For Consumers

Self-funded group health plans and surprise billing

The Federal No Surprises Act ( protects consumers enrolled in self-funded group health from surprise billing. 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-in 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 before it intends to participate in the Balance Billing Protection Act. If the plan is administered by a third-party administrator, that administrator must also follow 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 the OIC at least 15 days before the end of the year to opt-out.