BP BHEAD INT H [atlas:bill]

AN ACT Relating to health insurance for individuals and families; amending RCW 48.14.0201; adding new sections to chapter 70.47 RCW; adding a new section to chapter 48.14 RCW; creating a new section; and providing an effective date.

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

NEW SECTION. Sec. 1. The legislature finds that health plans through the individual market are scarce and not available at all in many parts of the state, threatening the health of Washington residents who do not have access to health insurance through their employer, medicare, or medicaid. The legislature intends to provide a safety net for Washington citizens by establishing an affordable catastrophic health plan that is available throughout the state for individuals and their families.

NEW SECTION. Sec. 2. A new section is added to chapter 70.47 RCW to read as follows:

(1) The administrator shall offer a catastrophic health plan designed as follows:

(a) Copayments and other cost sharing shall be the same as the nonsubsidized basic health plan, as set forth in RCW 70.47.060, except that there shall be a requirement of a seven hundred fifty dollar annual deductible.

(b) The schedule of benefits shall be the same as the nonsubsidized basic health plan, as set forth in RCW 70.47.060, except there shall be exclusion of chemical dependency services, mental health services, and organ transplant services for those over sixty years old.

(c) Except as required by federal law, participating health carriers may impose a twelve-month waiting period for coverage of a preexisting condition if such condition existed, was diagnosed, or was treated during the six-month period prior to enrollment.

(d) Monthly premiums for this coverage shall not exceed eighty-five dollars per enrollee and twenty-five dollars per dependent. The administrator may increase these premiums by rule every five years based on the consumer price index.

(e) There is a lifetime limit of four hundred thousand dollars per enrollee.

(2)(a) Any health carrier that contracts with Washington state and/or the health care authority must offer or contract with another to offer the health plan described in this section in a manner required by the administrator in rule.

(b) The health care authority may offer the health plan under this section in areas not covered by health carriers or where health carriers do not have adequate networks in a similar manner as the uniform medical plan.

(3) The difference between the cost of providing the plan under this section and the premiums collected under subsection (1)(d) of this section shall be reimbursed from the account created in section 3 of this act and as provided in section 5 of this act.

(4) The administrator may adopt rules necessary to implement this section and section 5 of this act.

NEW SECTION. Sec. 3. A new section is added to chapter 70.47 RCW to read as follows:

The catastrophic health plan account is created in the custody of the state treasurer. A portion of insurance premium taxes shall be deposited in the account as prescribed in section 5 of this act. Expenditures from the account may be used only for expenses related to the catastrophic health plan under section 2 of this act. Only the administrator of the health care authority or a designee may authorize expenditures from the account. The account is subject to allotment procedures under chapter 43.88 RCW, but no appropriation is required for expenditures.

Sec. 4. RCW 48.14.0201 and 1998 c 323 s 1 are each amended to read as follows:

(1) As used in this section, "taxpayer" means a health maintenance organization, as defined in RCW 48.46.020, or a health care service contractor, as defined in RCW 48.44.010.

(2) Each taxpayer shall pay a tax on or before the first day of March of each year to the state treasurer through the insurance commissioner's office. The tax shall be equal to the total amount of all premiums and prepayments for health care services received by the taxpayer during the preceding calendar year multiplied by the rate of two percent.

(3) Taxpayers shall prepay their tax obligations under this section. The minimum amount of the prepayments shall be percentages of the taxpayer's tax obligation for the preceding calendar year recomputed using the rate in effect for the current year. For the prepayment of taxes due during the first calendar year, the minimum amount of the prepayments shall be percentages of the taxpayer's tax obligation that would have been due had the tax been in effect during the previous calendar year. The tax prepayments shall be paid to the state treasurer through the commissioner's office by the due dates and in the following amounts:

(a) On or before June 15, forty-five percent;

(b) On or before September 15, twenty-five percent;

(4) For good cause demonstrated in writing, the commissioner may approve an amount smaller than the preceding calendar year's tax obligation as recomputed for calculating the health maintenance organization's, health care service contractor's, or certified health plan's prepayment obligations for the current tax year.

(5) Except as provided in section 5 of this act, moneys collected under this section shall be deposited in ((~~the general fund through March 31, 1996, and in~~)) the health services account under RCW 43.72.900 ((~~after March 31, 1996~~)).

(6) The taxes imposed in this section do not apply to:

(a) Amounts received by any taxpayer from the United States or any instrumentality thereof as prepayments for health care services provided under Title XVIII (medicare) of the federal social security act.

(b) Amounts received by any health care service contractor, as defined in RCW 48.44.010, as prepayments for health care services included within the definition of practice of dentistry under RCW 18.32.020.

(7) Beginning January 1, 2000, the state does hereby preempt the field of imposing excise or privilege taxes upon taxpayers and no county, city, town, or other municipal subdivision shall have the right to impose any such taxes upon such taxpayers. This subsection shall be limited to premiums and payments for health benefit plans offered by health care service contractors under chapter 48.44 RCW and health maintenance organizations under chapter 48.46 RCW. The preemption authorized by this subsection shall not impair the ability of a county, city, town, or other municipal subdivision to impose excise or privilege taxes upon the health care services directly delivered by the employees of a health maintenance organization under chapter 48.46 RCW.

NEW SECTION. Sec. 5. A new section is added to chapter 48.14 RCW to read as follows:

(1) Except for moneys deposited in the catastrophic health plan account as provided in subsection (2) of this section, the state treasurer shall deposit moneys received by the treasurer for the tax obligation under RCW 48.14.020 in the general fund and for the tax obligation under RCW 48.14.0201 in the health services account.

(2) The state treasurer shall deposit a percentage of the tax obligations under RCW 48.14.020 and 48.14.0201 in the catastrophic health plan account created in section 3 of this act. The percentage to be deposited in the catastrophic health plan account shall be determined by the administrator of the health care authority as provided in this subsection (2). The administrator of the health care authority shall adopt by rule a procedure to determine at least annually the amount of losses under section 2(3) of this act and shall express this amount as a percentage of the total premium taxes under RCW 48.14.020 and 48.14.0201. The state treasurer, at least annually, shall apply this percentage to the premium taxes received by the treasurer and shall deposit this amount in the catastrophic health plan account created in section 3 of this act and shall deposit the remainder in the general fund or the health services account as provided in subsection (1) of this section.

(3) The state treasurer, the administrator of the health care authority, and the insurance commissioner shall collaborate on implementing this section and may adopt rules necessary to implement this section. The rules may provide for estimates of losses where appropriate and adjustments to be made for actual losses when that information is available the following year.

(4) The administrator of the health care authority shall estimate the amount necessary to cover the losses in the first year of operation of the catastrophic health plan established in section 2 of this act and calculate a percentage for the state treasurer to use under subsection (2) of this section beginning with moneys received on or after the effective date of this act. Adjustments based on the actual losses experienced in the first year of operation shall be made in the second year of the plan.

NEW SECTION. Sec. 6. This act takes effect July 1, 2000.