Brief Description: Requiring large employers to reimburse the state for basic health plan and medical assistance coverage of its employees.

Sponsors: Representatives Conway, Wood, Cooper, Moeller, Kirby and Simpson.

Hearing Date: 2/20/03

Staff: Dave Knutson (786-7146).

Background:

The Basic Health Plan provides services to people who are not eligible for Medicare, not confined in government-operated facilities, live in an area of the state served by a participating managed care program, have a household income below 200 percent of the federal poverty level, and agree to make periodic payments to the plan. The employer of an eligible person may, but is not required to, pay the premium of an enrollee.

The Department of Social and Health Services (Department) provides medical services to low-income persons who meet income and resource eligibility standards set by the Department. The Department seeks to coordinate benefits with available private health insurance coverage, but does not require employers to contribute to the cost of medical services provided to employed clients.

Summary of Bill:

The Health Care Authority administrator is authorized to seek reimbursement for the cost of providing Basic Health Plan services to enrollees who are employees of large employers. The Department of Social and Health Services is authorized to seek reimbursement for the cost of providing medical services to clients who are employees of large employers. The reimbursement would equal 70 percent of the per capita cost of the services provided to the employed enrollee or client. A large employer means an employer with at least 100 full-time equivalent employees.

Appropriation: None.

Fiscal Note: Requested on February 13, 2003.

Effective Date: The bill takes effect ninety days after adjournment of session in which bill is passed.