Risk Pool

The Washington State Health Insurance Pool (WSHIP)

What is WSHIP?

The Washington State Health Insurance Pool provides health insurance for people who are unable to get individual coverage in the private marketplace. This plan provides comprehensive coverage, including a prescription drug benefit. Its premiums are based on your age and type of plan you select.

Premiums for WSHIP coverage are higher than commercial health plans. However, WSHIP offers some high-deductible plan options with lower premiums.

State High Risk Pool
The Washington State Health Insurance Pool (WSHIP) is an independent, non-profit health plan created by the Washington State Legislature. We offer individual health insurance coverage to state residents rejected for coverage due to medical reasons.

Federal High Risk Pool – Applications Now Available
A temporary federal high risk pool, called “Pre-existing Condition Insurance Plan,” is being operated alongside the current state high risk pool. The federal pool has been created by the new federal health reform law to give individuals with pre-existing conditions who have been uninsured for at least six months, access to health insurance.

New-PCIP-WA Brochure
COMPARISON CHART of Washington State and Federal Pool

New – Coverage Available for Children (under age 19)
New consumer protections under the Affordable Care Act prevent carriers from discriminating against children because of a pre-existing condition. However, special enrollment periods are allowed. Washington state’s 2010 individual plan open-enrollment period was Nov. 1-Dec.15. During this time, children under age 19 could enroll in an individual health plan with a carrier without having to take a health screen. Insurance Commissioner Mike Kreidler created the special open enrollment period. Beginning December 16, 2010 until the next open enrollment period, children under age 19 can get coverage through the Washington State Health Insurance Pool (WSHIP) or if they qualify, through the new Pre-existing Condition Insurance Plan (PCIP-WA) (to qualify for PCIP-WA you must have been uninsured for at least six months and have an eligible pre-existing medical condition). If applying to WSHIP, mark the eligibility box on the application for “I reside in a county without individual coverage.”

There are some exceptions where parents can apply for coverage anytime in the individual market, such as the birth or adoption of a child or if a child or the parent: is no longer eligible for a state program; loses coverage due to a divorce; loses employer-sponsored coverage; or moves and their plan is not available in where they live.

Consumers with questions about their health insurance should call the Insurance Consumer Hotline at 1-800-562-6900.

For information regarding WSHIP or PCIP-WA, contact WSHIP Customer Service at 1-800-877-5187 or PCIP-WA Customer Service at 1-877-505-0514.

Open Enrollment Information and 2011 Premium Rates and Benefits
Open enrollment is the period each fall when enrollees may switch plans for coverage that will begin January 1 of the following year. The open enrollment period is November 15 thru December 15, 2010. Click Here for open enrollment information, 2011 Premium Rates and 2011 Benefit Plan Summaries.

Impact of Health Reform on Current WSHIP Program
WSHIP is not subject to the provisions of health reform that apply to licensed insurers, and some of them are precluded by state law. No changes to the current WSHIP program are anticipated at this time. The WSHIP Board is looking into voluntarily complying with those that are legal and working with the state legislature to potentially modify our statute in the future.

Quit For LifeĀ® Program
To take advantage of this benefit, or to learn more about the program, call 1.866.QUIT.4.LIFE (1.866.784.8454) or go to

WSHIP plans

There are five WSHIP options available for people who are not on Medicare:

  1. Preferred Provider Organization (PPO) Plan: Uses providers from the First Choice Health network. PPO plans provide a higher level of coverage when you use a network provider.
  2. Health Savings Account (HSA) Qualified Preferred Provider Plan: A high deductible health plan you can use with an HSA.
  3. Limited Preferred Provider Plan A: A less comprehensive PPO plan with limited prescription drug benefits.
  4. Limited Preferred Provider Plan B: Similar to Limited Plan A, but offers no maternity coverage.
  5. Standard Plan: A fee-for-service plan, which pays the same level of coverage for network and non-network providers.

WSHIP provides some discount rates to people who have:

  • a low income;
  • been continuously insured for 18 months with their previous plan;
  • been in WSHIP for more than three years; or
  • a combination of more than three years of WSHIP coverage and 18 months of continuous coverage under their prior health plan.

WSHIP also has a separate plan available to Medicare enrollees, called the Basic Plan.

Contact WSHIP

For more information about WSHIP, call them at 1-800-877-5187 or visit them at www.wship.org