WSR 19-15-127
[Insurance Commissioner Matter R 2019-09—Filed July 23, 2019, 1:06 p.m.]
Subject of Possible Rule Making: Correction of language in essential health benefit (EHB), WAC 284-43-5642 (3)(b)(i).
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 48.02.060 and 48.43.715.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: WAC 284-43-5642 (3)(b)(i) currently states that, for Affordable Care Act plans, coverage of hospitalization for mental illness is an optional benefit. This violates the requirement for mental health (MH)/substance use disorder (SUD) EHB, as well as federal Mental Health Parity Addiction and Equity Act requirements.
This language was meant to read that carriers must cover hospitalization for MH/SUD, but cannot include it in the actuarial value calculation for the hospitalization EHB (it must be included in the calculation for actuarial value of the MH/SUD EHB).
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.
Process for Developing New Rule: Submit comments by September 13, 2019.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Tabba Alam, P.O. Box 40260, Olympia, WA 98504-0260, phone 360-725-7170, fax 360-586-3109, TTY 360-586-0241, email, web site
July 23, 2019
Mike Kreidler
Insurance Commissioner