WSR 26-12-076
PREPROPOSAL STATEMENT OF INQUIRY
OFFICE OF THE
INSURANCE COMMISSIONER
[Insurance Commissioner Matter R 2026-01—Filed June 3, 2026, 8:56 a.m.]
Subject of Possible Rule Making: Geographic rating area factors for individual and small group health plans.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW
48.02.060 and
48.43.733; and 45 C.F.R. § 147.102.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The office of the insurance commissioner (commissioner) appreciates concerns from consumers, policymakers, and interested organizations regarding the availability of individual market health plans across Washington state and the broader stability and affordability of the individual health insurance market.
Current rules at WAC 284-43-6680 through 284-43-6701 set geographic rating area factors for individual and small group market health plans. Carriers must follow these geographic rating area factors as a component in how they develop rates. Among other requirements, these current rules establish nine geographic rating areas across the state and set maximum premium ratios between the highest and lowest cost geographic rating area. Through the rate review process, the commissioner reviews and approves carriers' rates for individual and small group health plans.
The commissioner is considering amending these geographic rating factors. This potential rule making aims to ensure consumers' access to individual market health plans and promote market stability and competition.
To accomplish these aims, the commissioner may amend WAC 284-43-6680 through 284-43-6701 or other sections of chapter 284-43 WAC as necessary.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies:
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| • | The Washington health benefit exchange (HBE) certifies individual market health plans, known as qualified health plans (QHPs), to be sold on Washington Healthplanfinder. Washington Healthplanfinder is Washington state's online health insurance marketplace, through which eligible consumers enroll in QHPs. The commissioner will coordinate with HBE regarding this potential rule making. |
| • | The federal Centers for Medicare and Medicaid Services implements the Affordable Care Act (ACA). ACA, in part, regulates the individual and small group markets and state-based exchanges, including HBE. |
Process for Developing New Rule: Please submit comments by June 16, 2026.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Rules Coordinator, 302 Sid Snyder Avenue S.W., Olympia, WA 98504, phone 360-725-7171, fax 360-586-3109, TTY 360-586-0241, email rulescoordinator@oic.wa.gov, website www.insurance.wa.gov.
June 3, 2026
Patty Kuderer
Insurance Commissioner