For Consumers

How to report a Balance Billing Protection Act final decision (Appendix B and C)

Arbitrators must issue their final decisions within 30 days of the parties’ written submissions. For each arbitration proceeding they oversee, the arbitrator must submit to the Office of the Insurance Commissioner (OIC):

  1. The applicable reporting form; and
  2. Their written decision

Reporting forms (Appendix B or Appendix C)

There are two arbitrator decision reporting forms, referred to as Appendix B and Appendix C. A brief description is provided below to assist you in determining which form is the appropriate one to use.

Once you have determined the appropriate form, there are two ways to submit:

  • Submit the information online, or
  • Download and print the hardcopy form. After completing it, submit it via the contact the arbitration team form. (If you use this option, the form and your decision can be uploaded at the same time).

Arbitrator decision reporting form - “Appendix B”

The arbitrator decision reporting form is required for arbitration proceedings under RCW 48.49.040 (leg.wa.gov). This mandatory form for arbitrators to use is referred to as “Appendix B” in WAC 284-43B-037(6)(b) (leg.wa.gov) and WAC 284-43B-090 (leg.wa.gov). This form assists the OIC with its annual reporting requirements under RCW 48.49.050 (leg.wa.gov).  Submission of this form and the written decision satisfies the notification requirements under RCW 48.49.040(8)(a) (leg.wa.gov). Note: Appendix B cannot be used for arbitration decisions under RCW 48.49.135 (leg.wa.gov).

Arbitrator reporting form for proceedings under RCW 48.49.135 – "Appendix C"

The arbitrator decision reporting form is required for arbitration proceedings under RCW 48.49.135 (leg.wa.gov). This mandatory form for arbitrators to use is referred to as “Appendix C” in WAC 284-43B-037(6)(b) (leg.wa.gov) and WAC 284-43B-095 (leg.wa.gov). The form assists the OIC with its annual reporting requirements under RCW 48.49.050 (leg.wa.gov). Submission of this form and the written decision satisfies the reporting requirements under RCW 48.49.040(8)(a) (leg.wa.gov)

The written decision

Arbitrators’ decision

RCW 48.49.040 lists the factors the arbitrator must consider in choosing one of the parties’ final offer amount. The arbitrator’s decision must include:

  • Explanation of the elements of the parties' submissions the arbitrator relied upon to make their decision and
  • Why those elements were relevant to their decision. 

What are the formatting guidelines?

There is no template or form for the written decision. We recommend that the decision:

  • Be in a Word of PDF document file
  • Header includes the parties' names and the arbitration initiation request form number

Arbitrator fees

Arbitrator fees must be paid by the parties within 30 calendar days of receipt of the arbitrator's decision. If the parties reach an agreement before the arbitrator makes their decision, any arbitrator fees must be paid by the parties within 30 calendar days of the date the settlement is reported to the OIC.

How to submit the written decision

The final written decision must be submitted to the arbitration team form.

Settlements before the final decision

If the parties settle before the arbitrator has decided, the parties must submit a settlement reporting form to the OIC. The arbitrator is not required to submit information about the parties’ settlement to the OIC.