1569-S2.E AMS PARL NEED 113 1569-S2.E AMS PARL NEED 113
E2SHB 1569 S AMD to S AMD (S-3448.1/07) 440
By Senators Parlette and Haugen
NOT ADOPTED 4/12/2007
On page 3, at the beginning of line 4 of the amendment, strike all material through page 20, line 19 and insert the following:
"NEW SECTION. Sec. 4. A new section is added to chapter 41.05 RCW
to read as follows:
(1) The authority, in collaboration with an advisory board
established under subsection (3) of this section, shall design a
Washington health insurance connector and submit implementing
legislation and supporting information, including funding options, to
the governor and the legislature by December 1, 2007. The connector
shall be designed to serve as a statewide, public-private
partnership, offering maximum value for Washington state residents,
through which nonlarge group health insurance may be bought and sold.
It is the goal of the connector to:
(a) Ensure that employees of small businesses and other
individuals can find affordable health insurance;
(b) Provide a mechanism for small businesses to contribute to
their employees' coverage without the administrative burden of
directly shopping or contracting for insurance;
(c) Ensure that individuals can access coverage as they change
and/or work in multiple jobs;
(d) Coordinate with other state agency health insurance
assistance programs, including the department of social and health
services medical assistance programs and the authority's basic health
program; and
(e) Lead the health insurance marketplace in implementation of
evidence-based medicine, data transparency, prevention and wellness
incentives, and outcome-based reimbursement.
(2) In designing the connector, the authority shall:
(a) Address all operational and governance issues;
(b) Consider best practices in the private and public sectors
regarding, but not limited to, such issues as risk and/or purchasing
pooling, market competition drivers, risk selection, and consumer
choice and responsibility incentives; and
(c) Address key functions of the connector, including but not
limited to:
(i) Methods for small businesses and their employees to realize
tax benefits from their financial contributions;
(ii) Options for offering choice among a broad array of
affordable insurance products designed to meet individual needs,
including waiving some current regulatory requirements. Options may
include a health savings account/high-deductible health plan, a
comprehensive health benefit plan, and other benchmark plans;
(iii) Benchmarking health insurance products to a reasonable
standard to enable individuals to make an informed choice of the
coverage that is right for them;
(iv) Aggregating premium contributions for an individual from
multiple sources: Employers, individuals, philanthropies, and government;
(v) Mechanisms to collect and distribute workers' enrollment
information and premium payments to the health plan of their choice;
(vi) Mechanisms for spreading health risk widely to support
health insurance premiums that are more affordable;
(vii) Opportunities to reward carriers and consumers whose
behavior is consistent with quality, efficiency, and evidence-based
best practices;
(viii) Coordination of the transmission of premium assistance
payments with the department of social and health services for
individuals eligible for the department's employer-sponsored
insurance program.
(3) The authority shall appoint an advisory board and designate
a chair. Members of the advisory board shall receive no compensation,
but shall be reimbursed for expenses under RCW 43.03.050 and
43.03.060. Meetings of the board are subject to chapter 42.30 RCW,
the open public meetings act, including RCW 42.30.110(1)(l), which
authorizes an executive session during a regular or special meeting
to consider proprietary or confidential nonpublished information.
(4) The authority may enter into contracts to issue, distribute,
and administer grants that are necessary or proper to carry out the
requirements of this section.
Sec. 2. RCW 70.47A.040 and 2006 c 255 s 4 are each amended to read as
follows:
(1) Beginning July 1, 2007, the administrator shall accept
applications from eligible employees, on behalf of themselves, their
spouses, and their dependent children, to receive premium subsidies
through the small employer health insurance partnership program.
(2) Premium subsidy payments may be provided to eligible
employees ((if:)) or participating carriers on behalf of employees.
(a) The eligible employee ((is)) must be employed by a small
employer((;)).
(b) ((The actuarial value of the health benefit plan offered by
the small employer is at least equivalent to that of the basic health
plan benefit offered under chapter 70.47 RCW. The office of the
insurance commissioner under Title 48 RCW shall certify those small
employer health benefit plans that are at least actuarially
equivalent to the basic health plan benefit; and)) Small employers
may offer any available health benefit plan including health savings
accounts. Health savings account subsidy payments may be provided to
eligible employees if the eligible employee participates in an
employer-sponsored high deductible health plan and health savings
account that conforms to the requirements of the United States
internal revenue service.
(c) The small employer will pay at least forty percent of the
monthly premium cost for health benefit plan coverage of the eligible
employee.
(3) The amount of an eligible employee's premium subsidy shall
be determined by applying the sliding scale subsidy schedule
developed for subsidized basic health plan enrollees under RCW
70.47.060 to the employee's premium obligation for his or her
employer's health benefit plan.
(4) After an eligible individual has enrolled in the program,
the program shall issue subsidies in an amount determined pursuant to
subsection (3) of this section to either the eligible employee or to
the carrier designated by the eligible employee.
(5) An eligible employee must agree to provide verification of
continued enrollment in his or her small employer's health benefit
plan on a semiannual basis or to notify the administrator whenever
his or her enrollment status changes, whichever is earlier.
Verification or notification may be made directly by the employee, or
through his or her employer or the carrier providing the small
employer health benefit plan. When necessary, the administrator has
the authority to perform retrospective audits on premium subsidy
accounts. The administrator may suspend or terminate an employee's
participation in the program and seek repayment of any subsidy
amounts paid due to the omission or misrepresentation of an applicant
or enrolled employee. The administrator shall adopt rules to define
the appropriate application of these sanctions and the processes to
implement the sanctions provided in this subsection, within available
resources."
E2SHB 1569 - S AMD to S AMD (S-3448.1/07)
Beginning on page 20, line 20 of the title amendment, after "line" strike all material through "emergency" on page 21, line 3, and insert "2 of the title, after "state;" insert "amending RCW 70.47A.040, and creating a new section"
EFFECT: Inserts the "connector" study from SB 5930, modifies the benefit requirement for SEHIP and allows premium assistance for any small group product including an HSA, eliminates the Partnership modifications, the two Partnership studies and the benefit mandate study, reverts to the original House Bill title.
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