1046-S.E AMS QUIG S3326.2

ESHB 1046 - S AMD TO S AMD (S-3275.3/95)  399

By Senator Quigley

    On page 9, after line 19 of the amendment, insert the following:

    "(3) No health plan delivered, issued for delivery, or renewed by a health carrier on and after January 1, 1996, shall offer an individual policy community-rated premium that is higher than the lesser value of actual experience or one hundred ten percent of the health plan's comparable small group policy community-rated premium.  If actual experience for the individual policy exceeds one hundred ten percent of the small group premium, the carrier must freeze the individual premium at the one hundred ten percent value and may apply to the high-risk pool under chapter 48.41 RCW for funding to pay for its excess costs in the individual market.

NEW SECTION. Sec. 9.  A new section is added to chapter 48.41 RCW to read as follows:

    (1) The board shall develop and implement procedures by which the pool shall fund any health plan's costs that result from actual claims experience for individual policies exceeding one hundred ten percent of their small group premiums.

    (2) The board shall make any recommendations necessary to the legislature for changes to the pool, its membership, or operation to facilitate compliance with this section."

    Renumber the remaining sections consecutively and correct internal references accordingly.

ESHB 1046 - S AMD TO S AMD (S-3275.3/95)

By Senator Quigley

    On page 11, beginning on line 24 of the amendment, after "individuals." strike all material through "small group premium rate." on line 27

EFFECT:  Premiums for health insurance sold to individuals may not exceed 110% of premiums for comparable insurance sold to employers of less than 50 employees.  If actual costs for these individual policies exceeds 110% of small employer policies, the state's high risk pool must reimburse carriers for their excess costs.

ESHB 1046 - S AMD TO S AMD (S-3275.3/95)

By Senator Quigley

    On page 33, line 23 of the title amendment, after "48.43 RCW;" insert "adding a new section to chapter 48.41 RCW;"

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