PO BOX 134, OLYMPIA WA 98507 | (360) 943-3880 | (800) 491-9322

About WFCA Health Care Program

WFCA-SPONSORED HEALTH & WELFARE BENEFIT OFFERINGS

For more than 40 years, the WFCA has sponsored health and welfare benefits to cover fire service personnel and their families, fire commissioners*, qualified volunteers** and part-time employees**. In order to be eligible for the Program, fire service organizations must be dues-paying members of the WFCA. Here is what we offer:

  • Self-funded health insurance options (PPO-Plus, PPO-100, PPO-300, PPO-750, Traditional and High Deductible Plans)
  • Two managed care plans (Kaiser Foundation Health Plan of WA and Kaiser Foundation Health Plan of the NW)
  • Self-funded dental benefits (Delta Dental of Washington)
  • Life Insurance (Standard Insurance Company)

* Commissioners are eligible for the PPO-100, 300, 750, Plus and HD Plans only
** Volunteers are eligible for the PPO-300, 750 and HD Plans only
*** Part-time employees who pay 100% of their premiums are eligible for the PPO-300, 750 and High Deductible (HD) Plans only

PROGRAM RESERVES & OPERATIONS

The Program is a risk pool established to provide affordable health care and maintain long-term financial viability. Adequate reserve funding is necessary to cover any unforeseen or extraordinary medical claims expenses that might accrue to a publicly funded risk pool. In cases where extraordinary medical claims occur, the Program is protected by stop loss insurance. The Program has always met and exceeded the minimum reserve requirements of the State Risk Manager. As a result, no re-assessments of our participating fire service organizations during any Plan Year have been necessary to cover extraordinary medical expenses.

The Washington State Auditor's Office performs financial audits of the Program annually and accountability audits every three years.

The Health Care Committee, comprised of fire commissioners whose entities are Program participants, is responsible for overseeing the operations of the Program and recommending annual premium levels and benefit coverage changes to the WFCA Board of Directors. The annual renewal process involves the review of benefits, changes in medical inflation and utilization of medical services by participants. The Committee and Board seek to ensure that the Health Care Program is adequately funded and in balance with the financial capacity of our member employer organizations.

ELIGIBILITY, ENROLLMENT, CLAIMS ADMINISTRATION--TRUSTEED PLANS SERVICE CORPORATION

The Program contracts with Trusteed Plans Service Corporation (TPSC), a third-party administrator, for services to support the self-funded medical and dental plans and administrative activities associated with the insured carriers. TPSC's proficiency in handling provider networks, medical billings, receiving premium funds and paying medical claims has led to a long-term working relationship with the WFCA. For members enrolled in Kaiser Foundation Health Plans and Standard Life Insurance, TPSC receives and pays the premiums to each private insurance carrier based on plan enrollment.

BENEFITS BROKER & CONSULTANT--PARKER, SMITH & FEEK

The Program contracts with Parker, Smith & Feek (PS&F), an insurance consultant, for benefit consulting services. An integral part of these services is the expertise PS&F brings in designing the best possible self-funded plans and developing premium levels necessary to adequately fund benefits. PS&F also negotiates and maintains the contracts associated with the Program’s insured carriers.

PROGRAM HISTORY

In 1979 the health care contract, policy owner/holder Washington Fire Commissioners Association, produced a $95,000 surplus (expenses, claims versus premium income). The contractor, Washington Physicians Service, sent the $95,000 to the Washington Fire Commissioners Association because of stipulations in the contract that required Washington Physicians Service to return surpluses to the policy owner, and further that shortages would be paid by the policy owner to the contractor.  Read more...