(1) To the extent funding is
appropriated in the operating budget for this purpose or obtained
through federal resources, 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 RCW 70.47A.110, 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;
(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. Except to the extent authorized in RCW 70.47A.110(1)(e), neither the employer nor the partnership shall
limit an employee's choice of coverage from among the health
benefit plans offered through the partnership;
(c) 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;
(d) Establish and manage a system for determining
eligibility for and making premium subsidy payments under chapter
259, Laws of 2007;
(e) Establish a mechanism to apply a surcharge to each
health benefit plan purchased through the partnership, 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 purchased through the
partnership. Any surcharge amount may be added to the premium,
but shall not be considered part of the small group community
rate, and shall be applied only to the coverage purchased through
the partnership. Surcharges may not be used to pay any premium
assistance payments under this chapter. The surcharge shall
reflect administrative and operational expenses remaining after
any appropriation provided by the legislature or resources
received from the federal government to support administrative or
operational expenses of the partnership during the year the
surcharge is assessed;
(f) 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.
[2011 c 287 § 2; 2009 c 257 § 1; 2008 c 143 § 2; 2007 c 259 § 58; 2006 c 255 § 3.]
NOTES:
Severability -- Subheadings not law -- 2007 c 259: See notes following RCW 41.05.033.