What is a policyholder?

A policyholder is an individual or group of people who have purchased a health insurance policy in Washington. They have typically paid a monthly premium in exchange for coverage of medically necessary services and treatments. The policyholder is the primary party in the health insurance relationship and is ultimately responsible for paying any balance that their insurance coverage doesn’t cover. It is important to understand that policyholders are responsible for any bills resulting from treatments they receive, even if they are fully insured. Policyholders are usually covered under the terms of their policy, which define the type and extent of coverage they can receive. Washington law dictates that policyholders have the right to choose their insurer and their coverage and are protected from unfair practices and discrimination by their insurance plan. Washington law also establishes the processes for appealing claims and seeking compensation for any wrongfully denied claims. Understanding your rights and responsibilities as a policyholder is vital to making the most of your health insurance benefits.

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