For Consumers

Self-funded group health plans and surprise billing

Consumers enrolled in self-funded group health plans are protected from surprise billing under the Federal No Surprises Act ( This includes any emergency services they receive from a behavioral crisis facility. If an employer self-insures and wants to offer its employees more protections, it must opt to follow Washington state law. 

How to opt-in to the Balance Billing Protection Act

A self-funded group health plan must notify the Office of the Insurance Commissioner at least 15 days in advance of when it intends to participate in and follow the Balance Billing Protection Act. If the plan is administered by a third-party administrator, that administrator also must comply with the law. 

Opt-in is for a full year unless the self-funded plan selects to automatically renew. The plan can participate for any calendar or plan year and must notify us at least 15 days before the end of the year if it wants to opt-out of the law.