H-3064.2 _______________________________________________
HOUSE BILL 2536
_______________________________________________
State of Washington 57th Legislature 2002 Regular Session
By Representatives Fromhold, Cox, Schual‑Berke, Talcott, Conway, Doumit, Grant, Cody, Benson, McDermott, Delvin, Sullivan, Armstrong, Eickmeyer, Miloscia, Roach, Casada, Mielke, Morell, Boldt, Barlean, Chase, Rockefeller, Ogden, Lantz, Edwards, Simpson, Kessler, Haigh, Pearson, Dunn, Quall, Veloria, Kagi, McIntire, Wood, Santos and Linville
Read first time 01/21/2002. Referred to Committee on Appropriations.
AN ACT Relating to offering health care benefit plans to school district employees; amending RCW 41.05.011; and reenacting and amending RCW 41.05.075.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 41.05.075 and 1994 sp.s. c 9 s 724, 1994 c 309 s 3, and 1994 c 153 s 6 are each reenacted and amended to read as follows:
(1) The administrator shall provide benefit plans designed by the board through a contract or contracts with insuring entities, through self-funding, self-insurance, or other methods of providing insurance coverage authorized by RCW 41.05.140.
(2) The administrator shall establish a contract bidding process that:
(a) Encourages competition among insuring entities;
(b) Maintains an equitable relationship between premiums charged for similar benefits and between risk pools including premiums charged for retired state and school district employees under the separate risk pools established by RCW 41.05.022 and 41.05.080 such that insuring entities may not avoid risk when establishing the premium rates for retirees eligible for medicare;
(c) Is timely to the state budgetary process; and
(d) Sets conditions for awarding contracts to any insuring entity.
(3) The administrator shall establish a requirement for review of utilization and financial data from participating insuring entities on a quarterly basis.
(4) The administrator shall centralize the enrollment files for all employee and retired or disabled school employee health plans offered under chapter 41.05 RCW and develop enrollment demographics on a plan-specific basis.
(5) All claims data shall be the property of the state. The administrator may require of any insuring entity that submits a bid to contract for coverage all information deemed necessary including subscriber or member demographic and claims data necessary for risk assessment and adjustment calculations in order to fulfill the administrator's duties as set forth in this chapter.
(6) All contracts with insuring entities for the provision of health care benefits shall provide that the beneficiaries of such benefit plans may use on an equal participation basis the services of practitioners licensed pursuant to chapters 18.22, 18.25, 18.32, 18.53, 18.57, 18.71, 18.74, 18.83, and 18.79 RCW, as it applies to registered nurses and advanced registered nurse practitioners. However, nothing in this subsection may preclude the administrator from establishing appropriate utilization controls approved pursuant to RCW 41.05.065(2) (a), (b), and (d).
(7) Beginning in
January 1990, and each January thereafter ((until January 1996)), the
administrator shall publish and distribute to each school district a
description of health care benefit plans available through the authority ((and
the estimated cost if school district employees were enrolled)). Beginning
January 1, 2003, school districts and employees of school district bargaining
units who enroll in an insurance or self-insurance program administered under
this chapter shall be charged the same composite rate amount as state agencies
and state agency employees for the same plans. If a school district and
employees of school district bargaining units choose to purchase medical-only
insurance coverage from the authority, they shall be similarly charged a
composite rate, less the composite rate costs for dental, life, and long-term
disability.
Sec. 2. RCW 41.05.011 and 2001 c 165 s 2 are each amended to read as follows:
Unless the context clearly requires otherwise, the definitions in this section shall apply throughout this chapter.
(1) "Administrator" means the administrator of the authority.
(2) "State purchased health care" or "health care" means medical and health care, pharmaceuticals, and medical equipment purchased with state and federal funds by the department of social and health services, the department of health, the basic health plan, the state health care authority, the department of labor and industries, the department of corrections, the department of veterans affairs, and local school districts.
(3) "Authority" means the Washington state health care authority.
(4) "Insuring entity" means an insurer as defined in chapter 48.01 RCW, a health care service contractor as defined in chapter 48.44 RCW, or a health maintenance organization as defined in chapter 48.46 RCW.
(5) "Flexible benefit plan" means a benefit plan that allows employees to choose the level of health care coverage provided and the amount of employee contributions from among a range of choices offered by the authority.
(6)
"Employee" includes all full-time and career seasonal employees of
the state, whether or not covered by civil service; elected and appointed
officials of the executive branch of government, including full-time members of
boards, commissions, or committees; and includes any or all part-time and
temporary employees under the terms and conditions established under this
chapter by the authority; justices of the supreme court and judges of the court
of appeals and the superior courts; and members of the state legislature or of
the legislative authority of any county, city, or town who are elected to
office after February 20, 1970. "Employee" also includes: (a)
Employees of a county, municipality, or other political subdivision of the
state if the legislative authority of the county, municipality, or other
political subdivision of the state seeks and receives the approval of the
authority to provide any of its insurance programs by contract with the
authority, as provided in RCW 41.04.205; (b) employees of employee
organizations representing state civil service employees, at the option of each
such employee organization, and, effective October 1, 1995, employees of
employee organizations currently pooled with employees of school districts for
the purpose of purchasing insurance benefits, at the option of each such
employee organization; and (c) employees of a school district ((if the
authority agrees to provide any of the school districts' insurance programs))
by contract with the authority as provided in RCW 28A.400.350.
(7) "Board" means the public employees' benefits board established under RCW 41.05.055.
(8) "Retired or disabled school employee" means:
(a) Persons who separated from employment with a school district or educational service district and are receiving a retirement allowance under chapter 41.32 or 41.40 RCW as of September 30, 1993;
(b) Persons who separate from employment with a school district or educational service district on or after October 1, 1993, and immediately upon separation receive a retirement allowance under chapter 41.32, 41.35, or 41.40 RCW;
(c) Persons who separate from employment with a school district or educational service district due to a total and permanent disability, and are eligible to receive a deferred retirement allowance under chapter 41.32, 41.35, or 41.40 RCW.
(9) "Benefits contribution plan" means a premium only contribution plan, a medical flexible spending arrangement, or a cafeteria plan whereby state and public employees may agree to a contribution to benefit costs which will allow the employee to participate in benefits offered pursuant to 26 U.S.C. Sec. 125 or other sections of the internal revenue code.
(10) "Salary" means a state employee's monthly salary or wages.
(11) "Participant" means an individual who fulfills the eligibility and enrollment requirements under the benefits contribution plan.
(12) "Plan year" means the time period established by the authority.
(13) "Separated employees" means persons who separate from employment with an employer as defined in:
(a) RCW 41.32.010(11) on or after July 1, 1996; or
(b) RCW 41.35.010 on or after September 1, 2000; or
(c) RCW 41.40.010 on or after March 1, 2002;
and who are at least age fifty-five and have at least ten years of service under the teachers' retirement system plan 3 as defined in RCW 41.32.010(40), the Washington school employees' retirement system plan 3 as defined in RCW 41.35.010, or the public employees' retirement system plan 3 as defined in RCW 41.40.010.
(14) "Emergency service personnel killed in the line of duty" means law enforcement officers and fire fighters as defined in RCW 41.26.030, and reserve officers and fire fighters as defined in RCW 41.24.010 who die as a result of injuries sustained in the course of employment as determined consistent with Title 51 RCW by the department of labor and industries.
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