WSR 15-15-142

AGENDA

OFFICE OF

INSURANCE COMMISSIONER

[Filed July 17, 2015, 4:04 p.m.]

Rule Development Agenda

July 31, 2015, through January 31, 2016

The commissioner has introduced the following rule makings. Each rule making is currently between the CR-101, CR-102, and CR-103 stage. They are currently under review and there may be further rule-making activity before January 31, 2016. If you have any questions regarding any of these rule makings, please contact Jim Keogh, rulescoordinator@oic.wa.gov or (360) 725-7056.


			Current Activity
WAC	RCW Authority	Subject	CR-103E	CR-101	CR-105	CR-102
	48.02.060, 48.21.270, 48.44.380, 48.46.460	Conversion health plans.		12-07-091 3/21/12
	48.02.060, 48.44.050, 48.46.200	Issuer disclosures, notices, and processes to protect privacy of health care information.		13-11-144 5/22/13
	48.02.060, 48.83.170, 48.84.030	Long-term care unintentional lapse notices.		14-02-074 12/30/13
	48.02.060, 48.18.120, 48.20.450, 48.20.460, 48.43.505, 48.43.510, 48.43.515, 48.43.525, 48.43.530, 48.43.535, 48.44.020, 48.44.050, 48.44.080, 48.46.030, 48.46.200, 45 C.F.R. 156.230, 45 C.F.R. 156.235, 45 C.F.R. 156.245	Network access.		14-15-104 7/18/14		15-13-117 6/16/15
	48.02.060, 48.43.510, 48.165.0301	Prior authorization of pharmacy benefits.		14-22-086 11/3/14
	48.21.241, 48.21.320, 48.44.460, 48.44.341, 48.46.291, 48.46.530, 48.43.715	Designation of base benchmark plan for essential health benefits purposes as well as any necessary supplementation.		15-11-083 5/19/15
	48.02.060, 48.43.007	Attestation of transparency tools for consumer information on health care cost and quality.		15-11-084 5/19/15
	48.02.060, SSB 5023 (chapter 19, 2015 Laws—effective 7/24/15)	Adjusting rate and form filing procedures for life and disability insurers to comply with SSB 5023.		15-12-107 6/2/15
	48.02.060, 48.31B.040	Amendment of chapter 284-18 WAC, WAC 284-03-030, 284-07-110 and 284-07-600 and the repeal of chapter 284-18A WAC to conform with amendments made to chapter 48.31B RCW (the Holding Company Act) by chapter 122, Laws of 2015.		15-13-067 6/11/15
	48.02.060, 48.30.010	Notice of payment of settlements by insurers.		15-13-068 6/11/15
	48.02.060, 48.17.005	Rules providing guidance to licensed insurance providers about what may/may not constitute sharing commissions were adopted in August 2014. ESSB 5743, passed in the 2015 legislative session, amended some of the statutes on which the rules were based. The rules now will be brought into conformity with this new legislation.		15-13-101 6/16/15
	48.02.060, sections 7 (1)(b) and (c), (3)(b), (4), (5), and 15, chapter 63, Laws of 2015	Credit for reinsurance model regulation.		15-15-132 7/17/15
	48.02.060, 48.18.120(2), 48.20.450, 48.46.200	Health plan special enrollment rules.		15-15-133 7/17/15

Possible Rule Makings: In addition to the rules listed above, the commissioner continues the effort to update and clarify the code as well as implement recent legislation. In the period before January 31, 2016, subjects that may be considered for rule making in this effort include:

Annuity marketing and disclosure requirements

Statistical data reporting

Carrier submission of IRO decision data

Coordination of benefits

Disability insurance loss ratios

Discontinuation and renewal of health plan coverage

Discrimination in health plan design

Electronic filing of state specific reporting

Electronic notices and document delivery of insurance products

Essential health benefits—Pharmacy/formulary tiers

External review of adverse benefit decisions for health plans

Federal financial reform implementation

Federal health care reform implementation

Hearing rules revisions

Large group filing requirements

NAIC Model Act implementation (as needed, dependent on legislation)

Numeric recodification of chapter 284-43 WAC

OIC emergency powers

Pregnancy as a qualifying event

Prior authorization of health care claims form and process requirements

Repeal of requirement for multiple Washington attendees at continuing education trainings

Ride-sharing insurance coverage

Student health plans

Summary of health insurance benefits coverage

Trainee requirements for adjuster licensing

Use of vehicle history in rating

Wellness programs (health plans)

Mike Kriedler