By state / Washington

Washington

Regulator

Washington Office of the Insurance Commissioner (OIC)

External review

State-run. Request it through the regulator after the plan's final internal denial; the federal floor is 4 months (45 CFR 147.136).

Published reversal rate

0.25% of reviews reversed the plan (2024) · source

Notes

~25% overturn rate in 2024 per NBC News attribution to WA OIC. 2024 WA OIC Annual Report identified.

Before external review

File the plan's internal appeal first (at least 180 days for ACA-compliant plans; the letter states the date). Ask for the claim file and the criteria the plan applied; both are free on request. Self-funded employer plans use the federal external review and the U.S. Department of Labor, not the state.

More on Washington: state appeal rights · External Review Index entry · insurer denial rates (HealthCare.gov states).

Verified 2026-09-15. The regulator's site and your denial notice control.