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Washington Health Insurance Information

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Updated January 04, 2009

If you live in Washington, the following health insurance contact information may be helpful to you:

Washington State Office of the Insurance Commissioner

The Washington State Office of the Insurance Commissioner is responsible for regulating all types of insurance sold in the state of Washington, including health insurance policies.

If you are looking for health insurance coverage, the Office of the Insurance Commissioner keeps a list of insurance companies licensed to sell policies in Washington. You can also search for insurance agents on its website.

If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Office of the Insurance Commissioner. Find more information about how to file a complaint, or download and print a complaint form here.

Washington State Office of the Insurance Commissioner
5000 Capitol Boulevard
Tumwater, WA 98501
Phone: 800-562-6900
Email: CAP@oic.wa.gov

U.S. Department of Labor

If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees. For example, your employer cannot single out an individual employee and exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.

If you have concerns about your employer's practices in administering your job-based health coverage (for example, if you think you should have been offered COBRA continuation coverage, but were not), contact your regional EBSA office.

U.S. Department of Labor Employee Benefits Security Administration
Seattle District Office
1111 Third Avenue, Suite 860
Seattle, WA 98101-3212
Duane Peterson - Supervisor
Phone: 206-553-4244
Fax: 206-553-0913

Buying Individual Policies in Washington

As a general rule, insurers in Washington are allowed to reject your application for coverage based on your health status. Most applicants will be required to complete a standard health questionnaire designed to determine your health status. There are some individuals who may be exempt from this requirement. For example, individuals who have exhausted all of their COBRA continuation benefits do not need to fill out the questionnaire. For more information, see the questionnaire instructions.

People who are denied coverage from a private insurer have the right to purchase coverage through the Washington State Health Insurance Pool (described below).

Washington State Health Insurance Pool (WSHIP)

WSHIP offers coverage to individuals who are unable to purchase an individual health insurance policy because they have pre-existing health conditions. It also covers "HIPAA-eligible" individuals. You may qualify for coverage as a "HIPAA-eligible" individual if you:

  • had at least 18 months of continuous creditable coverage, the last day of which was under a group plan
    AND
  • you have exhausted all COBRA continuation coverage available to you

If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Washington State Office of the Insurance Commissioner can help you find out. For more information about WSHIP, including premium rates, contact WSHIP.

WSHIP
P.O. Box 1090
Great Bend, KS 67530
Phone: 800-877-5187

Washington State Children's Health Insurance Program (SCHIP)

The SCHIP program provides health insurance coverage for children whose family income meets certain guidelines.

SCHIP
Phone: 877-KIDS-NOW

Statewide Health Insurance Benefits Advisors (SHIBA)

SHIBA provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit or Medigap coverage.

SHIBA HelpLine
Mailing Address: Office of Insurance Commissioner, P.O. Box 40256, Olympia, WA 98504-0256
Phone: 800-541-7735
Email: SHIBAhelpLine@oic.wa.gov

Washington Medicaid

Medicaid is a government program designed to help the poor and indigent obtain healthcare services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals.

Washington Medicaid
Phone: 800-562-3022

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