OFFICE OF THE
[R 2019-14 BBPA—Filed December 16, 2019, 11:21 a.m., effective December 16, 2019, 11:21 a.m.]
Effective Date of Rule: Immediately upon filing.
Purpose: Clarify the annual notice requirement for self-funded group health plans that operate on a calendar year basis and elect to participate in the balance billing protection act for plan year 2020. R 2019-14 BBPA self-funded group election 2020.
Citation of Rules Affected by this Order: New WAC 284-43B-071.
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: RCW 48.49.130
requires self-funded group health plans to file an annual notice with the commissioner of their election to participate in the balance billing protection provisions in RCW 48.49.020
. The law is effective January 1, 2020. Without the commissioner prescribing a specific election process for the 2020 plan year, plans with plan years beginning on a date in January 2020 will be unable to participate in the balance billing protections until their 2021 plan year. Providers and facilities would continue to balance bill those plan beneficiaries who would otherwise be protected by their self-funded group's election to participate. In order to provide all self-funded plans with the same access to balance billing protection during the first year of Balance Billing Protection Act implementation, the commissioner is permitting the annual election to occur with a shortened notice period, and to permit a partial year election for 2020 only if the plan year begins between January 1 and February 1. Because there is less than thirty days before January 1, the normal notice and comment opportunity would be contrary to the public interest and result in delayed access to these protections for the duration of that comment period.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 1, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, 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 0, Amended 0, Repealed 0.
Date Adopted: December 16, 2019.
WAC 284-43B-071Self-funded group health plan opt-in for plan years beginning between January and February 2020.
(1) For self-funded group plans whose plan year begins January 1, 2020, the self-funded group may elect to participate in the provisions of RCW 48.49.020
by filing its annual notice of election to the commissioner, using the form available on the oic.wa.gov
website, not later than December 27, 2019.
(2) A self-funded group whose plan year begins on or before February 1, 2020, may elect to participate in the protections of RCW 48.49.020
, pursuant to RCW 48.49.130
, by filing the annual notice of election with the commissioner, using the form available on the oic.wa.gov
website, not later than January 25, 2020. The commissioner deems the annual filing requirement for such filed notices satisfied on a partial plan year basis for the 2020 plan year.