WSR 13-03-140




[ Insurance Commissioner Matter No. R 2013-02 -- Filed January 23, 2013, 9:53 a.m. ]

     Subject of Possible Rule Making: Open and special enrollment in the individual and small group health plan markets.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.18.120(2), 48.20.450, 48.43.720, 48.44.050, and 48.46.200.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Beginning October 1, 2013, the health benefit exchange will conduct open enrollment for health plans offered on the exchange. The first year, open enrollment closes in March 2014; subsequently it will end earlier. Beginning January 1, 2014, health plan issuers must enroll all applicants, whether the applicant seeks coverage during open enrollment (on or off the exchange) or off-exchange at any time during the calendar year. This creates a risk of adverse selection for the off-exchange markets, because someone with a specific health care need can enroll, receive the service, and disenroll, unless open enrollment periods are established that parallel the exchange's time frames.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: There are no other federal or state agencies that regulate the off-exchange marketplace with regard to this subject.

     Process for Developing New Rule: Submit written comments by March 8, 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,, phone (360) 725-7170, fax (360) 586-3109.

January 23, 2013

Mike Kreidler

Insurance Commissioner