Washington insurance law and regulation
The Office of the Insurance Commissioner can be reached by telephone at 800-562-6900 or by mail at PO Box 40256, Olympia WA 98504. The state children’s health insurance plan (CHIP) Web site is Washington Children’s Health Insurance Program.
News that affects your health insurance and planning
June 3, 2019 – Status of alternative non-ACA health plans: Washington does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market. Washington limits the sale of short-term coverage more strictly than the federal government. A maximum policy of 3 months and short-term coverage cannot exceed 3 months in a 12-month period.
January 1, 2019 – a new state law requires major medical health plans to cover contraception.
The history of health care planning in Washington (Information is outdated and links may be expired)
6/8/2016 Washington health insurance companies’ proposal to raise 2017 health insurance rates by an average of 5% has sparked concern by individuals and small businesses that purchased Obamacare coverage. New York Times reports that similar health insurance cost hikes are proposed in many other states.
7/1/2015 The HealthPlanFinder exchange board will increase its current $4.19 per member monthly assessment fee to help cover its budget shortfall. The exchange is funded through a 2 percent state tax on premiums, and reimbursements from the state and federal government.
5/12/2015 Four additional insurance companies filed applications to offer individual health insurance to Washington residents for 2016. Washington was once considered to have few health insurance choices but that appears to no longer be the case.
3/20/2015 About 11 million customers of Premera BlueCross, Premera BlueCross/BlueShield of Alaska, Vivacity and Connexion Insurance Solutions, Inc. customers have been affected by a cyber attack and security breach. On March 17, 2015 the companies began notifying customers that “cyber attackers had executed a sophisticated attack to gain access to the company’s information technology systems”. Customer information that may have been accessed includes names, dates of birth, email addresses, addresses, telephone numbers, social security numbers, member identification numbers, bank account information, claims information and clinical information.
12/19/2014 Unfortunately Washington state residents do not have access to the popular employer-provided or individual supplemental converge to protect workers from high unexpected medical costs not covered by Obamacare. These costs can run more than $10,000 per year and cause significant financial stress to those who are unable to pay. OnlineNavigator recommends non-insurance strategies be used instead.
2/11/2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Washington residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
12/14/2012 Washington is one of a minority of states that will run a health insurance exchange for individuals and small businesses that is not managed by the federal government. Consumer advocates who once viewed a state-run exchange as a positive are growing concerned that the state may not be fully committed to implementing all of the funding and features expected to be part of the federal health insurance exchanges that are expected to open in the fall of 2013.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Regence BlueShield are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
10/14/2011 Time Insurance Company has requested a 37 percent rate increase in Washington State. Most of the increase comes from an increase in the cost of itemized medical costs rather than an increase in people using more medicine.
8/19/2011 HIP of Spokane County operating as “Community-Minded Enterprises” received a federal grant totaling $596,464 for a program to promote health insurance for teens. Neighborcare Health received a $300,000 grant to target ethnic and immigrant groups for government health insurance.
1/19/2011 Child-only health insurance for children with significant medical problems will be available through an open enrollment period mandated by federal state law under new rules developed by the state. All children, regardless of medical condition, continue to be eligible for insurance when applying as a dependent on a parent’s policy and healthy children are eligible for child-only insurance at any time. When applying for child-only insurance for more than one child, make a separate application for each child.
12/16/2010 Washington Health Care Authority officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, the Health Care Authority said that it would: 1) Develop an implementation plan by September 30, 2011, 2) Focus on cost containment and quality, 3) Conduct IT Infrastructure Review and Assessment – coordinate with requirements and business functions in the Planning Report. In 2011, a technology work plan will supplement the implementation plan, and 4) Focus on legislation that will likely follow the completion of the implementation plan specifies the intent and legal direction of a State-based Exchange.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
10/19/2010 Open enrollment period for children’s health insurance – The state Insurance Commissioner ordered Regence Blue Shield, the state’s largest health insurance company, to offer an open enrollment period for children’s with pre-existing medical problems during a special enrollment period from Nov. 1-Dec. 15, 2010 at which time anyone looking for an individual policy for their families or for their children only can enroll them without undergoing a health screen. All U.S. major insurance plans stopped offering child-only major medical insurance after September 23, 2010 but Washington state has traditionally taken a more radical approach to regulating insurance companies. The executive order gives families with sick children an immediate opportunity to obtain coverage without concern for pre-existing medical conditions.
Self employed individuals and sole proprietors now qualify for group type major medical health insurance regardless of medical history if they are able to show (with a copy of a filed income tax return) that they have been in business for more than one year and that the majority of their earnings come from self-employment income. This new law became effective September 2010. Group coverage may be more expensive than individual medical insurance but covers more potential medical costs.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Washington state is now available at Freedom Benefits.
3/23/2010 Washington and ten other states including Alabama, Florida, Michigan, Nebraska, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas and Utah will make a joint legal challenge to the federal health reform bill on the basis that it improperly usurps state sovereignty over health insurance and that requiring health insurance is an illegal and improper government action.
2/22/2010 State legislators failed to support a bill to allow health insurance consumers the opportunity to purchase health insurance across state lines despite support from the small business community and an endorsement from the chair of the health committee.