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ENGROSSED
HOUSE BILL 1876
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Passed
Legislature - 1995 Regular Session
State of Washington 54th
Legislature 1995 Regular Session
By
Read first time 02/13/95.
Referred to Committee on Health Care.
Modifying provision
of dental services by certified health plans.
AN ACT
Relating to the modification of provisions governing certified health plans
providing dental benefits only; adding a new section to chapter 48.01 RCW;
repealing RCW 48.01.210 and 43.72.110; providing an effective date; and
declaring an emergency.
BE IT ENACTED BY THE LEGISLATURE
OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. A new
section is added to chapter 48.01 RCW to read as follows:
(1) An
insurer, health care service contractor, or health maintenance organization
that offers coverage for dental services and that currently holds a certificate
of authority or certificate of registration issued by the insurance
commissioner under chapter 48.05, 48.44, or 48.46 RCW may provide coverage for
dental services as authorized by chapter 48.05, 48.44, or 48.46 RCW and as
provided in this section. Such a company is deemed certified and registered as
a certified health plan under RCW 43.72.090 and 48.43.010 for the delivery of
coverage for dental services. The Washington health services commission and
the insurance commissioner shall adopt standards and procedures to permit, upon
request, the prompt certification and registration of such a company, and the
issuance of a certificate as a certified health plan. Such a certification and
registration only authorizes the company to provide coverage for dental
services and does not subject the company to requirements applicable to
certified health plans except as specifically provided in this section. Such a
company shall be known as a "Dental-Only CHP." The legislature does
not intend by creating this designation to convey a market advantage over
certified health plans providing coverage for dental services.
(2) A
Dental-Only CHP may provide coverage for dental services to individuals, to
employers for the benefit of employees or for the benefit of employees and
their dependents, and to other persons, entities, and agencies authorized by
law to purchase health care services from, or enroll in, a certified health
plan. A Dental-Only CHP may provide such coverage by separate policy,
contract, or rider issued directly to the purchaser, or it may subcontract to a
certified health plan that provides the dental coverage as part of the uniform
benefits package, supplemental benefits, or other arrangement delivered to the
purchaser.
(3) If
an individual, employer, or other purchaser purchases coverage for dental
services from a Dental-Only CHP and that coverage is part of the uniform
benefits package or supplemental benefits designed by the Washington health
services commission and regulated by the commissioner, or part of a
state-managed program of health care coverages, a certified health plan may
provide to the purchaser the other coverages comprising the balance of the
uniform benefits package, supplemental benefits, or state-managed program, by
separate policy, contract, or rider. Notwithstanding any other provision of
law, an individual, employer, or other purchaser may purchase coverage for
dental services in the uniform benefits package, supplemental benefits, or
state-managed program from a Dental-Only CHP and concurrently purchase the
balance of the required coverages separately from a certified health plan. To
foster such concurrent purchases, the Washington health services commission and
the commissioner shall develop and enforce separate cost containment and filing
systems and procedures for dental coverages and other coverages, including
separate community-rated premium submaximums and enrollee financial
participation submaximums.
(4) A
Dental-Only CHP shall fully comply with all applicable laws under chapter
48.05, 48.44, or 48.46 RCW governing the financial supervision and solvency of
such organizations, including but not limited to applicable laws concerning
capital and surplus requirements, reserves, deposits, bonds, and indemnities.
In the sale of coverage for dental services that is part of the uniform
benefits package, a Dental-Only CHP shall comply with all applicable
administrative rules prescribed by the health services commission, the
insurance commissioner, and other state agencies governing certified health
plans under RCW 43.72.100. The sale of dental coverages that are part of supplemental
benefits are not subject to RCW 43.72.100, 43.72.160, or 43.72.170.
NEW
SECTION. Sec. 2. The
following acts or parts of acts are each repealed:
(1) RCW
48.01.210 and 1993 c 462 s 51; and
(2) RCW
43.72.110 and 1993 c 492 s 429.
NEW SECTION. Sec. 3. This act
is necessary for the immediate preservation of the public peace, health, or
safety, or support of the state government and its existing public
institutions, and shall take effect July 1, 1995.
