This report is due each year on March 1.
Required fields are marked with an *.
*Do you have Washington resident insured persons to list in sections 2a. Health plans or 2b. Stop-Loss Coverage for Self-Insured? Yes No
If no, please skip to section 4. Questions.
Insurers that are WSHIP members elect four members of the WSHIP Board. See RCW 48.41.040(2). Each company’s vote is weighed by the number of persons it has in health plans subject to WSHIP assessments. For more information about WSHIP Board voting see the WSHIP web site page “ About WSHIP - Plan of Operations”.
This is the person who votes for their WSHIP board representative.
Regarding WSHIP Assessment Report content - call 1-800-290-1368 X 1044
Regarding assistance submitting your form - call 360-725-7038 or email WSHIP@oic.wa.gov