WSR 97-13-072



[Insurance Commissioner Matter No. R 97-2--Filed June 18, 1997, 9:15 a.m.]

Subject of Possible Rule Making: Procedures and standards for health care service contractors and health maintenance organizations to use in filing contract forms and rate schedules with the Insurance Commissioner.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.44.050, and 48.46.200.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Specific provisions of the existing Washington Administrative Code that address filing and review requirements are outdated, or fail to provide clear and consistent guidance for carriers to be able to comply with the law.

New rules would provide consistent and up-to-date guidelines for the filing of contract forms and rate schedules, and specify the standard to be used to determine when proposed premiums are unreasonable in relation to benefits. Such rules can help keep the costs of regulation to the minimum necessary to protect the public, by setting forth on a consistent basis, what documentation a carrier is required to provide with its rate filing; and how the filing will be evaluated. They also will help make the review process smoother and more understandable for all concerned.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

Process for Developing New Rule: Agency study; and (1) solicitation of written comments; and (2) the Insurance Commissioner will set up a working group of interested parties to participate in development of the rule.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication. Interested parties may request to participate in the working group by contacting Lillian Harjo at (360) 664-2569 or FAX (360) 586-3535. The commissioner plans to hold two public meetings to take comments and suggestions prior to the formulation of the proposed rule at a time and place to be announced. Interested persons are also encouraged to submit written comments prior to August 1, 1997, to Kacy Brandeberry, P.O. Box 40255, Olympia, WA 98504-0255, e-mail, FAX (360) 586-3535. Substantive questions may be directed to Bethany Weidner at (360) 664-2532.

June 17, 1997

Greg J. Scully

Chief Deputy Commissioner

Legislature Code Reviser


Washington State Code Reviser's Office