(1) To the extent funding is
appropriated in the operating budget for this purpose, the health
insurance partnership is established. The administrator shall be
responsible for the implementation and operation of the health
insurance partnership, directly or by contract. The
administrator shall offer premium subsidies to eligible
partnership participants under RCW 70.47A.040.
(2) Consistent with policies adopted by the board under
*section 59 of this act, the administrator shall, directly or by
contract:
(a) Establish and administer procedures for enrolling small
employers in the partnership, including publicizing the existence
of the partnership and disseminating information on enrollment,
and establishing rules related to minimum participation of
employees in small groups purchasing health insurance through the
partnership. Opportunities to publicize the program for outreach
and education of small employers on the value of insurance shall
explore the use of online employer guides. As a condition of
participating in the partnership, a small employer must agree to
establish a cafeteria plan under section 125 of the federal
internal revenue code that will enable employees to use pretax
dollars to pay their share of their health benefit plan premium.
The partnership shall provide technical assistance to small
employers for this purpose;
(b) Establish and administer procedures for health benefit
plan enrollment by employees of small employers during open
enrollment periods and outside of open enrollment periods upon
the occurrence of any qualifying event specified in the federal
health insurance portability and accountability act of 1996 or
applicable state law. Neither the employer nor the partnership
shall limit an employee's choice of coverage from among all the
health benefit plans offered;
(c) Establish and manage a system for the partnership to be
designated as the sponsor or administrator of a participating
small employer health benefit plan and to undertake the
obligations required of a plan administrator under federal law;
(d) Establish and manage a system of collecting and
transmitting to the applicable carriers all premium payments or
contributions made by or on behalf of partnership participants,
including employer contributions, automatic payroll deductions
for partnership participants, premium subsidy payments, and
contributions from philanthropies;
(e) Establish and manage a system for determining
eligibility for and making premium subsidy payments under chapter
259, Laws of 2007;
(f) Establish a mechanism to apply a surcharge to all health
benefit plans, which shall be used only to pay for administrative
and operational expenses of the partnership. The surcharge must
be applied uniformly to all health benefit plans offered through
the partnership and must be included in the premium for each
health benefit plan. Surcharges may not be used to pay any
premium assistance payments under this chapter;
(g) Design a schedule of premium subsidies that is based
upon gross family income, giving appropriate consideration to
family size and the ages of all family members based on a
benchmark health benefit plan designated by the board. The
amount of an eligible partnership participant's premium subsidy
shall be determined by applying a sliding scale subsidy schedule
with the percentage of premium similar to that developed for
subsidized basic health plan enrollees under RCW 70.47.060. The
subsidy shall be applied to the employee's premium obligation for
his or her health benefit plan, so that employees benefit
financially from any employer contribution to the cost of their
coverage through the partnership.
(3) The administrator may enter into interdepartmental
agreements with the office of the insurance commissioner, the
department of social and health services, and any other state
agencies necessary to implement this chapter.
[2007 c 259 § 58; 2006 c 255 § 3.]
NOTES:
*Reviser's note: Section 59 of this act was vetoed by the governor.
Severability -- Subheadings not law -- 2007 c 259: See notes following RCW 41.05.033.