Indian Health Care Reform Manual for Washington State

Indian Health Care Reform Manual for Washington State

Indian Health Care Reform Manual for WA State (click below to view all chapters)

Health Care Reform Chapters

Chapter 1: Overview of Indian Health Care Reform

Chapter 2: Washington Apple Health/Medicaid

Chapter 3: AI/AN Cost Sharing Benefits and Premium Tax Credits

Chapter 4: Tax Penalty Exemptions- for Tax year 2018 and prior

How to Claim an Exemption for AI/AN from the “Individual Mandate” Tax Penalty

American Indian/Alaska Native and IHS User Tax Penalty Exemption Guidance 1-7-15

IRS Guidance – Health Care Law — What Is New for Individuals and Families

Chapter 5: AI/AN Income and Resource Exemptions

AIHC American Indian/Alaska Native Income Exemptions for Medicaid MAGI Determinations 7-31-14 (update in progress)

CMS Guidance Document – American Indian and Alaska Native Trust Income and MAGI

Chapter 6: Washington Healthplanfinder

Washington Health Benefit Exchange Information for American Indians and Alaska Natives

  • Resources:

FPL Calculator

List of Lead Organizations

WAHBE Application Quick Tips


Contact Deb Sosa,

Healthplanfinder Password Reset: 855.256.9598

Quick Resource Guide WAHBE

Certified Tribal Assister Welcome Packet June 29 2016

Problems–Who to Contact (Cross-Agency Desk Aid) (update in progress)

  • Washington Apple Health – HCA Training Modules – Explains changes to WAH and detailed application requirements including household composition and financial guidelines (rev. 9/18) | Module 1 | Module 2 | Module 3 | Module 4 | Module 5

Unpartnering Applications

How to Create Applications for Families with AI/AN members and non-AI/AN Members

Per Capita Payments – One-Time Income Discrepancy (update in progress)

Special Enrollment – Enrolling Outside of the Open Enrollment Period, For Individuals Not Enrolled in a Federally-Recognized Tribe Need (update in progress)

Transitioning from QHP to Medicare Demo

Access HBE’s Navigator Program Resources (Including: Operator’s Manual, Troubleshooting Desk Aid, Training, etc.)

HBE Navigator Program Web Resources

Username:  Client

Password:  Cl1#nt!

Chapter 7: WHBE Tribal Assister Certification

To Become a New Tribal Assister, Contact:

Deb Sosa,

For a Learning Management System (LMS) Account, Contact:

Deb Sosa,, or

Monica Chambers,

For Problems Using the LMS System, Contact:

Learning Management System (LMS) support:

LMS Log In Page

LMS Password Reset

Chapter 8: Indian Health Care Providers and Qualified Health Plans

COMPLAINTS Against Insurance Companies, Agents, Brokers, or Agencies

What the OIC (Office of Insurance Commissioner) Can and Can’t Do

Simple On-Line Process for Submitting a Complaint

What is the Path or Process Flow of a Complaint

WHBE Guidance for Participation in Exchange (update in progress)

Washington State Indian Health Provider Addendum (QHP) 7-24-14

Managed Care Organization (MCO) Indian Addendum 3-28-16

Washington Insurance Issuer Requirements for AI-AN 9-30-15 (update in progress)

AIHC PowerPoint for Washington Issuers – Contracting With Indian Health Care Providers–Washington Requirements (update in progress)

How to Remain On or be Added To the Federal List of Essential Community Providers

Chapter 9: Tribal Premium Sponsorship


Deb Sosa,

Jami LaBathe,

Washington Health Benefit Exchange Premium Sponsorship Webpage

HBE Premium Sponsorship Program – Summary for Coverage Year 2019

Tribal Premium Sponsorship Toolkit:

AIHC Tribal Premium Sponsorship Model Policy and Checklist

Top 10 Sponsorship Policies Dos and Don’ts

Review of Tribal Premium Sponsorship in Washington State 2015 – Report

Examples of Tribal Premium Sponsorship Program Workflows (update in progress)

Chapter 10: Tribal Consultation

WHBE Letter Re Tribal Consultation Policy

WHBE Tribal Consultation Policy

Chapter 11: Outreach and Education Materials

Indian Health Care Reform Overview (update in progress)

Understanding Medicare (update in progress)

Medicaid-Spenddown-and-Washington-Connection (update in progress)

OIC Consumer Advocacy Program

NIHB Enrollment Assistor Toolkit




2020 Meeting Documents

Work in progress!



American Indian Health Commission Insurance Carriers Fair & Tribal Assister Training: April 30- May 1, 2019 Meeting Documents in a Google folder

Washington State Tribal and Urban Indian Health Program Electronic Health Records Workshop:
Wednesday, May 8, 2019 Meeting Documents in a Google Folder

2018 Archives

2017 List of Archived Documents

OIC Network Access Rule Archived Documents

Leave a Reply

Your email address will not be published.