Frequently Asked Questions
What is the Washington Health Benefit Exchange?
The Washington Health Benefit Exchange is a public-private partnership with the mission to redefine people’s experience with health care. Part of the Affordable Care Act, the Exchange is responsible for Washington Healthplanfinder – an easily accessible, online marketplace for individuals, families and small businesses to compare and enroll in Qualified Health Plans. The Exchange works in close coordination with our state agency partners, including the Health Care Authority (Washington Apple Health), Office of the Insurance Commissioner and Department of Social and Health Services.
How was the Exchange created and established?
The Exchange was created in Washington State statute in 2011 (SSB 5445) and was established as a “public-private partnership.” The Exchange complies with open public meetings and public disclosure guidelines but is not subject to other laws that govern state agencies. In 2012, legislation was passed (ESSHB 2319) that established market rules, requirements for Qualified Health Plans, essential health benefits and more. The Exchange initially started in the state’s Health Care Authority (HCA) and has transitioned to an independent organization.
How is Washington Healthplanfinder funded?
Washington Healthplanfinder is currently funded by federal Exchange Establishment grants. Beginning Jan. 1, 2015, the Exchange is required to be financially self-sustaining. The Exchange worked closely with industry experts to formulate a projected operating budget and expected enrollment numbers. Senate House Bill 1947, which outlines a secure funding source for the Exchange and is most similar to the “hybrid” funding model the Exchange Board presented to the legislature in December 2013, was signed by Gov. Inslee on June 30, 2013. The state allocated the Exchange a $40 million annual budget that is to be generated from a 2 percent premium tax on all health plans sold through Washington Healthplanfinder. Any remaining funding needs will be generated through an assessment on participating insurance carriers. The Exchange Board is currently discussing additional funding needs for 2015. For more information, visit our Exchange Board page.
What’s coming up next for the Washington Health Benefit Exchange?
Qualified Health Plans: Insurance carriers have submitted their health plans to the Washington State Office of the Insurance Commissioner and been approved to be offered through Washington Healthplanfinder for the next open enrollment period, which runs from Nov. 15, 2014, through Feb. 15, 2015. Current Qualified Health Plan customers will be also be offered the choice to renew their 2014 coverage for 2015.
Funding for 2015: The Exchange is working through several possible budget scenarios to craft a budget for 2015 that will maintain essential services such as the Customer Support Center, the functionality of Washington Healthplanfinder and IT infrastructure. The Exchange Board will vote on a budget proposal that will then be submitted to the legislature for review and approval.
How can the public get involved?
We work with consumers, community organizations, small businesses, insurance carriers, brokers and navigators to gather valuable input on our work. Examples include:
Consumer Workgroup: The Consumer Workgroup includes community members and organizations seeking to offer input on a variety of consumer issues related to Washington Healthplanfinder. You can find information about participating here.
Public Comment: All Washington Health Benefit Exchange meetings are open to the public and open for public comment. These include our monthly Board meetings and technical advisory committees Click here for more information about submitting a public comment.
Email Sign-Up: Consumers interested in receiving regular updates from Washington Healthplanfinder may sign up for our electronic mailing list.
How is Washington Healthplanfinder different from websites that sell insurance?
Washington Healthplanfinder is redefining people’s experience with health care. Unlike other websites that sell one company’s specific health insurance plan, Washington Healthplanfinder is a central location where multiple health insurance companies compete for your business. Depending on how much you earn, you can get access to financial help that lowers the cost of your premiums.
Washington Healthplanfinder also allows you to make side-by-side comparisons of health insurance plans, so you can choose the right plan based on cost, coverage, convenience and other factors. Plus, Washington Healthplanfinder gets rid of the fine print and makes it easier to understand what a plan covers and how much it costs. Every plan offered through Washington Healthplanfinder has been certified to meet the requirements under the Affordable Care Act.
What kind of plans are offered through Washington Healthplanfinder?
Washington Healthplanfinder offers private health insurance plans – Qualified Health Plans – and Washington Apple Health (Medicaid) for those who qualify. Every Qualified Health Plan offered through Washington Healthplanfinder has been certified to meet the requirements under the ACA and covers the 10 essential benefits.
If you are an employer who would like to offer employer-sponsored plans to your employees, please refer to our Businesses page.
Washington Healthplanfinder does not offer Medicare coverage. Visit the Washington State Office of the Insurance Commissioner website for more information regarding Medicare.
How will Washington Healthplanfinder make coverage more affordable?
Depending on how much you earn, you can qualify for a free or low-cost health plan, or be eligible for financial help that can lower the cost of your premiums and copays. About 85 percent of Washingtonians that enrolled for coverage through Washington Healthplanfinder qualified for free or low-cost health insurance. Washington Healthplanfinder gives you the option to check out the health coverage options available to you before you apply.