WSR 21-13-105
PERMANENT RULES
HEALTH CARE AUTHORITY
(Public Employees Benefits Board)
[Admin #2021-01.05—Filed June 18, 2021, 3:20 p.m., effective January 1, 2022]
Effective Date of Rule: January 1, 2022.
Purpose: The purpose of this proposal is to amend WAC 182-12-300 to support the public employees benefits board (PEBB) program.
Implement PEBB policy resolution:
Amended WAC 182-12-300 to implement policy resolution PEBB 2021-15 rescinding PEBB policy resolution #4 SmartHealth as adopted on July 12, 2017.
Citation of Rules Affected by this Order: Amending WAC 182-12-300.
Other Authority: Policy resolution PEBB 2021-15.
Adopted under notice filed as WSR 21-10-075 on May 3, 2021.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: June 18, 2021.
Wendy Barcus
Rules Coordinator
OTS-3019.1
AMENDATORY SECTION(Amending WSR 20-16-062, filed 7/28/20, effective 1/1/21)
WAC 182-12-300Public employees benefits board (PEBB) wellness incentive program eligibility and procedural requirements.
The board annually determines the design of the PEBB wellness incentive program.
(1) All subscribers, except PEBB subscribers who are enrolled in both medicare Parts A and B, and in the medicare risk pool as described in RCW
41.05.080(3), are eligible to participate in the PEBB wellness incentive program.
(2) Effective January 1, 2020, to receive the PEBB wellness incentive of a reduction to the subscriber's medical plan deductible or a deposit to the subscriber's health savings account for the following plan year, eligible subscribers must complete PEBB wellness incentive program requirements during the current plan year by the following deadline:
(a) For subscribers continuing enrollment in PEBB medical and subscribers enrolling in PEBB medical with an effective date in January through September, the deadline is November 30th; or
(b) For subscribers enrolling in PEBB medical with an effective date in October through December, the deadline is December 31st.
(3) Subscribers who do not complete the requirements according to subsection (2) of this section, except as noted, within the time frame described are not eligible to receive a PEBB wellness incentive the following plan year.
Note: | All eligible subscribers can earn a wellness incentive. Subscribers who cannot complete the wellness incentive program requirements may be able to earn the same incentive by different means. The contracted vendor will work with enrollees (and their physician, if they wish) to define an individual wellness program that provides the opportunity to qualify for the same incentive in light of the enrollee's health status. |
(4) ((Effective January 1, 2018, an eligible subscriber will receive a separate PEBB wellness incentive for completing the SmartHealth well-being assessment on or before December 31st, of the current plan year. An eligible subscriber may only earn this separate PEBB wellness incentive once per plan year. Once earned, subscribers must claim the incentive on or before December 31st of the same calendar year it was earned.
(5))) A PEBB wellness incentive will be provided only if:
(a) For the wellness incentive described in subsection (2) of this section the subscriber is still eligible for the PEBB wellness incentive program and is enrolled in a PEBB medical plan in the year the incentive applies;
(b) The funding rate provided by the legislature is designed to provide a PEBB wellness incentive program or a PEBB wellness incentive, or both; or
(c) Specific appropriations are provided for wellness incentives.