WSR 15-15-133
[Insurance Commissioner Matter No. R 2015-10—Filed July 17, 2015, 11:57 a.m.]
Subject of Possible Rule Making: Health plan special enrollment rules.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060, 48.18.120(2), 48.20.450, 48.44.050, and 48.46.200.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: In 2013, the office of the insurance commissioner (OIC) adopted rules implementing open and special enrollment periods for the individual and small group market under the Affordable Care Act.
Since then, the agency has received questions from health carriers, producers, consumer groups, the health benefit exchange (exchange) and others about how the OIC's existing rules regarding special enrollment align with guidance that the federal government has adopted since the OIC finished its enrollment rule in 2013.
In addition, some sections of the OIC's existing special enrollment rules paraphrase the federal law in a manner that can be difficult to understand. Revising this language would make it easier for stakeholders to understand and comply with the requirements.
Overall, adding the recent federal guidance to WAC and amending some of the existing language in WAC will reduce confusion and make it easier for carriers, consumers, and others to find and comply with these requirements.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The exchange doesn't regulate the special enrollment rules, but it does use them to decide whether to allow consumers to go on health plans outside of the regular open enrollment period. As a result, the exchange is an important stakeholder in regard to this process, and the OIC will work closely with them in implementing these rules.
Process for Developing New Rule: Submit written comments by September 4, 2015, to, 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 98504-0258,
July 17, 2015
Mike Kreidler
Insurance Commissioner