The Washington state Legislature passed multiple bills during the 2024 legislative session that will impact the insurance industry, modify the way the Office of the Insurance Commissioner (OIC) operates and task the OIC with leading new committees and workgroups.
Modernizing the Insurer Company Holding Company Act
We requested legislation that would adopt the National Association of Insurance Commissioner’s (NAIC) accreditation standards. The Legislature approved Senate Bill 6027. We’re now working through rulemaking to adopt uniform standards for group capital calculations and liquidity stress tests.
Protecting consumers from out-of-network health care services charges
Senate Bill 5986 protects consumers from surprise bills for ground ambulance emergency and nonemergency services, beginning in 2025. The law establishes a formula to determine the amount paid for out-of-network ambulance claims and directs our agency to conduct several studies over the coming years. The studies include a review of the reasonableness of the Medicare percentage for out-of-network ground ambulance rates, an actuarial analysis to cover treatment without transport services and a study of whether ambulatory services should be treated as essential health services provided by government agencies.
Learn more about ground ambulance services and surprise billing.
Increased oversight of health care benefit managers
Senate Bill 5213 strengthens our oversight of health care benefit managers (HCBMs). HCBMs carry out core functions of health care coverage, including reviewing prescription drug benefits, prior authorization and claims payment. The new law also includes reforms specific to pharmacy benefit managers (PBMs), removing spread pricing and giving consumers more choice in the pharmacy they choose to fill a prescription.
Current legislative studies
The Legislature directed our agency to study different aspects of the fully insured health plan and property and casualty market in Washington. We’ll provide recommendations and data to policymakers for future policy considerations.
Learn more about recent studies and reports published by the OIC.
Reviewing Washington’s essential health benefits
The Legislature passed Senate Bill 5338 during the 2023 session. It directs our agency to update the states’ essential health benefits (EHB). We reviewed Washington's EHB benchmark plan, which sets the minimum services that individual and small group health plans must cover. We looked at the potential impacts on qualified health plan design, actuarial values and premium rates if certain services were included. We delivered the initial report in December 2023. Our final proposal submitted to the Centers for Medicare and Medicaid Services (CMS) in April 2024 would add coverage of hearing aids and associated services, human donor milk and artificial insemination to our states’ benchmark plan.
Learn more about the essential health benefits benchmark plan.
Affordability of healthcare
In collaboration with the Office of the Attorney General, we’re studying approaches to improve health care affordability and we delivered a preliminary report on health care affordability on December 1, 2023. A final report due Aug. 1, 2024 will include actuarial and economic analyses of several health care affordability policy options
Learn more about health care cost affordability.
Developing strategies to reduce or remove cost-sharing for maternal support services and postpartum care
The Legislature passed Senate Bill 5581 during the 2023 session, directing our agency to develop strategies to reduce or remove cost-sharing for maternal support services and postpartum care. A legislative report is due July 1, 2024.
Essential worker health benefits feasibility
In the 2024 supplemental operating budget, the Legislature directed the Department of Social and Health Services (DSHS) to develop a program to improve health care coverage for nursing home employees in Washington. In the next phase of this effort, we’re doing a feasibility analysis of expanding or modifying the program developed by DSHS to include additional groups of essential workers whose employers receive public funding to provide direct services to vulnerable populations. A report to the Legislature is due June 30, 2025.
Current legislative committees and workgroups
The Washington state Legislature tasks the Office of the Insurance Commissioner to lead committees and workgroups to review proposed or existing laws and rules to ensure they address the critical needs of our state.
Learn more about recent committees and workgroups.
Study on the insurance market for housing providers that receive housing trust fund resources
House Bill 2329 tasked our agency with studying the property and liability coverages available to housing providers receiving housing trust fund resources and serving extremely low-income households. We’re consulting with housing providers that serve extremely low-income households, authorized insurers, unauthorized insurers, providers of nonprofit insurance services, risk-sharing pools for public housing authorities and nongovernmental owners of affordable housing properties, risk retention groups, relevant association groups including the surplus lines association of Washington, as well as relevant state agencies including the Department of Enterprise Services (DES), the Office of Risk Management (ORM), and the Department of Commerce (DOC). A report to the Legislature is due December 31, 2024.
Learn more about the supportive housing study.
Palliative care benefit workgroup
Senate Bill 5936 directed the OIC and the Health Care Authority (HCA) to create a workgroup that will design a palliative care benefit and payment model for fully insured health plans. A report to the Legislature is due November 1, 2025.
Adult family home liability workgroup
In the 2024 supplemental operating budget, we were tasked with chairing an adult family home liability insurance workgroup. The workgroup will review the availability and cost of liability insurance for adult family homes, identify obstacles or underwriting restrictions and make policy recommendations to improve access to liability insurance coverage for adult family homes.
A preliminary report to the Legislature is due December 31, 2024 with a final deport due June 30, 2025.
Learn more about the adult family homes liability workgroup.
Malpractice insurance for community health care providers operating in state jails and prisons
In the 2024 supplemental operating budget, the Legislature asked us to study how to increase the availability of health care malpractice liability coverage or other liability protection options for community-based health care providers who deliver transition of care services to incarcerated individuals. A report to the Legislature is due December 31, 2024.
Learn more about the malpractice insurance study.
Follow our rulemaking activity
We manage an ongoing public rulemaking development process to write regulations that provide guidance to consumers, insurers, carriers, producers and other regulated entities.