Effective Date of Rule: Thirty-one days after filing.
Purpose: The rule formally defines the benchmark reference plan for the state of Washington's essential health benefits package.
Statutory Authority for Adoption: Chapter 87, Laws of 2012; RCW 48.02.060.
Adopted under notice filed as WSR 12-15-082 on July 18, 2012.
Changes Other than Editing from Proposed to Adopted Version: The name of the health care service contractor was corrected, from Regence Blue Cross Blue Shield to Regence Blue Shield.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
Date Adopted: September 19, 2012.
(1) The benefits and services covered by health care service contractor Regence Blue Shield as the Innova small group plan policy form, policy form number WW0711CCONMS, and certificate form number WW0112BINNS, offered during the first quarter of 2012. The SERFF filing number is RGWA-127372701.
(2) The services and items covered by a health benefit plan that are within the categories identified in Section 1302(b) of PPACA including, but not limited to, ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care, and as supplemented by the commissioner or required by the secretary of the U.S. Department of Health and Human Services.
(3) Mandated benefits pursuant to Title 48 RCW enacted before December 31, 2011.