SHB 1154 -
By Representative Serben
FAILED 01/28/2005
On page 6, after line 26, insert the following:
"(6) The mandate to provide coverage for mental health services
shall not apply with respect to a group of fifty or more employees if
the insurer chooses to contest the application of the mandate and can
demonstrate an increase in the cost of the plan of more than one
percent. The insurer can file documentation of any increases due to
the mandate with the office of the insurance commissioner. If the
commissioner determines that an increase of more than one percent is
due to the cost of complying with this act, the plan does not have to
comply with the mandates in this act. The insurer may appeal the
determination under chapters 48.04 and 34.05 RCW."
On page 8, after line 31, insert the following:
"(6) The mandate to provide coverage for mental health services
shall not apply with respect to a group of fifty or more employees if
the health care service contractor chooses to contest the application
of the mandate and can demonstrate an increase in the cost of the plan
of more than one percent. The health care service contractor can file
documentation of any increases due to the mandate with the office of
the insurance commissioner. If the commissioner determines that an
increase of more than one percent is due to the cost of complying with
this act, the plan does not have to comply with the mandates in this
act. The health care service contractor may appeal the determination
under chapters 48.04 and 34.05 RCW."
On page 10, after line 38, insert the following:
"(6) The mandate to provide coverage for mental health services
shall not apply with respect to a group of fifty or more employees if
the health maintenance organization chooses to contest the application
of the mandate and can demonstrate an increase in the cost of the plan
of more than one percent. The health maintenance organization can file
documentation of any increases due to the mandate with the office of
the insurance commissioner. If the commissioner determines that an
increase of more than one percent is due to the cost of complying with
this act, the plan does not have to comply with the mandates in this
act. The health maintenance organization may appeal the determination
under chapters 48.04 and 34.05 RCW."
EFFECT: Plans offered by private health insurers do not have to comply with the mental health parity provisions if they can demonstrate the mandates have increased the cost of a plan by more than one percent.