H-1212.1 _______________________________________________
HOUSE BILL 1643
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State of Washington 52nd Legislature 1991 Regular Session
By Representatives Bowman, Fraser, Silver, Sheldon, Tate, Brumsickle and Winsley.
Read first time February 5, 1991. Referred to Committee on Health Care.
AN ACT Relating to retired state government employees' medical care coverage; amending RCW 41.05.065; and creating a new section.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. The legislature finds that when state employees purchase retired employees' medical care coverage through the health care authority the coordination of benefits clause may deprive them of benefits when their primary insurer is medicare. The legislature further finds that a nonduplication of benefits provision may mean that no benefits will be paid by the secondary insurer. It is the legislature's intent that retired employees covered under medicare are able to continue in the state insurance plan through individual purchase and receive a true medicare supplement that will pay the difference between the medicare benefits and the allowed charge, but not exceed one hundred percent of the allowed charge.
Sec. 2. RCW 41.05.065 and 1988 c 107 s 8 are each amended to read as follows:
(1) The board shall study all matters connected with the provision of health care coverage, life insurance, liability insurance, accidental death and dismemberment insurance, and disability income insurance or any of, or a combination of, the enumerated types of insurance for employees and their dependents on the best basis possible with relation both to the welfare of the employees and to the state: PROVIDED, That liability insurance shall not be made available to dependents.
(2) The state employees' benefits board shall develop employee benefit plans that include comprehensive health care benefits for all employees. In developing these plans, the board shall consider the following elements:
(a) Methods of maximizing cost containment while ensuring access to quality health care;
(b) Development of provider arrangements that encourage cost containment and ensure access to quality care, including but not limited to prepaid delivery systems and prospective payment methods;
(c) Wellness incentives that focus on proven strategies, such as smoking cessation, exercise, and automobile and motorcycle safety;
(d) Utilization review procedures including, but not limited to prior authorization of services, hospital inpatient length of stay review, requirements for use of outpatient surgeries and second opinions for surgeries, review of invoices or claims submitted by service providers, and performance audit of providers; and
(e) Effective coordination of benefits considering the differing needs of employees and retirees insured under medicare and providing for a medicare supplemental plan.
(3) The board shall design benefits and determine the terms and conditions of employee participation and coverage, including establishment of eligibility criteria.
(4) The board may authorize premium contributions for an employee and the employee's dependents. Such authorization shall require a vote of five members of the board for approval.
(5) Employees may choose participation in only one of the health care benefit plans developed by the board.
(6) The board shall review plans proposed by insurance carriers that desire to offer property insurance and/or accident and casualty insurance to state employees through payroll deduction. The board may approve any such plan for payroll deduction by carriers holding a valid certificate of authority in the state of Washington and which the board determines to be in the best interests of employees and the state. The board shall promulgate rules setting forth criteria by which it shall evaluate the plans.