The Washington Insurance Exchange (Marketplace) is called the Washington Health Benefit Exchange. The State of Washington administers the Washington Health Benefit Exchange.
General information about the Washington Health Benefit Exchange can be found at: http://www.wahbexchange.org/.
PATIENTS
The Washington Health Benefit Exchange is essentially a marketplace for individuals and small businesses with up to 100 employees to shop for health insurance if they do not already have insurance coverage from another source. If they have insurance from another source (such as employment, retirement benefits, or spousal benefits), they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the Federally-facilitated Marketplace.
This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.
As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
5000 Capitol Blvd SE
Tumwater, WA 98501
800-562-6900
http://www.insurance.wa.gov/
Complaints: http://www.insurance.wa.gov/complaints-and-fraud/file-a-complaint/insurance-company/
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Federally-facilitated Marketplace.
Wyoming has established Blue Cross Blue Shield of WY as the “benchmark” plan.
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.
Asuris Northwest Health
Plan Website: https://www.asuris.com/web/asuris_individual/
Provider Enrollment: https://www.asuris.com/web/asuris_provider
Plan types offered: Individual
BridgeSpan Health Company
Plan Website: https://www.bridgespanhealth.com/
Provider Enrollment: https://www.bridgespanhealth.com/web/bridgespan_provider/home
Plan types offered: Individual
Columbia United Providers
Plan Website: https://www.cuphealth.com/
Provider Enrollment: https://www.cuphealth.com/info-for-providers
Plan types offered: Individual
Community Health Plan of Washington
Plan Website: http://www.chpw.org/
Provider Enrollment: http://chpw.org/for-providers/welcome/
Plan types offered: Individual
Coordinated Care
Plan Website: http://www.coordinatedcarehealth.com/
Provider Enrollment: http://ambetter.coordinatedcarehealth.com/for-providers/
Plan types offered: Individual
Group Health Cooperative
Plan Website: http://www.ghc.org/
Provider Enrollment: https://provider.ghc.org/open/workingWithGroupHealth/index.jhtml;jsessionid=M4KIHLRKCH3JJJCISQ3SGWQ
Plan types offered: Individual
Group Health Options
Plan Website: http://www.ghc.org/
Provider Enrollment: https://provider.ghc.org/open/index.jhtml
Plan types offered: Individual
Kaiser Foundation Health Plan of the Northwest
Plan Website: https://healthy.kaiserpermanente.org/html/kaiser/index.shtml
Provider Enrollment: http://www.kaiserpermanentejobs.org/default.aspx
Plan types offered: Individual, SHOP
LifeWise Health Plan of Washington
Plan Website: https://www.lifewisewa.com/
Provider Enrollment: https://www.lifewisewa.com/provider/join-our-network/
Plan types offered: Individual
Moda Health Plan, Inc.
Plan Website: https://www.modahealth.com/
Provider Enrollment: https://www.modahealth.com/contact_us.shtml
Plan types offered: Individual, SHOP
Molina Healthcare of Washington
Plan Website: http://www.molinahealthcare.com/
Provider Enrollment: http://www.molinahealthcare.com/members/common/en-us/abtmolina/compinfo/pages/contactus.aspx#
Plan types offered: Individual
Premera Blue Cross
Plan Website: https://www.premera.com/wa/visitor/
Provider Enrollment: https://www.premera.com/wa/provider/
Plan types offered: Individual
Regence BlueCross BlueShield of Oregon
Plan Website: https://www.regence.com/web/regence_individual/
Provider Enrollment: https://www.regence.com/web/regence_provider/
Plan types offered: Individual
Regence BlueShield
Plan Website: https://www.regence.com/web/regence_individual/
Provider Enrollment: https://www.regence.com/web/regence_provider/home
Plan types offered: Individual
Time Insurance Company (Assurant Health)
Plan Website: http://www.assuranthealth.com/
Provider Enrollment: http://www.assuranthealth.com/
Plan types offered: Individual