2018-S AMH CODY H2877

2018-S AMH CODY H2877.1

SHB 2018 - H AMD TO H AMD (H-2836.2/97) 305 FAILED 3-18-97

By Representative Cody

On page 27, after line 18 of the amendment, insert the following:

"(16)(a) To develop and implement a three-year pilot program to provide group health insurance coverage that is attractive and affordable for employers seeking to offer health insurance benefits for employees and their dependents, and that addresses the employers' administrative needs. The goal of the pilot program is to encourage employers in Washington state to provide employee health benefits, with particular focus on small businesses and employers that are uninsured. By October 1, 1998, the health care authority shall make available group insurance coverage for purchase by employers, with ten or fewer employees, who apply and are selected to participate in the pilot program. Coverage provided under the pilot program shall replace group coverage currently offered for employers, including home care agencies, through the basic health plan. The health care authority may contract with managed health care systems or other health insurance carriers to provide group coverage under this program. The health care authority may establish enrollment limits for the employer group pilot program, based on available funding, and may adopt rules to implement the pilot program consistent with this subsection. Participation of employers and home care agencies in the pilot program is subject to reasonable guidelines and eligibility rules established by the health care authority.

(b) To establish a technical advisory committee to advise the health care authority on the development of the employer group pilot program under this subsection, including administrative policies and procedures, eligibility criteria, structure of premium subsidies, and benefit design. The technical advisory committee shall include, but is not limited to, representatives of small businesses both those that have not participated in basic health plan coverage as well as those that have; home care agencies; employees; licensed insurance agents and brokers with expertise in employee health benefit programs; and managed health care plans. The technical advisory committee shall review current barriers to providing employer group coverage through the basic health plan, including issues regarding the administration of state premium funding for low-income group enrollees. The committee shall study alternative strategies for encouraging employers to offer employee health insurance coverage, including but not limited to: Incentives such as reduced premiums and tax credits for employers providing coverage; alternative eligibility criteria and benefit designs for the employer group product; strategies and requirements for marketing to employer groups; and policies on commissions for licensed agents and brokers for sale of the employer group coverage. The committee shall consider ways to prevent undue competition with private insurance carriers; prevent impacts on access to health care coverage; and ensure compliance with applicable state and federal laws and regulations. The health care authority may contract with consultants with expertise in group products to assist the technical advisory committee in developing and evaluating alternatives.

(c) To submit to the legislature by December 1, 1997, a report that summarizes the work of the technical advisory committee and provides a plan for implementing the employer group pilot program. The report must include recommended statutory changes, if any, and must outline the proposed design of the employer group coverage and other administrative policies for implementation of the pilot program.

(d) To monitor and evaluate the effectiveness of the employer group pilot program established under this subsection. By December 1, 2000, the health care authority shall submit a report to the legislature on the preliminary results of the pilot program. The report must include recommendations on whether to continue the program beyond the three‑year pilot period."

EFFECT: Directs the Health Care Authority [HCA] to operate a three year pilot project for small businesses to purchase employee benefits through the HCA.