Information for Washington health care insurance companies about the required Washington State Health Insurance Pool (WSHIP) annual assessment report.

Q1: What does WSHIP do?

A1: WSHIP provides health insurance to all residents of Washington state who are unable to get health insurance coverage. WSHIP has members who offer health care coverage plans to Washington residents.

Q2: Who's considered a WSHIP member?

A2: You are considered a WSHIP member if you're a health care contractor (HCSC), health maintenance organization (HMO), have a self-funded Multiple Employer Welfare Arrangement (MEWA), or you're a disability carrier that has health care coverage or stop-loss plans.

Q3: Why does Washington state require this annual report?

A3: This report gives WSHIP the number of Washington state residents insured under your health insurance products. This information is used to determine what your contribution will be to WSHIP. You pay a portion of the expenses that exceed the premiums and other income received by WSHIP. You must fill out the report before March 1st of each year. For more information, see:

Q4: What does the Office of the Insurance Commissioner do with the information from the report?

A4: We collect this information and send it to Benefit Management Inc. They in turn review and assess the information to determine your required contribution to WSHIP.

Q5: Which health care plan enrollees need to be reported?

A5: In general, you will need to report enrollees in:

group or individual disability insurance policies,
health care service contracts and
health maintenance agreements.

This also includes:

Medicare Supplement coverage,
stop-loss policies,
individual health insurance policies,
small and large group health plans,
Washington state Healthly Options Medicaid program,
Washington state Children's Health Insurance Program contracts,
Basic Health Plan and
Basic Health Plan Plus.

For more information, see: RCW 48.41.030 - Definitions.

Q6: How do I report enrollment in self-funded health plans that have stop-loss coverage?

A6: Lives insured by a stop-loss carrier are assessed at a rate of 1 enrollee in 10. Just report the total number of insured persons and we will calculate the 1/10 assessment rate for you.