Section 182-23-020. Eligibility.

(1) To be eligible for enrollment in WHP, an individual may have any income level and must:

(a) Not be eligible for free or purchased medicare;

(b) Not be receiving medical assistance from the department of social and health services (DSHS);

(c) Not be enrolled in BHP;

(d) Not be confined or residing in a government-operated institution, unless he or she meets eligibility criteria adopted by the administrator;

(e) Be accepted for enrollment by the administrator as provided in RCW 48.43.018, either because the potential enrollee cannot be required to complete the standard health questionnaire or SHQ under RCW 48.43.018, or, based upon the results of the SHQ, the potential enrollee would not qualify for coverage under the Washington state health insurance pool;

(f) Reside in an area of the state served by a managed health care system participating in the plan;

(g) Choose to obtain coverage from a particular managed health care system; and

(h) Pay or have paid on their behalf the full costs for participation in the plan, including the cost of administration, without any subsidy from HCA.

(2) Persons not meeting these criteria, as evidenced by information submitted on the application for enrollment or otherwise obtained by WHP, will not be enrolled. An enrollee who is no longer a Washington resident or who is later determined to have failed to meet WHP's eligibility criteria at the time of enrollment, will be disenrolled.

[Statutory Authority: Chapter 70.47 RCW. WSR 10-24-062 (Order 10-03), § 182-23-020, filed 11/30/10, effective 12/31/10.]

Chapter 70.47 RCW. WSR 10-24-062 (Order 10-03), § 182-23-020, filed 11/30/10, effective 12/31/10.