1947-S AMH CODY CORN 188

SHB 1947 - H AMD 285

By Representative Cody

ADOPTED 03/11/2013

    On page 3, line 10, after "act." insert "If the exchange is charging an assessment, the exchange shall set forth the amount of the assessment per member per month on monthly billing statements."

    On page 3, line 23, after "installments." insert "Upon determination of the amount of the assessment, the exchange shall notify carriers of the due dates of the quarterly installments."

    On page 3, after line 25, insert the following:

    "(4) The exchange shall reconcile assessment payments based on actual covered lives at the end of the calendar year of the assessment.  At the end of the calendar year, the exchange shall compare the amount of the assessment for each carrier calculated in subsection (2) of this section to the amount of the assessment that would have been collected from each carrier based on each carrier's actual covered lives in qualified health plans and dental plans in the exchange during that calendar year.  If a carrier's share of the assessment would have been smaller if it were based on actual covered lives, the exchange shall refund the carrier for the difference between the collected amount of the assessment and the amount of the assessment that would have been collected based on the carrier's actual covered lives.  If the carrier's share of the assessment would have been larger if it were based on actual covered lives, the exchange shall collect from the carrier the difference between the collected amount of the assessment and the amount of the assessment that would have been collected based on the carrier's actual covered lives.

    (5) The assessment described in this section shall be considered a special purpose obligation or assessment in connection with coverage described in this section for the purpose of funding the operations of the exchange."

    Renumber the remaining subsections consecutively and correct any internal references accordingly.

    On page 5, line 6, after "plans" insert "and dental plans"

    On page 5, line 23, after "received" insert "from business conducted outside of the health benefit exchange under chapter 43.71 RCW"

EFFECT:   Requires the Washington Health Benefit Exchange (Exchange) to set forth the amount of the assessment per member per month on monthly billing statements.  Requires the Exchange to notify carriers of the due dates of the quarterly installments upon determination of the amount of the assessment.  Requires the Exchange to reconcile assessments based on the actual number of covered lives that each carrier covered in the Exchange during the calendar year of the assessment.  Specifies that the assessment is a special purpose obligation or assessment for the purpose of funding the operations of the Exchange.  Removes the premium tax exemption for dental benefits and dental plans sold through the Exchange.

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