WSR 13-12-080




[ Insurance Commissioner Matter No. R 2013-13 -- Filed June 5, 2013, 11:31 a.m. ]

     Subject of Possible Rule Making: Health plan market transition requirements.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.43.700, 48.43.715, 48.44.050, 48.46.200.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: A number of market reforms established by the Affordable Care Act must be included in health plans beginning January 1, 2014. As a result, plans currently issued must be replaced with compliant plans. The health benefit coverage marketplace will benefit if one approach to replacement is used, for both consumer and issuer certainty regarding access to coverage and regulatory compliance. For health plans already issued, this can be managed either by requiring wholesale replacement on a specific date, or by requiring the replacement to occur on the plan's renewal date for the purchaser.

     The proposed rules will address the commissioner's requirements for grandfathered and nongrandfathered plan replacement, and explain how grandfathered status is determined and applies to different types of group and individual plans.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: United States Department of Health and Human Services (HHS) regulates this subject as well. The commissioner plans to rely on the HHS regulations and guidance implementing the Affordable Care Act, and will communicate with HHS as the rule is being developed.

     Process for Developing New Rule: Submit written comments by July 10, 2013.

     Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Meg Jones, P.O. Box 40258, Olympia, WA 98504,, fax (360) 586-3109, phone (360) 725-7170.

June 5, 2013

Mike Kreidler

Insurance Commissioner