For Insurers

Small group and individual templates

The U.S. Department of Health and Human Services (HHS) requires issuers to send discontinuation and renewal notices to consumers. This applies to both individual plans and small-group health plans, regardless of whether they are grandfathered or not.

For small-group health plans, issuers must notify consumers of discontinuations or renewals in writing, but they do not need to use a specific template as long as they include all of the required elements in the notices.

For individual health plans, issuers must notify consumers of discontinuations or renewals in writing using approved templates. Links to the templates can be found below.

Requirements for plan year 2019 notices

For individual health plans, issuers must use the Washington state individual health plan templates.

Issuers may not change the content of the templates except where indicated within the template by the bracketed text. For questions about how to use the bracketed text or for situations that aren’t covered by the templates, call the Health and Disability Forms/Contracts Manager at 360-725-7119.

For both individual and small-group plans, issuers need to submit their draft notices to the Office of the Insurance Commissioner (OIC) through the System for Electronic Rate and Form Filing (SERFF) for review and approval.

Cover letters

Issuers shouldn't send consumers cover letters with the templates, but if a cover letter is sent, don't include information that conflicts with information on the OIC's template. Also, don't tell Exchange enrollees they will be auto-enrolled unless you're certain that is the case.

Issuers must email a copy of the letter to the OIC's senior health policy analyst for review and must give the OIC a minimum of three business days to complete the review.

Individual plans

Group plans

Notice of language and disability accommodations

  • Issuers must include notice of language accommodations as required by 45 CFR 155.250 (www.ecfr.gov)

  • Language taglines per CCIIO Technical Guidance (www.cms.gov) – March 30, 2016 Guidance and Population Data for Exchanges, Qualified Health Plan Issuers, and Web-Brokers to Ensure Meaningful Access by Limited-English Proficient Speakers Under 45 CFR §155.205(c) and §156.250. For Plan Year 2019, the OIC will allow the Notice and Taglines to be "posted" with forms either by being embedded in the forms or as an inset enclosed with the forms. 

    • For Plan Year 2018, the OIC will allow the Notice and Taglines to be "posted" with forms either by being embedded in the forms, or as an insert enclosed with the forms.

  • Appendix A (www.cms.wa.gov) – Top 15 Non-English Languages by State

  • Appendix B (www.cms.wa.gov) –  Sample translated taglines – languages are listed in alphabetical order