HOUSE BILL REPORT
HB
2782
As Passed House
February 13, 1992
Title: An act relating to health maintenance organizations.
Brief Description: Including coinsurance in health maintenance organizations provisions.
Sponsor(s): Representatives Zellinsky, R. Johnson, Mielke, Winsley, Anderson, Paris, Wineberry, D. Sommers and Wood.
Brief History:
Reported by House Committee on:
Financial Institutions & Insurance, January 31, 1992, DP;
Passed House, February 13, 1992, 96-0.
HOUSE COMMITTEE ON
FINANCIAL INSTITUTIONS & INSURANCE
Majority Report: Do pass. Signed by 11 members: Representatives Dellwo, Chair; Zellinsky, Vice Chair; Broback, Ranking Minority Member; Mielke, Assistant Ranking Minority Member; Anderson; Dorn; Inslee; R. Johnson; Paris; Schmidt; and Winsley.
Staff: John Conniff (786-7119).
Background: In 1990, the Legislature substantially amended the Health Maintenance Organization (HMO) Act. The changes were primarily designed to improve regulation of the solvency of HMOs and to provide a mechanism for addressing the claims and needs of subscribers holding agreements with a defunct HMO. Part of the legislation defined "copayment" and "deductible" for purposes of describing the type of coverage a subscriber of a defunct HMO was entitled to obtain from another solvent HMO. No definition of coinsurance was included in the legislation. A coinsurance provision requires a subscriber to share a percentage portion of the cost of a particular health care service as distinguished from a deductible or copayment provision which requires the subscriber's payment of a specific dollar amount of the cost of a health care service. Without a definition of coinsurance, HMO agreements cannot contain coinsurance provisions as most agreements now provide.
Summary of Bill: HMO agreements may contain coinsurance provisions requiring subscribers to share a percentage portion of the costs of a specific health care service.
Fiscal Note: Not requested.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Testimony For: The definition of coinsurance corrects an unintentional oversight in the drafting of the changes to the HMO Act in 1990.
Testimony Against: None.
Witnesses: (Pro) Kenneth F. Bertrand, Group Health Cooperative; and J. Scott Jarvis, Insurance Commissioner's Office.