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, 2017.
- 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.
- A directive for the WSHIP Board to revisit its study of eligibility completed in 2012 with another review of the populations that may need ongoing access to coverage through the Pool, for submission to the Governor and Legislature in November 2015.
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). All WSHIP plans except Limited Plan A are recognized by HHS as MEC for plan years beginning January 1, 2015 or later. These plans were endorsed with changes required by HHS. This means that enrollees not ready to transition to new coverage or who do not have other coverage options will continue to be exempt from the ACA tax penalty.
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. In 2015, nine counties (up from 5 in 2014) have reasonable choice of Medicare Advantage plans. Those counties are Clark, Cowlitz, King, Lewis Pierce, Snohomish, Spokane, Thurston and Whatcom
Training & Directory
The WSHIP Agent Directory lists agents who have reviewed our Agent Training Module and program materials and can assist applicants applying to WSHIP. The directory is also posted to our website. Agents in our directory will receive bulletins and/or other email communications from WSHIP. Fill out the Agent Directory Listing Form to add or update your listing. Mail the form to WSHIP, PO Box 1090, Great Bend, KS 67530, fax the form to 620-792-0535 or send an email to email@example.com.
Agent Training Module – Online refresher and reference tool
The WSHIP Agent Training Module allows you to click on links to quickly view more detailed information or download forms from our website. We hope you will find this helpful not only in your initial training but as an ongoing reference tool.
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.
Agent bulletins provide useful updates about WSHIP, including changes to WSHIP's benefits, rates or application process. Bulletins also include important updates related to Board of Directors, and legislative or program activities.
WSHIP Application & Rates
Click below to view printer friendly versions of the WSHIP Application & Rates
WSHIP Eligibility & Benefit Plans 2016