WSR 12-22-069




[ Insurance Commissioner Matter No. R 2012-28 -- Filed November 7, 2012, 7:45 a.m. ]

     Subject of Possible Rule Making: Carrier allocation account requirements.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.43.715, 48.44.050, 48.46.200.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Section 1303 of the Affordable Care Act (Pub. L. 111-148, 2010, as amended) requires carriers to establish allocation accounts that segregate subsidy funding for a plan's abortion benefit from other premium funds received from exchange enrollees. The section also requires inclusion of notice of the fund segregation in the summary of benefits and coverage explanation. Specifically, 1303 (b)(E)(i) places the obligation to ensure compliance with the segregation requirements on state insurance commissioners. Because termination of pregnancy is an essential health benefit in Washington's benchmark plan, carriers participating in the exchange are required to comply with this section.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The United States Department of Health and Human Services (HHS) has rule-making authority in this area as well, and issued 45 C.F.R. 156.280 related to this topic, requiring carriers to submit their segregation plan to the state insurance commissioner, and outlining the segregation plan contents in general terms.

     Process for Developing New Rule: Submit written comments by January 4, 2013.

     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 98504-0258, phone (360) 725-7170, e-mail, fax (360) 586-3109.

November 7, 2012

Mike Kreidler

Insurance Commissioner