READ FIRST TIME 02/07/14.   

     AN ACT Relating to the grace period for enrollees of the Washington health benefit exchange; adding a new section to chapter 43.71 RCW; and adding a new section to chapter 48.43 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 43.71 RCW to read as follows:
     The exchange must provide electronic notification to the qualified health plan before the sixth of the month indicating an enrollee has not paid the premium.

NEW SECTION.  Sec. 2   A new section is added to chapter 48.43 RCW to read as follows:
     (1)(a) An issuer of a qualified health plan shall provide a notice to a health care provider or health care facility that an enrollee is in a grace period if the health care provider or health care facility:
     (i)(A) Submits a request to the issuer regarding the enrollee's eligibility, coverage, or health plan benefits;
     (B) Submits a request to the issuer regarding the status of a claim for services provided to an enrollee; or
     (C) Reports a claim in a remittance advice; and
     (ii) Request or claim is for a date during the second or third month of the enrollee's grace period.
     (b) The issuer of a qualified health plan shall provide the notice to the health care provider or health care facility. The notice to the health care provider or health care facility must include:
     (i) The purpose of the notice;
     (ii) The enrollee's full legal name and any unique numbers identifying the enrollee; and
     (iii) The name of the qualified health plan and the issuer.
     (2) For purposes of this section "grace period" means a period of three consecutive months if an enrollee receiving advance payments of the premium tax credit has previously paid at least one full month's premium during the benefit year.