For Consumers

Relating to health care benefit managers (R 2024-02)

E2SSB 5213 (Chapter 242, Laws of 2024) amends state law concerning the business practices of health care benefit managers (HCBMs) and pharmacy benefit managers (PBMs, which are a type of HCBM). The law’s provisions address, among other issues: PBM reimbursement to pharmacies for dispensing prescription drugs; consumer access to mail order and retail pharmacies; consumer out-of-pocket costs for prescription drugs; HCBM registration and reporting; and the Office of the Insurance Commissioner (OIC)’s oversight authority regarding HCBM registration and operations. Rulemaking is necessary to revise existing HCBM rules at Chapter 284-180 Washington Administrative Code (WAC) and to ensure that all affected entities understand their rights and obligations under the new law. 

In addition, rulemaking related to HCBMs is necessary to ensure that OIC can effectively oversee HCBMs in light of recent health care industry developments. OIC may revise provisions of Chapter 284-180 WAC or Chapter 284-170 WAC to accomplish this.

Public hearing on Nov. 26, 2024

  • When: November 26, 2024, at 11:00 a.m. Pacific Time Zone  
  • Where: Virtual Meeting
  • Register in advance for this meeting.

  • After registering, you will receive a confirmation email containing information about joining the meeting.

Proposed rulemaking filed Oct. 23, 2024

Second prepublication draft released Sept. 6, 2024

Prepublication draft released July 12, 2024

Notice to start rulemaking filed May 21, 2024