privacy Go Now

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Aliera ordered to pay $1 million for selling illegal

Details: November 24, 2020. OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler’s action against Aliera Healthcare, Inc. (Aliera) ordering the company to stop selling health insurance illegally was upheld on Nov. 13 after the company appealed. Today, Aliera was ordered to pay a $1 million fine.It has 90 days to appeal. Kreidler took action against Aliera and its partner, Trinity Healthshare, Inc

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› Url: https://www.insurance.wa.gov/news/aliera-ordered-pay-1-million-selling-illegal-health-insurance Go Now

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What are my out-of-pocket costs

Details: Limits on out-of-pocket costs. For 2021, out-of-pocket costs (deductible, copayments and coinsurance) are limited to $8,550 for self-only coverage and $17,100 for family coverage. Once you meet the limit, your health plan starts to pay 100% of your allowed amount for a covered benefit. Note: Neither your premiums, or costs for medical services

› Verified 7 days ago

› Url: https://www.insurance.wa.gov/what-are-my-out-pocket-costs Go Now

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Health insurance discrimination and gender affirming

Details: Health insurance discrimination and gender affirming treatment (R 2021-14) This rulemaking implements the recently passed Gender Affirming Treatment Act, SB 5313 (leg.wa.gov) . This will involve updating and adding to the rules as necessary to clarify carrier requirements and prohibitions in relation to coverage for gender affirming treatment.

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› Url: https://www.insurance.wa.gov/health-insurance-discrimination-and-gender-affirming-treatment-r-2021-14 Go Now

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