WSHIP recognizes that agents (producers) play an important role in helping applicants obtain individual health benefits and navigating the ever-changing health insurance landscape with the advent of the federal Affordable Care Act (ACA) and state implementation of the Washington Health Benefit Exchange (HBE).
In 2013, the Washington State Legislature passed several laws affecting the future operation of the Washington State Health Insurance Pool (WSHIP) and reflecting the implementation of the ACA and the HBE. Changes effective January 1, 2014 include:
- Washington carriers no longer administer the Standard Health Questionnaire (SHQ) to applicants (and WSHIP no longer maintains the SHQ).
- Only individuals enrolled in WSHIP plans prior to December 31, 2013 will be eligible for WSHIP non-Medicare plans if all counties are determined to have at least one individual health plan offered during defined open enrollment or special enrollment periods.
- WSHIP non-Medicare plans are scheduled to be discontinued on December 31, 2022.
- There are no changes to WSHIP’s eligibility or application process for its Medicare-eligible plan (Basic). This plan remains open to individuals unable to obtain comprehensive supplemental coverage or a Medicare Advantage Plan, and there is no scheduled discontinuation date.
Currently, Non-Medicare Coverage is available in all counties in Washington.
Therefore, no applications for WSHIP non-Medicare coverage are being accepted. Enrollment is “closed” and this is noted on WSHIP’s website. The WSHIP Non-Medicare Application is inaccessible on the website and viewers are directed to Washington Healthplanfinder.
WSHIP and Minimum Essential Coverage (MEC). WSHIP Non-Medicare plans are recognized by HHS as MEC for plan years beginning January 1, 2015 or later.
For Medicare enrollees, there is no change in the enrollment process. WSHIP’s Medicare plan continues to be available to Medicare-enrolled persons who live in a county where they do not have access to a reasonable choice of Medicare Advantage Plans and they have been turned down for a Medicare supplement plan for medical reasons or coverage offered has pre-existing conditions limitations or uprated premiums.
WSHIP will pay a $100 fee to Washington state licensed insurance agents who assist applicants in filling out a WSHIP Application form. The Agent Information, Section I of the WSHIP Application, must be completed and submitted by the agent in order for WSHIP to process an agent's commission payment. Agents must also submit a complete Form W-9 and a copy of their current State of Washington Agent License.