WSR 20-23-037

PROPOSED RULES

OFFICE OF THE

INSURANCE COMMISSIONER

[Insurance Commissioner Matter R 2020-12—Filed November 10, 2020, 12:05 p.m.]

Supplemental Notice to WSR 20-20-123.

Preproposal statement of inquiry was filed as WSR 20-15-129.

Title of Rule and Other Identifying Information: Health coverage supplementing medicare Part D provided through a federally authorized employer group waiver plan.

Hearing Location(s): On January 4, 2021, at 10:00 a.m. Remote access information for public testimony will be made available at the web page https://www.insurance.wa.gov/medicare-part-d-r-2020-12. Due to the COVID-19 public health emergency, this hearing will be held via Zoom.

Date of Intended Adoption: January 5, 2021.

Submit Written Comments to: Bode Makinde, P.O. Box 40260, Olympia, WA 98504-0260, email rulescoordinator@oic.wa.gov, fax 360-586-3109, by January 4, 2021.

Assistance for Persons with Disabilities: Contact Melanie Watness, phone 360-725-7013, fax 360-586-2023, TTY 360-586-0241 or 360-725-7087, email MelanieW@oic.wa.gov, by January 3, 2021.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: This supplemental filing will seek to define product requirements and filing submission requirements for these new plans.

Reasons Supporting Proposal: The legislature recently passed SSB 6051 that permits insurers to offer medicare Part D wraparound coverage, which is a new type of plan in the market.

Statutory Authority for Adoption: RCW 48.02.060, 48.18.030, 48.19.035, 48.20.025, 48.20.550, 48.38.075, 48.43.730, 48.43.733, 48.44.050, and 48.46.030.

Statute Being Implemented: None.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Mike Kreidler, insurance commissioner, governmental.

Name of Agency Personnel Responsible for Drafting: Bode Makinde, P.O. Box 40260, Olympia, WA 98504-0260, 360-725-7041; Implementation: Melanie Anderson, P.O. Box 40255, Olympia, WA 98504-0255, 360-725-7156; and Enforcement: Toni Hood, P.O. Box 40255, Olympia, WA 98504-0255, 360-725-7264.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Bode Makinde, P.O. Box 40260, Olympia, WA 98504-0260, phone 360-725-7041, fax 360-586-2023, TTY 360-725-7087, email rulescoordinator@oic.wa.gov.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act (RFA) because the proposal:

Is exempt under RCW 19.85.025(3) as the rule content is explicitly and specifically dictated by statute; and rules adopt, amend, or repeal a procedure, practice, or requirement relating to agency hearings; or a filing or related process requirement for applying to an agency for a license or permit.

Is exempt under RCW 34.05.310 (4)(e): WAC 284-58-030.

Explanation of exemptions: WAC 284-58-030 adopts the requirements as dictated by SSB 6051.

The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated.

Section 1 - Background: An EGWP, or "Egg Whip" as it is called, is a form of medicare advantage (MA) plan offered by very large employers and allows their group retirees to receive their MA benefits through the group. Part of this EGWP will generally include the medicare Part D prescription drug component, which has a variety of cost-sharing limitations. The plans which are the subject of this rule making are stand-alone prescription drug plans which supplement this EGWP Part D coverage and pay for some or all of the remaining cost sharing. These plans are relatively rare in the marketplace.

Section 2 - Rule groups and their status relative to RFA analysis:

Section 3 - Cost of compliance/minor cost threshold: The insurers that are affected by this rule are not small businesses as defined in RCW 19.85.020(3). The office of insurance commissioner applied a default cost of compliance ($100) when analyzing whether the rules would have a disproportionate impact on small businesses as defined in RCW 19.85.020(3). Below are calculations for minor cost thresholds across all impacted industries based on the best analogous NAICS types. For these reasons, the proposed rules do not impose more-than-minor costs on businesses as defined by RCW 19.85.020(2).

November 10, 2020

Mike Kreidler

Insurance Commissioner