Washington · statute · Wash. Rev. Code ch. 43.71 · 18 active provisions
(1) The legislature finds that the affordable care act requires the establishment of health benefit exchanges. The legislature intends to establish an exchange, including a governance structure. There are many policy decisions associated with establishing an exchange that need to be made that will take a great deal of…
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise. Terms and phrases used in this chapter that are not defined in this section must be defined as consistent with implementation of a state health benefit exchange pursuant to applicable federal law.(1) "Authority"…
(1) The Washington health benefit exchange is established and constitutes a self-sustaining public-private partnership separate and distinct from the state, exercising functions delineated in chapter 317, Laws of 2011. By January 1, 2014, the exchange shall operate consistent with applicable federal law subject to stat…
(1) The exchange has the authority to:(a) Provide an application and enrollment portal for individual and small group health and dental insurance and state and federal health care programs;(b) Certify qualified health and dental plans to be offered for enrollment through the exchange;(c) Provide consumer education and…
(1) The health benefit exchange account is created in the state treasury. Moneys in the account may be spent only after appropriation. Expenditures from the account may only be used to fund the operation of the exchange and identification, collection, and distribution of premium taxes collected under RCW 48.14.0201(5)(…
(1) The board shall certify a plan as a qualified health plan to be offered through the exchange if the plan is determined by the:(a) Insurance commissioner to meet the requirements of Title 48 RCW and rules adopted by the commissioner pursuant to chapter 34.05 RCW to implement the requirements of Title 48 RCW;(b) Boar…
(1) For qualified health plans, an issue [issuer] offering a qualified health plan may not employ marketing practices or benefit designs that have the effect of discouraging enrollment in the plan by individuals with significant health needs.(2) Unless preempted by federal law, the commissioner shall adopt any rules ne…
The board shall establish a rating system consistent with applicable federal law, for qualified health plans to assist consumers in evaluating plan choices in the exchange. Rating factors established by the board may include, but are not limited to:(1) Affordability with respect to premiums, deductibles, and point-of-s…
(1) A person or entity functioning as a navigator shall not be considered soliciting or negotiating insurance as stated under chapter 48.17 RCW.(2)(a) A person or entity functioning as a navigator may only request health care information that is relevant to the specific assessment and recommendation of health plan opti…
(1)(a) Beginning January 1, 2015, the exchange may require each issuer writing premiums for qualified health benefit plans or stand-alone pediatric dental plans offered through the exchange to pay an assessment in an amount necessary to fund the operations of the exchange, applicable to operational costs incurred begin…
(1) The exchange, in consultation with the commissioner, the authority, an independent actuary, and other stakeholders, must establish up to three standardized health plans for each of the bronze, silver, and gold levels.(a) The standardized health plans must be designed to reduce deductibles, make more services availa…
(1) Beginning November 1, 2021, the exchange shall provide individuals seeking to enroll in coverage on its website with access to the information a health carrier must provide under RCW 48.43.725 for any qualified health plan the health carrier offers that excludes, under state or federal law, any benefit required or…
(1) Subject to the availability of amounts appropriated for this specific purpose, a premium assistance and cost-sharing reduction program is hereby established to be administered by the exchange.(2) Premium assistance and cost-sharing reduction amounts must be established by the exchange within parameters established…
(1) The exchange, in close consultation with the authority and the office of the insurance commissioner, must explore all opportunities to apply to the secretary of health and human services under 42 U.S.C. Sec. 18052 for a waiver or other available federal flexibilities to:(a) Receive federal funds for the implementat…
(1) The state health care affordability account is created in the state treasury. Expenditures from the account may only be used for premium and cost-sharing assistance programs established in RCW 43.71.110.(2) The following funds must be deposited in the account:(a) Any grants, donations, or contributions of money col…
(1) By January 1, 2025, the exchange must establish a worker health plan access program to help Washingtonians who lose health care coverage provided by their employer or a joint labor management trust as a result of an active strike, lockout, or other labor dispute.(2) Subject to the availability of funding, the excha…
If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not…
Nothing in chapter 87, Laws of 2012 prohibits the offering of benefits for spiritual care services deductible under section 213(d) of the internal revenue code in health plans inside and outside of the exchange.