Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
SSB 6051
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. |
Brief Description: Concerning health coverage supplementing medicare part D provided through a federally authorized employer group waiver plan.
Sponsors: Senate Committee on Health & Long Term Care (originally sponsored by Senators Cleveland, O'Ban, Becker and Wilson, C.).
Brief Summary of Substitute Bill |
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Hearing Date: 2/20/20
Staff: Kim Weidenaar (786-7120).
Background:
Health Plans.
Health plans are policies, contracts, or agreements offered by a health carrier to provide, arrange, reimburse, or pay for health care services. Health plans must comply with various insurance regulations including rate review, guaranteed issue requirements, prohibitions on rescission of coverage, minimum coverage and mandated benefits requirements, and other filing and reporting requirements. Health plans do not include:
long-term care insurance;
Medicare supplemental insurance;
certain federal health insurance programs offered to members of the military and to veterans;
limited health care services offered by limited health care service contractors;
disability income;
worker's compensation;
accident-only coverage;
certain fixed payment insurance;
employer-sponsored self-funded health plans;
dental-only and vision-only coverage; and
plans deemed to have a short-term limited purpose or duration.
Medicare Part D.
Citizens and permanent residents of the United States who are age 65 or older, or under 65 with disabilities or end-stage renal disease are generally eligible for Medicare. Medicare Part D is an optional part of the federal Medicare program allowing for the purchase of a prescription drug benefit. Individuals who are eligible for Medicare are eligible for Part D if they are enrolled in Part A, hospital coverage, or Part B, primary care and outpatient services.
Supplemental Prescription Drug Coverage.
Employers and unions are permitted under a federal group waiver program to offer prescription drug coverage under the employer's or union's sponsored health coverage to retirees who are eligible for Medicare Part D. Employers offering supplemental Part D coverage must follow all Medicare Part D prescription drug requirements, except those explicitly waived by the Centers for Medicare and Medicaid Services
Summary of Bill:
Stand-alone prescription drug coverage that exclusively supplements Medicare Part D coverage provided through an employer or union-sponsored prescription drug plan is excluded from the definition of “health plan.”
Appropriation: None.
Fiscal Note: Preliminary fiscal note available.
Effective Date: The bill contains an emergency clause and takes effect immediately.