BILL REQ. #:  S-3783.1 

Read first time 01/16/12.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to prescription drug benefits; and adding a new section to chapter 48.43 RCW.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 48.43 RCW to read as follows:
     (1)(a) A health carrier that provides coverage for prescription drugs shall provide a single limit on out-of-pocket expenses in all of its health plans. All out-of-pocket expenses incurred by a covered person for medical services, surgical services, mental health services, or prescription drugs shall be included in the limit. The out-of-pocket limit required by this subsection may not exceed five thousand nine hundred fifty dollars for plans that cover a single enrollee or eleven thousand nine hundred dollars for plans that cover more than one enrollee. In July 2013 and every July thereafter, the insurance commissioner shall adjust the out-of-pocket limits in this subsection to reflect the percentage change in the consumer price index for medical care for a preceding twelve months, as determined by the United States department of labor. The adjusted amounts shall apply on the following January 1st.
     (b) This subsection (1) does not apply to catastrophic health plans.
     (2) This section applies to health plans delivered, issued for delivery, or renewed on or after January 1, 2013.