(1) Each health carrier offering a health benefit
plan shall submit to the commissioner on or before April 1st of
each year as part of the additional data statement or as a
supplemental data statement the following information:
(a) The following information for the preceding year that is
derived from the carrier's annual statement, including the
exhibit of premiums, enrollments, and utilization for its
Washington business, and the additional data to the annual
statement. The information must be shown for five categories,
total, individual contracts, small group contracts, and large
group contracts (excluding government contracts), and government
contracts:
(i) The total number of members;
(ii) The total amount of revenue;
(iii) The total amount of hospital and medical payments;
(iv) The medical loss ratio, that is computed by dividing
the total amount of hospital and medical payments by the total
amount of revenues;
(v) The average amount of premiums per member per month; and
(vi) The percentage change in the average premium per member
per month, measured from the previous year; and
(b) The following aggregate financial information for the
preceding year that is derived from the carrier's annual
statement:
(i) The total amount of claim adjustment expenses;
(ii) The total amount of general administrative expenses,
including identification of the five largest nonmedical
administrative expenses and the assessment against the carrier
for the Washington state health insurance pool;
(iii) The total amount of the reserves maintained for unpaid
claims;
(iv) The total net underwriting gain or loss;
(v) The carrier's net income after taxes;
(vi) Dividends to stockholders;
(vii) The net change in capital and surplus from the prior
year; and
(viii) The total amount of the capital and surplus.
(2) A carrier shall electronically submit the information
described in subsection (1) of this section in a format and
according to instructions prescribed by the commissioner.
(3) The commissioner shall make the information reported
under this section available to the public in a format that
allows comparison among carriers through a searchable public web
site on the internet.
(4) For the purposes of licensed disability insurers, the
commissioner shall work collaboratively with insurers to develop
an additional or supplemental data statement that utilizes to the
maximum extent possible information from the annual statement
forms that are currently filed by these entities.
[2006 c 104 § 2.]
NOTES:
Intent -- 2006 c 104: "Health carriers are currently required
to file statutory annual statements with the office of the
insurance commissioner or the national association of insurance
commissioners. These annual statements are extensive and contain
a significant amount of financial information. These annual
statements are public documents; however, such financial
information can be complex and difficult to read and understand.
It is the intent of this act to provide a method of
reporting certain financial data in a user friendly format. It
is also the intent of this act, to the extent possible, to
utilize existing information from the annual statements when
developing the additional or supplemental data statement required
by this act, and to the extent possible, avoid imposing
additional reporting requirements that have the unintended
consequences of unduly increasing administrative costs for
carriers required to file such information." [2006 c 104 § 1.]