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Medicare options for people with disabilities
https://www.insurance.wa.gov/medicare-options-people-disabilities
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For Consumers If you are under the age of 65 and receiving Social Security Disability Income (SSDI) benefits, you may be eligible for Medicare benefits. …, If you are eligible for Medicare , Medicare-eligible people with disabilities may be able to take advantage of these options: Get help paying for Medicare Medicare Advantage plans Medicare…, See also, How we can help you with Medicare Get help paying for Medicare Health insurance options for people with disabilities (PDF, 279KB), Need more help?, Get free Medicare help from SHIBA Call SHIBA at 800-562-6900 Contact the Washington state SHIBA program
What issuers need to know
https://www.insurance.wa.gov/what-issuers-need-know
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For Insurers & Regulated Entities Information to help issuers with the discontinuation and renewal process for the 2025 plan year:, Small group issuers using the Washington state templates or writing their own templates, Although small group issuers may write their own templates, we recommend they use the Washington templates. By using the provided templates, issuers can…, Cover letters and additional items, The OIC discourages cover letters to avoid potential contradictions with the templates. If they are used, don't include information that conflicts with…, Language taglines, Issuers must include notice of language accommodations as required by 45 CFR 156.250 . The OIC will allow the Notice and Taglines to be "posted" with forms…, Adding issuer identification to the notices, At the bottom of each template is a space for issuers to add their company's identification. Issuers may add a logo and identification information on the…, Sending notices by email, Issuers can email notices to consumers who have agreed to receive electronic notification for important issues. If an issuer emails a notice to a consumer…, Listing the names of all enrollees on notices for individual plans, We encourage issuers to list the names of all enrollees in the household who are on the plan. This can help to reduce confusion in households where some…, Small group plans requirement to notify each enrollee, When issuers send discontinuation notices for small-group plans, they need to send the notices to each employee on the plan, not just to the employer. This…, Requirement to provide written notice of open enrollment , Under WAC 284-43-1080(4) , issuers must provide written notice of open enrollment to consumers each September. Issuers can meet this requirement by adding…, Filing notices with the Office of the Insurance Commissioner (OIC), Issuers only need to file one template for each type of notice. For example, if an issuer's portfolio has: One Exchange-only individual product with seven…, Note:, Discontinuation happens at the product level. Although the issuer in the example above is discontinuing the enrollees' plans, the issuer will map them to a…, Reporting notice errors, Use our online form to report errors concerning discontinuation or renewal notices ., Changes to include in the benefits and cost-sharing tables, Issuers should include any material changes between the current plan benefits and cost-sharing levels versus the upcoming new plan benefits and cost-…, Student health plans, For student health plans, issuers can send the notice to the school instead of having to send a notice to every student who's enrolled in the plan., Stand-alone pediatric dental plans, The OIC encourages, but does not require, issuers of stand-alone pediatric dental plans to use the OIC's templates to notify consumers about renewals and…, Notices for large-group plans, Per RCW 48.43.035(4) , plans for groups of up to two hundred members are required to provide notifications for discontinuations but not for renewals., Sending a renewal notice vs. a discontinuation notice, The correct notice for a particular enrollee is based upon whether the enrollee's, product, (not plan) is being renewed for plan year 2025. Under federal law, renewal and discontinuation happen at the product (not plan) level. Therefore, issuers…, renewal, notice if one of these criteria are met: The enrollee's plan is renewed for plan year 2025. The enrollee's plan is no longer offered for 2025, but the…, discontinuation, notice if the enrollee's 2024 product (not plan) is no longer being offered for 2025. This is true whether or not the enrollee is being mapped to a new…, Notices for American Indian/Alaskan Native and cost-sharing reduction plans - filing with the OIC through Systems for Electronic Rate and Form Filing (…, There are no differences between the standard plans and these reduced-cost plans, other than cost sharing. As a result, issuers should send the same…, The federal government's waiver of the 90-day requirement for discontinuation notices, Washington state requires issuers to provide discontinuation notices 90 days before discontinuation., Process for Qualified Health Plans (QHP) through the Exchange, The Washington Health Benefit Exchange provides additional information to issuers about mapping consumers for plan and product discontinuations. If you…, See also, Small group and individual templates, Need more help?, Call us at 360-725-7111
Small group and individual templates
https://www.insurance.wa.gov/small-group-and-individual-templates
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For Insurers & Regulated Entities The U.S. Department of Health and Human Services (HHS) requires issuers to send discontinuation and renewal notices…, Requirements for plan year 2025 notices, For individual health plans, issuers must use the Washington state individual health plan templates. Issuers may not change the content of the templates…, Cover letters, The OIC discourages cover letters to avoid potential contradictions with the templates. When using a cover letter, don't include information that conflicts…, Individual plans, Renewal notices (to be used for the same plan or another plan within the same product), On-Exchange renewal individual plan 2 (Word, 49.90 KB) Off-Exchange renewal individual plan 1 (Word, 47.03 KB) On-Exchange renewal with mapping to a…, Group plans, Automatic renewal notice 4 (Word, 38.16 KB) Discontinuation with Suggested New Plan Small Group 8 (Word, 45.14 KB) Renewal Not Automatic Notice Small Group…, Adding issuer identification to the notices, At the bottom of each template is a space for issuers to add their company's identification. Issuers may add a logo and identification information on the…, Notice of language and disability accommodations, Issuers must include notice of language accommodations as required by 45 CFR 156.250 Language taglines per CCIIO Technical Guidance - March 30, 2016,…, SEE ALSO, What issuers need to know Updated federal standard renewal and product discontinuation notices (PDF, 313 KB), NEED MORE HELP?, Call us at 360-725-7111
Submit a discontinuation and renewal cover letter
https://www.insurance.wa.gov/submit-discontinuation-and-renewal-cover-letter
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See also, What issuers need to know Updated federal standard renewal and product discontinuation notices (PDF, 313 KB), Need more help?, Call us at 360-725-7111
Public meetings and notices
https://www.insurance.wa.gov/public-meetings-and-notices
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About OIC Connect with us Online services and tools Laws & Rules The Office of the Insurance Commissioner (OIC) is required to provide information on…, See also, Proposed new rules Technical assistance advisories and emergency orders Administrative hearings, Need more help?, Call us at 800-562-6900, 8 a.m. to 5 p.m., Monday - Friday
Resources to help with counseling clients
https://www.insurance.wa.gov/resources-help-counseling-clients
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SHIBA volunteers can find tools here to help with counseling and communicating with Medicare clients who might need additional help with a Medicare issue,…, About OIC Connect with us Laws & Rules Log in 2024 All Counties D-SNP (Excel, 108.52 KB) 2024 East WA D-SNP (Excel, 169.09 KB) 2024 North, Central WA D…, See also, About SHIBA services SHIBA News Flash, Need more help?, Contact SHIBA staff (for volunteers and volunteer coordinators) Call us at 360-725-7097
Outreach
https://www.insurance.wa.gov/outreach
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SHIBA provides pre-approved public presentations, outreach tools and materials, online forms to submit requests for our online event calendar and…, About OIC Connect with us Laws & Rules Log in Medicare fraud prevention outreach campaign Public presentations SHIBA outreach videos Medicare fraud -…, See also, Washington Relay - telecommunication relay services Language Link services SHIBA events calendar, Need more help?, Contact SHIBA staff (for volunteers and volunteer coordinators) Call SHIBA's communications manager at 360-725-7238
Medicare Open Enrollment tools
https://www.insurance.wa.gov/medicare-open-enrollment-tools
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SHIBA volunteers can find and use helpful tools to counsel clients during Medicare Open Enrollment along with information about Medicare Open Enrollment…, About OIC Connect with us Laws & Rules Log in Counseling Medicare clients - OEP related Medicare Plan Finder walk-thru video Medicare outreach and…, See also, Medicare Unique IDs Medicare Plan Finder, Need more help?, Contact SHIBA staff (for volunteers and volunteer coordinators) Call SHIBA's administrative assistant at 360-725-7097
Producer advisory committees
https://www.insurance.wa.gov/producer-advisory-committees
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About OIC Connect with us Online services and tools Laws & Rules The Office of the Insurance Commissioner appoints members to act as consultants to the…, Producer Advisory Committee Members , Life and Disability Property and Casualty Alex Collins, Bothell Amberlyn McQuary, Spokane Cecilia Kidder, Redmond Carol Mickey, Bellevue Christopher D Free…, See also, Become a SHIBA (Statewide Health Insurance Benefits Advisors) volunteer Contact information for Producer Licensing and Oversight, Need more help?, Call us at 360-725-7144, 8 a.m. to 5 p.m., Monday - Friday Contact Producer Licensing and Oversight
Need help paying for Medicare?
https://www.insurance.wa.gov/need-help-paying-medicare
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Help with Medicare premiums, The Medicare Savings Program helps people on Medicare, who qualify, pay for all or part of their Medicare premiums. If you qualify, the Medicare Savings…, See if you qualify for a Medicare Savings Program, Medicare Savings Program income and resource (asset) levels Category Effective April 1, 2024, if your income is less than: Single person $1,752 per month/$…, Note:, There is no resource/asset test for the MSPs. This means you won't be asked to verify any resources, such as bank account balances., How to apply, Contact your local Statewide Health Insurance Benefits Advisors (SHIBA) program directly to ask for help applying. Or call our Insurance Consumer Hotline…, Help with paying for prescriptions, Medicare Part D prescription drug coverage Extra Help assists Medicare clients, who qualify, for help to pay their prescription drug plan costs. It covers…, Caution:, If you receive prescription coverage from an employer plan, you may not want to apply for this help. It could mean you would lose your employer health plan…, See if you qualify for Extra Help for Part D prescription drugs, (Effective February 2024) Extra Help Part D income and resource (asset) levels Category If your income is less than: If your resources (assets)* are less…, Note:, If you have income from working, your income could be higher, so we recommend applying to see if you qualify., How to apply, Contact your local Statewide Health Insurance Benefits Advisors (SHIBA) program directly to ask for help applying. Or call our Insurance Consumer Hotline…, See also, Get free Medicare help from SHIBA Learn about Medicare, Need more help?, Get free, unbiased Medicare help from the Washington SHIBA program Call SHIBA at 800-562-6900