SHB 2467 -
By Committee on Health Care
Strike everything after the enacting clause and insert the following:
"Sec. 1 RCW 43.71.065 and 2012 c 87 s 8 are each amended to read
as follows:
(1) The board shall certify a plan as a qualified health plan to be
offered through the exchange if the plan is determined by the:
(a) Insurance commissioner to meet the requirements of Title 48 RCW
and rules adopted by the commissioner pursuant to chapter 34.05 RCW to
implement the requirements of Title 48 RCW;
(b) Board to meet the requirements of the affordable care act for
certification as a qualified health plan; and
(c) Board to include tribal clinics and urban Indian clinics as
essential community providers in the plan's provider network consistent
with federal law. If consistent with federal law, integrated delivery
systems shall be exempt from the requirement to include essential
community providers in the provider network.
(2)(a) For plan years 2014 and 2015, consistent with section 1311
of P.L. 111-148 of 2010, as amended, the board shall allow stand-alone
dental plans to offer coverage in the exchange ((beginning January 1,
2014)). Dental benefits offered in the exchange must be offered and
priced separately to assure transparency for consumers.
(b) For plan years 2016 and higher, consistent with section 1311 of
P.L. 111-148 of 2010, as amended, the board shall allow pediatric oral
services to be offered in the exchange only through a stand-alone
dental plan or a separately rated stand-alone dental plan that is
offered in conjunction with an issuer's qualified health plan.
(3) The board may permit direct primary care medical home plans,
consistent with section 1301 of P.L. 111-148 of 2010, as amended, to be
offered in the exchange beginning January 1, 2014.
(4) Upon request by the board, a state agency shall provide
information to the board for its use in determining if the requirements
under subsection (1)(b) or (c) of this section have been met. Unless
the agency and the board agree to a later date, the agency shall
provide the information within sixty days of the request. The exchange
shall reimburse the agency for the cost of compiling and providing the
requested information within one hundred eighty days of its receipt.
(5) A decision by the board denying a request to certify or
recertify a plan as a qualified health plan may be appealed according
to procedures adopted by the board."
SHB 2467 -
By Committee on Health Care
On page 1, line 2 of the title, after "exchange;" strike the remainder of the title and insert "and amending RCW 43.71.065."
EFFECT: Specifies the dental benefits are the pediatric oral
services required under federal law.
Allows pediatric oral services to be offered through a stand-alone
plan or a separately rated stand-alone plan offered in conjunction with
the health insurance plan.