WSR 15-15-142
AGENDA
OFFICE OF
INSURANCE COMMISSIONER
[Filed July 17, 2015, 4:04 p.m.]
Rule Development Agenda
July 31, 2015, through January 31, 2016
The commissioner has introduced the following rule makings. Each rule making is currently between the CR-101, CR-102, and CR-103 stage. They are currently under review and there may be further rule-making activity before January 31, 2016. If you have any questions regarding any of these rule makings, please contact Jim Keogh, rulescoordinator@oic.wa.gov or (360) 725-7056.
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Current Activity |
WAC |
RCW Authority |
Subject |
CR-103E |
CR-101 |
CR-105 |
CR-102 |
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48.02.060, 48.21.270, 48.44.380, 48.46.460 |
Conversion health plans. |
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12-07-091 3/21/12 |
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48.02.060, 48.44.050, 48.46.200 |
Issuer disclosures, notices, and processes to protect privacy of health care information. |
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13-11-144 5/22/13 |
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48.02.060, 48.83.170, 48.84.030 |
Long-term care unintentional lapse notices. |
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14-02-074 12/30/13 |
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48.02.060, 48.18.120, 48.20.450, 48.20.460, 48.43.505, 48.43.510, 48.43.515, 48.43.525, 48.43.530, 48.43.535, 48.44.020, 48.44.050, 48.44.080, 48.46.030, 48.46.200, 45 C.F.R. 156.230, 45 C.F.R. 156.235, 45 C.F.R. 156.245 |
Network access. |
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14-15-104 7/18/14 |
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15-13-117 6/16/15 |
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48.02.060, 48.43.510, 48.165.0301 |
Prior authorization of pharmacy benefits. |
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14-22-086 11/3/14 |
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48.21.241, 48.21.320, 48.44.460, 48.44.341, 48.46.291, 48.46.530, 48.43.715 |
Designation of base benchmark plan for essential health benefits purposes as well as any necessary supplementation. |
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15-11-083 5/19/15 |
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48.02.060, 48.43.007 |
Attestation of transparency tools for consumer information on health care cost and quality. |
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15-11-084 5/19/15 |
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48.02.060, SSB 5023 (chapter 19, 2015 Laws-effective 7/24/15) |
Adjusting rate and form filing procedures for life and disability insurers to comply with SSB 5023. |
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15-12-107 6/2/15 |
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48.02.060, 48.31B.040 |
Amendment of chapter 284-18 WAC, WAC 284-03-030, 284-07-110 and 284-07-600 and the repeal of chapter 284-18A WAC to conform with amendments made to chapter 48.31B RCW (the Holding Company Act) by chapter 122, Laws of 2015. |
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15-13-067 6/11/15 |
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48.02.060, 48.30.010 |
Notice of payment of settlements by insurers. |
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15-13-068 6/11/15 |
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48.02.060, 48.17.005 |
Rules providing guidance to licensed insurance providers about what may/may not constitute sharing commissions were adopted in August 2014. ESSB 5743, passed in the 2015 legislative session, amended some of the statutes on which the rules were based. The rules now will be brought into conformity with this new legislation. |
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15-13-101 6/16/15 |
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48.02.060, sections 7 (1)(b) and (c), (3)(b), (4), (5), and 15, chapter 63, Laws of 2015 |
Credit for reinsurance model regulation. |
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15-15-132 7/17/15 |
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48.02.060, 48.18.120(2), 48.20.450, 48.46.200 |
Health plan special enrollment rules. |
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15-15-133 7/17/15 |
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Possible Rule Makings: In addition to the rules listed above, the commissioner continues the effort to update and clarify the code as well as implement recent legislation. In the period before January 31, 2016, subjects that may be considered for rule making in this effort include:
Annuity marketing and disclosure requirements
Statistical data reporting
Carrier submission of IRO decision data
Coordination of benefits
Disability insurance loss ratios
Discontinuation and renewal of health plan coverage
Discrimination in health plan design
Electronic filing of state specific reporting
Electronic notices and document delivery of insurance products
Essential health benefits-Pharmacy/formulary tiers
External review of adverse benefit decisions for health plans
Federal financial reform implementation
Federal health care reform implementation
Hearing rules revisions
Large group filing requirements
NAIC Model Act implementation (as needed, dependent on legislation)
Numeric recodification of chapter 284-43 WAC
OIC emergency powers
Pregnancy as a qualifying event
Prior authorization of health care claims form and process requirements
Repeal of requirement for multiple Washington attendees at continuing education trainings
Ride-sharing insurance coverage
Student health plans
Summary of health insurance benefits coverage
Trainee requirements for adjuster licensing
Use of vehicle history in rating
Wellness programs (health plans)
Mike Kriedler
