6210-S.E AMH MARS WEIK 130
ESSB 6210 - H AMD TO APP COMM AMD (H-3768.1/26) 2501
By Representative Marshall |
NOT CONSIDERED 03/12/2026
On page 11, line 11 of the striking amendment, after "(13)" insert "(a)"
On page 11, beginning on line 12 of the striking amendment, beginning with "there" strike all material through "exchange" on line 14 and insert "a quantifiable distinction between qualified health plans offered by a carrier on the exchange market based solely on actuarial value and cost‑sharing parameters, premium price differentials, and network adequacy measures as required by the office of the insurance commissioner.
(b) The exchange may not define “meaningfully different” to include subjective, qualitative, or discretionary factors, nor may it adopt criteria that would require carriers to:
(i) Create new provider networks;
(ii) Modify benefit structures outside actuarial value parameters mandated by federal or state law;
(iii) Withdraw from rating areas; or
(iv) Add rating areas"
| EFFECT: Replaces the existing definition of "meaningfully different" with the following definition: a quantifiable distinction between qualified health plans offered by a carrier on the Health Benefit Exchange (Exchange) market based solely on actuarial value and cost‑sharing parameters, premium price differentials, and network adequacy measures as required by the Office of the Insurance Commissioner. Prohibits the Exchange from defining meaningfully different to include subjective, qualitative, or discretionary factors, and from adopting criteria that would require carriers to create new provider networks; modify benefit structures outside actuarial value parameters mandated by state or federal law; withdraw from rating areas; or add rating areas.
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