WSR 15-11-083
[Insurance Commissioner Matter No. R 2015-02—Filed May 19, 2015, 3:29 p.m.]
Subject of Possible Rule Making: Designation of base benchmark plan for essential health benefits (EHB) purposes as well as any necessary supplementation.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.21.241, 48.21.320, 48.44.460, 48.44.341, 48.46.291, 48.46.530, and 48.43.715.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The federal government (Health and Human Services (HHS)) has decided to extend the base benchmark approach for establishing EHB coverage levels through at least plan year 2017. Under HHS rules the office of insurance commissioner (OIC) must adopt a new base benchmark plan by June 2015 and make any necessary adjustments in its EHB rules before the rate filings are due for 2017 individual and small group market plans. This will provide health plan issuers with specific guidance regarding form and rate filing of nongrandfathered individual and small group health plans for the 2017 benefit year, in relation to ensuring that an issuer's product and plan filing is substantially equal to the EHB-benchmark plan, and that the actuarial values for each EHB category are substantially equal to the EHB-benchmark plan. Any state legislation passed since 2012 affecting EHB coverage will also be considered as part of this rule making.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: In addition to state legislation on this same topic (RCW 48.43.715), OIC must also follow federal rules (45 C.F.R. 156) and coordinate data with HHS.
The Washington health exchange does not regulate the essential health benefits benchmark plan designation, but will use the information in planning the exchange. The commissioner will coordinate with the exchange by keeping its staff informed as the rule making progresses.
Process for Developing New Rule: Submit written comments by July 7, 2015, to Bianca Stoner,, fax (360) 586-3109.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Bianca Stoner, P.O. Box 40258, Olympia, WA 98504, (360) 725-7041, fax (360) 586-3109,
May 19, 2015
Mike Kreidler
Insurance Commissioner