WSR 13-16-044

EMERGENCY RULES

[Insurance Commissioner Matter No. R 2013-18—Filed July 31, 2013, 8:10 a.m., effective July 31, 2013, 8:10 a.m.]

Effective Date of Rule: Immediately upon filing.

Purpose: Provide issuers with the requirements for open enrollment in the individual health benefit plan market, and for special enrollment in the individual and small group health benefit plan markets.

Citation of Existing Rules Affected by this Order: Amending WAC 284-43-985.

Statutory Authority for Adoption: RCW 48.02.060, 48.18.120(2), 48.20.450, 48.43.0122, 48.44.050, and 48.46.200.

Other Authority: 45 C.F.R. 155.420; 45 C.F.R. 155.725.

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.

Reasons for this Finding: Emergency regulations are necessary because without clear instruction regarding the requirements for open and special enrollment applicable to the 2014 plan or policy year, confusion among insurers and policyholders regarding rights and obligations will occur, preventing uniform and timely access to coverage in the individual and small group markets. Without open enrollment in the off-exchange individual market occurring concurrently with open enrollment on the exchange, issuers participating off the exchange are at significant risk for adverse selection, which can jeopardize the financial solvency of an issuer, payment of claims, and access to coverage at a reasonable cost. A prior emergency rule on this subject permitted open enrollment for the small group market. That emergency expires on July 31. Recently issued federal rules permit enrollment at any time in the small group market both on and off the exchange, removing the risk of adverse selection for that marketplace, and requiring the adoption of new emergency rules explaining this standard, as well as new special enrollment requirements.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 8, Amended 1, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.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 8, Amended 1, 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 8, Amended 1, Repealed 0.

Date Adopted: July 31, 2013.

Mike Kreidler

Insurance Commissioner