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                         SENATE BILL 5847

          _______________________________________________

State of Washington      55th Legislature     1997 Regular Session

By Senators Wood, Deccio, Wojahn and Winsley; by request of Health Care Authority

Read first time 02/17/97.  Referred to Committee on Health & Long‑Term Care.

Authorizing health care authority standards for basic health plan agents and brokers.

    AN ACT Relating to health care authority standards for basic health plan agents and brokers; and amending RCW 70.47.015.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

    Sec. 1.  RCW 70.47.015 and 1995 c 265 s 1 are each amended to read as follows:

    (1) The legislature finds that the basic health plan has been an effective program in providing health coverage for uninsured residents.  Further, since 1993, substantial amounts of public funds have been allocated for subsidized basic health plan enrollment.

    (2) It is the intent of the legislature that the basic health plan enrollment be expanded expeditiously, consistent with funds available in the health services account, with the goal of two hundred thousand adult subsidized basic health plan enrollees and one hundred thirty thousand children covered through expanded medical assistance services by June 30, 1997, with the priority of providing needed health services to children in conjunction with other public programs.

    (3) Effective January 1, 1996, basic health plan enrollees whose income is less than one hundred twenty-five percent of the federal poverty level shall pay at least a ten-dollar premium share.

    (4) No later than July 1, 1996, the administrator shall implement procedures whereby hospitals licensed under chapters 70.41 and 71.12 RCW, health carrier, rural health care facilities regulated under chapter 70.175 RCW, and community and migrant health centers funded under RCW 41.05.220, may expeditiously assist patients and their families in applying for basic health plan or medical assistance coverage, and in submitting such applications directly to the health care authority or the department of social and health services.  The health care authority and the department of social and health services shall make every effort to simplify and expedite the application and enrollment process.

    (5) No later than July 1, 1996, the administrator shall implement procedures whereby health insurance agents and brokers, licensed under chapter 48.17 RCW, may expeditiously assist patients and their families in applying for basic health plan or medical assistance coverage, and in submitting such applications directly to the health care authority or the department of social and health services.  The administrator may establish:  (a) Minimum educational requirements that must be completed by the agents or brokers; (b) an appointment process for agents or brokers marketing the basic health plan; or (c) standards for revocation of the appointment of an agent or broker to submit applications for cause, including untrustworthy or incompetent conduct or harm to the public.  Brokers and agents shall be entitled to receive a commission for each individual sale of the basic health plan to anyone not ((at anytime previously)) signed up within the previous five years and a commission for each group sale of the basic health plan.  No commission shall be provided upon a renewal.  Commissions shall be determined based on the estimated annual cost of the basic health plan, however, commissions shall not result in a reduction in the premium amount paid to health carriers.  For purposes of this section "health carrier" is as defined in RCW 48.43.005.  The health care authority and the department of social and health services shall make every effort to simplify and expedite the application and enrollment process.

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