H-3057.1  _______________________________________________

 

                    SUBSTITUTE HOUSE BILL 2248

          _______________________________________________

 

State of Washington      55th Legislature     1997 Regular Session

 

By House Committee on Appropriations (originally sponsored by Representatives Huff and Cody; by request of Health Care Authority)

 

Read first time 04/04/97.

  Eliminating basic health plan agents' and brokers' commissions.


    AN ACT Relating to basic health plan agents' and brokers' commissions; amending RCW 70.47.015; providing an effective date; and declaring an emergency.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

 

    Sec. 1.  RCW 70.47.015 and 1995 c 265 s 1 are each amended to read as follows:

    (1) The legislature finds that the basic health plan has been an effective program in providing health coverage for uninsured residents.  Further, since 1993, substantial amounts of public funds have been allocated for subsidized basic health plan enrollment.

    (2) It is the intent of the legislature that the basic health plan enrollment be expanded expeditiously, consistent with funds available in the health services account, with the goal of two hundred thousand adult subsidized basic health plan enrollees and one hundred thirty thousand children covered through expanded medical assistance services by June 30, 1997, with the priority of providing needed health services to children in conjunction with other public programs.

    (3) Effective January 1, 1996, basic health plan enrollees whose income is less than one hundred twenty-five percent of the federal poverty level shall pay at least a ten-dollar premium share.

    (4) No later than July 1, 1996, the administrator shall implement procedures whereby hospitals licensed under chapters 70.41 and 71.12 RCW, health carrier, rural health care facilities regulated under chapter 70.175 RCW, and community and migrant health centers funded under RCW 41.05.220, may expeditiously assist patients and their families in applying for basic health plan or medical assistance coverage, and in submitting such applications directly to the health care authority or the department of social and health services.  The health care authority and the department of social and health services shall make every effort to simplify and expedite the application and enrollment process.

    (5) No later than July 1, 1996, the administrator shall implement procedures whereby health insurance agents and brokers, licensed under chapter 48.17 RCW, may expeditiously assist patients and their families in applying for basic health plan or medical assistance coverage, and in submitting such applications directly to the health care authority or the department of social and health services.  Brokers and agents ((shall be entitled to)) may receive a commission for each individual sale of the basic health plan to anyone not ((at anytime previously)) signed up within the previous five years and a commission for each group sale of the basic health plan, if funding for this purpose is provided in a specific appropriation to the health care authority.  No commission shall be provided upon a renewal.  Commissions shall be determined based on the estimated annual cost of the basic health plan, however, commissions shall not result in a reduction in the premium amount paid to health carriers.  For purposes of this section "health carrier" is as defined in RCW 48.43.005.  The administrator may establish:  (a) Minimum educational requirements that must be completed by the agents or brokers; (b) an appointment process for agents or brokers marketing the basic health plan; or (c) standards for revocation of the appointment of an agent or broker to submit applications for cause, including untrustworthy or incompetent conduct or harm to the public.  The health care authority and the department of social and health services shall make every effort to simplify and expedite the application and enrollment process.

 

    NEW SECTION.  Sec. 2.  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 takes effect July 1, 1997.

 


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