WSR 12-08-029




[ Insurance Commissioner Matter No. R 2012-09 -- Filed March 28, 2012, 3:58 p.m. ]

Subject of Possible Rule Making: Establishing Washington state's individual market reinsurance program.

Statutes Authorizing the Agency to Adopt Rules on this Subject: Section 15, chapter 87, Laws of 2012 (E2SHB 2319). Sections 132, 1341 - 1343, Pub.L. 111-148, 24 Stat 119 and 45 C.F.R. subtitle A, subchapter B part 153, subparts A, B, C and E.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Beginning January 1, 2014, Washington's health benefit coverage marketplace changes due to implementation related to the health care exchange, market reforms and patient protections under the Affordable Care Act. The Washington state legislature directed the commissioner to adopt rules establishing the state's reinsurance program pursuant to the Affordable Care Act. The reinsurance program is essential to addressing the risk of adverse selection for carriers offering qualified health plans in the exchange.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Federal: The United States Department of Health and Human Services (HHS) regulates this subject. The commissioner monitors all official HHS publications related to the reinsurance program under the Affordable Care Act, contacts the HHS with implementation questions, and participates in work groups and conference calls with HHS related to the reinsurance program.

State: E2SHB 2319 directs the exchange to monitor the exchange and nonexchange marketplaces for adverse selection, and report on this to the legislature. The commissioner must consult with the exchange related to their effort in this regard. Since the exchange is also empowered to request information from the commissioner, the commissioner will provide disclosable information regarding the reinsurance program as the exchange may request.

Process for Developing New Rule: Submit written comments by May 6, 2012.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Meg L. Jones, P.O. Box 40258, Olympia, WA 98504, (360) 725-7170, fax (360) 725-7170, e-mail

March 28, 2012

Mike Kreidler

Insurance Commissioner

Washington State Code Reviser's Office