FINAL BILL REPORT

SSB 5966

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background: The Office of the Insurance Commissioner (OIC) licenses and regulates insurance carriers offering products in Washington. Insurance laws govern these licensed carriers or health plans, but do not govern self-insured plans offered by employers, consistent with federal ERISA law. The state Health Care Authority (HCA) and Public Employees Benefits Board (PEBB) program contract with licensed health plans and self-insure. Special provisions have been provided that subject the state's self-insured plan to many of the insurance laws for licensed health plans. Health plans are required to track appeals and keep a log for three years that must be made available to the Insurance Commissioner, and each plan must identify and evaluate any trends in appeals.

In addition, Legislation passed in 2010 (SSB 6584) requires the HCA to report to the Legislature annually with a summary of complaints and appeals made by PEBB members within the following categories: customer service; quality of a health service; or the availability of a service. The first annual report was submitted this fall.

Summary: The volunteer position within OIC must assist retirees enrolled in PEBB with questions and concerns, assist the PEBB program with identification of retiree concerns, and maintain access to updated program information. The volunteer must be trained as part of the existing volunteer training provided to the statewide health insurance benefit advisors program.

Votes on Final Passage:

Senate	47	0
House	83	15