(1) Unless the
context clearly requires otherwise, the definitions in this
subsection apply throughout this section.
(a) "Disabled employee" means a person eligible to receive a
disability retirement allowance from the Washington law
enforcement officers' and firefighters' retirement system plan 2
and the public employees' retirement system.
(b) "Health plan" means a contract, policy, fund, trust, or
other program established jointly or individually by a county,
municipality, or other political subdivision of the state that
provides for all or a part of hospitalization or medical aid for
its employees and their dependents under RCW 41.04.180.
(c) "Retired employee" means a public employee meeting the
retirement eligibility, years of service requirements, and other
criteria of the Washington law enforcement officers' and
firefighters' retirement system plan 2 and the public employees'
retirement system.
(2) A county, municipality, or other political subdivision
that provides a health plan for its employees shall permit
retired and disabled employees and their dependents to continue participation
in a plan subject to the exceptions, limitations, and conditions
set forth in this section. However, this section does not apply
to a county, municipality, or other political subdivision
participating in an insurance program administered under chapter 41.05 RCW if retired and disabled employees and their dependents of the participating
county, municipality, or other political subdivision are covered
under an insurance program administered under chapter 41.05 RCW.
Nothing in this subsection or chapter 319, Laws of 2002 precludes
the local government employer from offering retired or disabled employees a health plan with a benefit structure,
copayment, deductible, coinsurance, lifetime benefit maximum, and
other plan features which differ from those offered through a
health plan provided to active employees. Further, nothing in
this subsection precludes a local government employer from
joining with other public agency employers, including
interjurisdictional benefit pools and multi-employer associations
or consortiums, to fulfill its obligations under chapter 319,
Laws of 2002.
(3) A county, municipality, or other political subdivision
has full authority to require a person who requests continued
participation in a health plan under subsection (2) of this
section to pay the full cost of such participation, including any
amounts necessary for administration. However, this subsection
does not require an employer who is currently paying for all or
part of a health plan for its retired and disabled employees to discontinue those payments.
(4) Payments for continued participation in a former
employer's health plan may be assigned to the underwriter of the
health plan from public pension benefits or may be paid to the
former employer, as determined by the former employer, so that an
underwriter of the health plan that is an insurance company,
health care service contractor, or health maintenance
organization is not required to accept individual payments from
persons continuing participation in the employer's health plan.
(5) After an initial open enrollment period of ninety days
after January 1, 2003, an employer may not be required to permit
a person to continue participation in the health plan if the
person is responsible for a lapse in coverage under the plan. In
addition, an employer may not be required to permit a person to
continue participation in the employer's health plan if the
employer offered continued participation in a health plan that
meets the requirements of chapter 319, Laws of 2002.
(6) If a person continuing participation in the former
employer's health plan has medical coverage available through
another employer, the medical coverage of the other employer is
the primary coverage for purposes of coordination of benefits as
provided for in the former employer's health plan.
(7) If a person's continued participation in a health plan
was permitted because of the person's relationship to a retired
or disabled employee of the employer providing the health plan and
the retired or disabled employee dies, then that person is permitted to continue
participation in the health plan for a period of not more than
six months after the death of the retired or disabled employee. However, the employer providing the health
plan may permit continued participation beyond that time period.
(8) An employer may offer one or more health plans different
from that provided for active employees and designed to meet the
needs of persons requesting continued participation in the
employer's health plan. An employer, in designing or offering
continued participation in a health plan, may utilize terms or
conditions necessary to administer the plan to the extent the
terms and conditions do not conflict with this section.
(9) If an employer changes the underwriter of a health plan,
the replaced underwriter has no further responsibility or
obligation to persons who continued participation in a health
plan of the replaced underwriter. However, the employer shall
permit those persons to participate in any new health plan.
(10) The benefits granted under this section are not
considered a matter of contractual right. Should the
legislature, a county, municipality, or other political
subdivision of the state revoke or change any benefits granted
under this section, an affected person is not entitled to receive
the benefits as a matter of contractual right.
(11) This section does not affect any health plan contained
in a collective bargaining agreement in existence as of January
1, 2003. However, any plan contained in future collective
bargaining agreements shall conform to this section. In
addition, this section does not affect any health plan contract
or policy in existence as of January 1, 2003. However, any
renewal of the contract or policy shall conform to this section.
(12) Counties, municipalities, and other political
subdivisions that make a documented good faith effort to comply
with the provisions of subsections (2) through (11) of this
section and are unable to provide access to a fully insured group
health benefit plan are discharged from any obligations under
subsections (2) through (11) of this section but shall assist disabled employees and retired employees in applying for health
insurance. Assistance may include developing and distributing
standardized information on the availability and cost of
individual health benefit plans, application packages, and health
benefit fairs.
(13) The office of the insurance commissioner shall make
available to counties, municipalities, and other political
subdivisions information regarding individual health benefit
plans, including a list of carriers offering individual coverage,
the rates charged, and how to apply for coverage.
[2004 c 173 § 1; 2002 c 319 § 2.]
NOTES:
Effective date -- 2004 c 173: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [March 26, 2004]." [2004 c 173 § 3.]
Intent -- 2002 c 319: "It is the intent of this act to provide retirees of local government employers access to health care benefits. It is also the intent of this act that local government employers be allowed the flexibility to design programs to meet the health care needs of their retirees and that the local government employer be able to recover all costs associated with providing retirees access to health benefits." [2002 c 319 § 1.]