reglab/statecodes huggingface dataset:
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.055 - Public employees' benefits board—Members.

RCW 41.05.055
Public employees' benefits board—Members.
(1) The public employees' benefits board is created within the authority. The function of the public employees' benefits board is to design and approve insurance benefit plans for employees and to establish eligibility criteria for participation in insurance benefit plans.
(2) The public employees' benefits board shall be composed of nine members through December 31, 2019, and of eight members thereafter, appointed by the governor as follows:
(a) Two representatives of state employees, one of whom shall represent an employee union certified as exclusive representative of at least one bargaining unit of classified employees, and one of whom is retired, is covered by a program under the jurisdiction of the public employees' benefits board, and represents an organized group of retired public employees;
(b) Through December 31, 2019, two representatives of school district employees, one of whom shall represent an association of school employees as a nonvoting member, and one of whom is retired, and represents an organized group of retired school employees. Thereafter, and only while retired school employees are served by the public employees' benefits board, only the retired representative shall serve on the public employees' benefits board;
(c) Four members with experience in health benefit management and cost containment, one of whom shall be a nonvoting member; and
(d) The director.
(3) The governor shall appoint the initial members of the public employees' benefits board to staggered terms not to exceed four years. Members appointed thereafter shall serve two-year terms. Members of the public employees' benefits board shall be compensated in accordance with RCW 43.03.250 and shall be reimbursed for their travel expenses while on official business in accordance with RCW 43.03.050 and 43.03.060. The public employees' benefits board shall prescribe rules for the conduct of its business. The director shall serve as chair of the public employees' benefits board. Meetings of the public employees' benefits board shall be at the call of the chair.
[ 2018 c 260 § 11; 2017 3rd sp.s. c 13 § 807; 2009 c 537 § 6; 1995 1st sp.s. c 6 § 4; 1994 c 36 § 1; 1993 c 492 § 217; 1989 c 324 § 1; 1988 c 107 § 7.]
NOTES:
Intent—2017 3rd sp.s. c 13: See note following RCW 28A.150.410.
Effective date—2009 c 537: See note following RCW 41.05.008.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
Effective date—1994 c 36: "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 shall take effect immediately [March 21, 1994]." [ 1994 c 36 § 2.]
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.066 - Domestic partner benefits.

RCW 41.05.066
Domestic partner benefits.
A certificate of domestic partnership qualified under the provisions of RCW 26.60.030 shall be recognized as evidence of a state registered domestic partnership fulfilling all necessary eligibility criteria for the partner of the public employee to receive benefits. Nothing in this section affects the requirements of domestic partners to complete documentation related to federal tax status that may currently be required by the board for public employees choosing to make premium payments on a pretax basis.
[ 2023 c 51 § 11; 2018 c 260 § 13; 2015 c 116 § 4; 2007 c 156 § 9.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.068 - Federal employer incentive program—Authority to participate.

RCW 41.05.068
Federal employer incentive program—Authority to participate.
The authority may participate as an employer-sponsored program established in section 1860D-22 of the medicare prescription drug, improvement, and modernization act of 2003, P.L. 108-173 et seq., to receive federal employer subsidy funds for continuing to provide retired employee health coverage, including a pharmacy benefit. The director, in consultation with the office of financial management, shall evaluate participation in the employer incentive program, including but not limited to any necessary program changes to meet the eligibility requirements that employer-sponsored retiree health coverage provide prescription drug coverage at least equal to the actuarial value of standard prescription drug coverage under medicare part D. Any employer subsidy moneys received from participation in the federal employer incentive program shall be deposited in the state general fund.
[ 2023 c 51 § 12; 2009 c 479 § 25; 2005 c 195 § 2.]
NOTES:
Effective date—2009 c 479: See note following RCW 2.56.030.
Effective date—2005 c 195: See note following RCW 41.05.065.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.074 - Public employees—Prior authorization standards and criteria—Health plan requirements—Definitions.

RCW 41.05.074
Public employees—Prior authorization standards and criteria—Health plan requirements—Definitions.
(1) A health plan offered to public employees and their covered dependents under this chapter that imposes different prior authorization standards and criteria for a covered service among tiers of contracting providers of the same licensed profession in the same health plan shall inform an enrollee which tier an individual provider or group of providers is in by posting the information on its website in a manner accessible to both enrollees and providers.
(2) The health plan may not require prior authorization for an evaluation and management visit or an initial treatment visit with a contracting provider in a new episode of chiropractic, physical therapy, occupational therapy, acupuncture and Eastern medicine, massage therapy, or speech and hearing therapies. Notwithstanding RCW 48.43.515(5) this section may not be interpreted to limit the ability of a health plan to require a referral or prescription for the therapies listed in this section.
(3) The health care authority shall post on its website and provide upon the request of a covered person or contracting provider any prior authorization standards, criteria, or information the health plan uses for medical necessity decisions.
(4) A health care provider with whom the administrator of the health plan consults regarding a decision to deny, limit, or terminate a person's covered health care services must hold a license, certification, or registration, in good standing and must be in the same or related health field as the health care provider being reviewed or of a specialty whose practice entails the same or similar covered health care service.
(5) The health plan may not require a provider to provide a discount from usual and customary rates for health care services not covered under the health plan, policy, or other agreement, to which the provider is a party.
(6) For purposes of this section:
(a) "New episode of care" means treatment for a new or recurrent condition for which the enrollee has not been treated by the provider within the previous ninety days and is not currently undergoing any active treatment.
(b) "Contracting provider" does not include providers employed within an integrated delivery system operated by a carrier licensed under chapter 48.44 or 48.46 RCW.
[ 2019 c 308 § 20; 2015 c 251 § 1.]
NOTES:
Findings—2019 c 308: See note following RCW 18.06.010.
Effective date—2015 c 251: "This act takes effect January 1, 2017." [ 2015 c 251 § 3.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.083 - Employer groups—Participation in insurance plans and contracts—Termination of agreement—Payment for retired or disabled employees.

RCW 41.05.083
Employer groups—Participation in insurance plans and contracts—Termination of agreement—Payment for retired or disabled employees.
(1) Employer groups that enter into a contractual agreement with the authority after May 4, 2023, and whose contractual agreement with the authority is subsequently terminated, shall make a one-time payment as calculated in subsection (2) of this section to the authority for each of the employer group's retired or disabled employees who continue their participation in insurance plans and contracts under RCW 41.05.080(1)(a)(ii).
(2) For each of the employer group's retired or disabled employees who will be continuing their participation, the authority shall determine the one-time payment amount by calculating the difference in cost between the rate charged to retired or disabled employees under RCW 41.05.080(2) and the actuarially determined value of the medical benefits for retired and disabled employees who are not eligible for parts A and B of medicare, and then multiplying that difference by the number of months until the retired or disabled employee would become eligible for medicare.
(3) Employer groups shall not be entitled to any refund of the amount paid to the authority under this section.
[ 2023 c 312 § 2.]
NOTES:
Effective date—2023 c 312: "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 [May 4, 2023]." [ 2023 c 312 § 4.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.085 - Retired state employee and retired or disabled school employee health insurance subsidy.

RCW 41.05.085
Retired state employee and retired or disabled school employee health insurance subsidy.
(1) Beginning with the appropriations act for the 2005-2007 biennium, the legislature shall establish as part of both the state employees' and the school and educational service district employees' insurance benefit allocation the portion of the allocation to be used to provide a prescription drug subsidy to reduce the health care insurance premiums charged to retired or disabled school district and educational service district employees, or retired state employees, who are eligible for parts A and B of medicare. The legislature may also establish a separate health care subsidy to reduce insurance premiums charged to individuals who select a medicare supplemental insurance policy option established in RCW 41.05.195.
(2) The amount of any premium reduction shall be established by the public employees' benefits board. The amount established shall not result in a premium reduction of more than fifty percent, except as provided in subsection (3) of this section. The public employees' benefits board may also determine the amount of any subsidy to be available to spouses and dependents.
(3) The amount of the premium reduction in subsection (2) of this section may exceed fifty percent, if the director, in consultation with the office of financial management, determines that it is necessary in order to meet eligibility requirements to participate in the federal employer incentive program as provided in RCW 41.05.068.
[ 2018 c 260 § 16; 2005 c 195 § 3; 1994 c 153 § 8.]
NOTES:
Effective date—2005 c 195: See note following RCW 41.05.065.
Intent—Effective dates—1994 c 153: See notes following RCW 41.05.011.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.095 - Coverage for dependents under the age of twenty-six.

RCW 41.05.095
Coverage for dependents under the age of twenty-six.
(1) Any plan offered to employees under this chapter must offer each employee the option of covering any dependent of the employee under the age of twenty-six.
(2) Coverage must terminate upon attainment of age twenty-six except in the case of a child who is and continues to be both (a) incapable of self-sustaining employment by reason of a developmental or physical disability and (b) chiefly dependent upon the employee for support and maintenance, provided proof of such incapacity and dependency is furnished by the employee within sixty days of the child's attainment of age twenty-six and subsequently as may be required by the authority, but not more frequently than annually after the two-year period following the child's attainment of age twenty-six.
[ 2020 c 274 § 20; 2015 c 116 § 6; 2010 c 94 § 11; 2007 c 259 § 18.]
NOTES:
Purpose—2010 c 94: See note following RCW 44.04.280.
Effective date—2007 c 259 §§ 18-22: "Sections 18 through 22 of this act take effect January 1, 2009." [ 2007 c 259 § 72.]
Subheadings not law—2007 c 259: See note following RCW 7.70.060.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.100 - Chapter not applicable to certain employees of Cooperative Extension Service.

RCW 41.05.100
Chapter not applicable to certain employees of Cooperative Extension Service.
The provisions of this chapter shall not be applicable to any employee of the Washington State University Cooperative Extension Service who holds a federal civil service appointment and is thereby eligible for insurance coverage under the regulations of the United States Department of Agriculture and the United States Civil Service Commission, and which employee elects participation in the federal programs in lieu of the programs established pursuant to this chapter. Such election may be made only once.
[ 1979 ex.s. c 9 § 1.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.130 - State health care authority administrative account—School employees' insurance administrative account.

RCW 41.05.130
State health care authority administrative account—School employees' insurance administrative account.
(1) The state health care authority administrative account is hereby created in the state treasury. Moneys in the account, including unanticipated revenues under RCW 43.79.270, may be spent only after appropriation by statute, and may be used only for operating expenses of the authority.
(2) The school employees' insurance administrative account is hereby created in the state treasury. Moneys in the account may be used for operating, contracting, and other administrative expenses of the authority in administration of the school employees insurance program, including reimbursement of the state health care authority administrative account for initial operating expenses of the authority associated with chapter 13, Laws of 2017 3rd sp. sess.
[ 2023 c 51 § 13; 2017 3rd sp.s. c 13 § 810; 2014 c 221 § 914; 1988 c 107 § 11.]
NOTES:
Intent—2017 3rd sp.s. c 13: See note following RCW 28A.150.410.
Effective date—2014 c 221: See note following RCW 28A.710.260.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.160 - Rules.

RCW 41.05.160
Rules.
The director may promulgate and adopt rules consistent with this chapter to carry out the purposes of this chapter. All rules shall be adopted in accordance with chapter 34.05 RCW.
[ 2023 c 51 § 14; 1988 c 107 § 15.]
NOTES:
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.165 - Rules—Insurance benefit reimbursement.

RCW 41.05.165
Rules—Insurance benefit reimbursement.
The authority shall adopt rules that provide for members of the legislature who choose reimbursement under RCW 44.04.230 in lieu of insurance benefits under this chapter.
[ 1998 c 62 § 2.]
NOTES:
Effective date—1998 c 62: See note following RCW 44.04.230.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.170 - Neurodevelopmental therapies—Employer-sponsored group contracts.

RCW 41.05.170
Neurodevelopmental therapies—Employer-sponsored group contracts.
(1) Each health plan offered to public employees and their covered dependents under this chapter which is not subject to the provisions of Title 48 RCW and is established or renewed on or after twelve months after July 23, 1989, shall include coverage for neurodevelopmental therapies for covered individuals age six and under.
(2) Benefits provided under this section shall cover the services of those authorized to deliver occupational therapy, speech therapy, and physical therapy. Benefits shall be payable only where the services have been delivered pursuant to the referral and periodic review of a holder of a license issued pursuant to chapter 18.71 or 18.57 RCW or where covered services have been rendered by such licensee. Nothing in this section shall preclude a self-funded plan authorized under this chapter from negotiating rates with qualified providers.
(3) Benefits provided under this section shall be for medically necessary services as determined by the self-funded plan authorized under this chapter. Benefits shall be payable for services for the maintenance of a covered individual in cases where significant deterioration in the patient's condition would result without the service. Benefits shall be payable to restore and improve function.
(4) It is the intent of this section that the state, as an employer providing comprehensive health coverage including the benefits required by this section, retains the authority to design and employ utilization and cost controls. Therefore, benefits delivered under this section may be subject to contractual provisions regarding deductible amounts and/or copayments established by the self-funded plan authorized under this chapter. Benefits provided under this section may be subject to standard waiting periods for preexisting conditions, and may be subject to the submission of written treatment plans.
(5) In recognition of the intent expressed in subsection (4) of this section, benefits provided under this section may be subject to contractual provisions establishing annual and/or lifetime benefit limits. Such limits may define the total dollar benefits available, or may limit the number of services delivered as established by the self-funded plan authorized under this chapter.
[ 1989 c 345 § 4.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.175 - Prescribed, self-administered anticancer medication.

RCW 41.05.175
Prescribed, self-administered anticancer medication.
(1) Each health plan offered to public employees and their covered dependents under this chapter, including those subject to the provision of Title 48 RCW, and is issued or renewed beginning January 1, 2012, and provides coverage for cancer chemotherapy treatment must provide coverage for prescribed, self-administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis at least comparable to cancer chemotherapy medications administered by a health care provider or facility as defined in *RCW 48.43.005 (25) and (26).
(2) Nothing in this section may be interpreted to prohibit a health plan from administering a formulary or preferred drug list, requiring prior authorization, or imposing other appropriate utilization controls in approving coverage for any chemotherapy.
[ 2020 c 18 § 13; 2011 c 159 § 2.]
NOTES:
*Reviser's note: RCW 48.43.005 was alphabetized pursuant to RCW 1.08.015(2)(k), changing subsections (25) and (26) to subsections (27) and (28).
Explanatory statement—2020 c 18: See note following RCW 43.79A.040.
Findings—2011 c 159: "The Washington state legislature finds that for cancer patients, there is an inequity in how much they have to pay toward the cost of a self-administered oral medication and how much they have to pay for an intravenous product that is administered in a physician's office or clinic. The legislature further finds that when these inequities exist, patients' access to medically necessary, appropriate treatment is often unfairly restricted. The legislature also acknowledges that self-administered chemotherapy is the only treatment for some types of cancer where there is no intravenous alternative. The legislature declares that in order to reduce the out-of-pocket costs for cancer patients whose diagnosis requires treatment through self-administered anticancer medication, the cost-sharing responsibilities for these patients must be on a basis at least comparable to those of patients receiving intravenously administered anticancer medication." [ 2011 c 159 § 1.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.177 - Prostate cancer screening—Required coverage.

RCW 41.05.177
Prostate cancer screening—Required coverage.
(1) Each plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is issued or renewed after December 31, 2006, shall provide coverage for prostate cancer screening, provided that the screening is delivered upon the recommendation of the patient's physician, advanced registered nurse practitioner, or physician assistant.
(2) This section shall not be construed to prevent the application of standard policy provisions applicable to other benefits, such as deductible or copayment provisions. This section does not limit the authority of the health care authority to negotiate rates and contract with specific providers for the delivery of prostate cancer screening services. This section shall not apply to medicare supplemental policies or supplemental contracts covering a specified disease or other limited benefits.
[ 2006 c 367 § 1.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.180 - Mammograms—Insurance coverage.

RCW 41.05.180
Mammograms—Insurance coverage.
Each health plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is established or renewed after January 1, 1990, and that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or advanced registered nurse practitioner as authorized by the *nursing care quality assurance commission pursuant to chapter 18.79 RCW or physician assistant pursuant to chapter 18.71A RCW.
This section shall not be construed to prevent the application of standard health plan provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of the state health care authority to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.
[ 1994 sp.s. c 9 § 725; 1989 c 338 § 5.]
NOTES:
*Reviser's note: The reference to "nursing care quality assurance commission" was changed to "board of nursing" by 2023 c 123.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.183 - General anesthesia services for dental procedures—Public employee benefit plans.

RCW 41.05.183
General anesthesia services for dental procedures—Public employee benefit plans.
(1) Each employee benefit plan offered to public employees that provides coverage for hospital, medical, or ambulatory surgery center services must cover general anesthesia services and related facility charges in conjunction with any dental procedure performed in a hospital or ambulatory surgical center if such anesthesia services and related facility charges are medically necessary because the covered person:
(a) Is under the age of seven, or physically or developmentally disabled, with a dental condition that cannot be safely and effectively treated in a dental office; or
(b) Has a medical condition that the person's physician determines would place the person at undue risk if the dental procedure were performed in a dental office. The procedure must be approved by the person's physician.
(2) Each employee benefit plan offered to public employees that provides coverage for dental services must cover general anesthesia services in conjunction with any covered dental procedure performed in a dental office if the general anesthesia services are medically necessary because the covered person is under the age of seven or physically or developmentally disabled.
(3) This section does not prohibit an employee benefit plan from:
(a) Applying cost-sharing requirements, maximum annual benefit limitations, and prior authorization requirements to the services required under this section; or
(b) Covering only those services performed by a health care provider, or in a health care facility, that is part of its provider network; nor does it limit the authority in negotiating rates and contracts with specific providers.
(4) This section does not apply to medicare supplement policies, or supplemental contracts covering a specified disease or other limited benefits.
(5) For the purpose of this section, "general anesthesia services" means services to induce a state of unconsciousness accompanied by a loss of protective reflexes, including the ability to maintain an airway independently and respond purposefully to physical stimulation or verbal command.
(6) This section applies to employee benefit plans issued or renewed on or after January 1, 2002.
[ 2001 c 321 § 1.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.185 - Diabetes benefits—State purchased health care.

RCW 41.05.185
Diabetes benefits—State purchased health care.
The legislature finds that diabetes imposes a significant health risk and tremendous financial burden on the citizens and government of the state of Washington, and that access to the medically accepted standards of care for diabetes, its treatment and supplies, and self-management training and education is crucial to prevent or delay the short and long-term complications of diabetes and its attendant costs.
(1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
(a) "Person with diabetes" means a person diagnosed by a health care provider as having insulin using diabetes, noninsulin using diabetes, or elevated blood glucose levels induced by pregnancy; and
(b) "Health care provider" means a health care provider as defined in RCW 48.43.005.
(2) All state purchased health care purchased or renewed after January 1, 1998, except the basic health plan described in chapter 70.47 RCW, shall provide benefits for at least the following services and supplies for persons with diabetes:
(a) For state purchased health care that includes coverage for pharmacy services, appropriate and medically necessary equipment and supplies, as prescribed by a health care provider, that includes but is not limited to insulin, syringes, injection aids, blood glucose monitors, test strips for blood glucose monitors, visual reading and urine test strips, insulin pumps and accessories to the pumps, insulin infusion devices, prescriptive oral agents for controlling blood sugar levels, foot care appliances for prevention of complications associated with diabetes, and glucagon emergency kits; and
(b) For all state purchased health care, outpatient self-management training and education, including medical nutrition therapy, as ordered by the health care provider. Diabetes outpatient self-management training and education may be provided only by health care providers with expertise in diabetes. Nothing in this section prevents any state agency purchasing health care according to this section from restricting patients to seeing only health care providers who have signed participating provider agreements with that state agency or an insuring entity under contract with that state agency.
(3) Coverage required under this section may be subject to customary cost-sharing provisions established for all other similar services or supplies within a policy.
(4) Health care coverage may not be reduced or eliminated due to this section.
(5) Services required under this section shall be covered when deemed medically necessary by the medical director, or his or her designee, subject to any referral and formulary requirements.
[ 1997 c 276 § 1.]
NOTES:
Effective date—1997 c 276: "This act takes effect January 1, 1998." [ 1997 c 276 § 6.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.188 - Eosinophilic gastrointestinal associated disorder—Elemental formula.

RCW 41.05.188
Eosinophilic gastrointestinal associated disorder—Elemental formula.
(1) Each health benefit plan offered to public employees and their covered dependents under this chapter that is not subject to chapter 48.43 RCW and that is issued or renewed after December 31, 2015, must offer benefits or coverage for medically necessary elemental formula, regardless of delivery method, when a licensed physician or other health care provider with prescriptive authority:
(a) Diagnoses a patient with an eosinophilic gastrointestinal associated disorder; and
(b) Orders and supervises the use of the elemental formula.
(2) Nothing in this section prohibits a health benefit plan from requiring prior authorization or imposing other appropriate utilization controls in approving coverage for medically necessary elemental formula.
[ 2014 c 115 § 1.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.195 - Medicare supplemental insurance policies.

RCW 41.05.195
Medicare supplemental insurance policies.
Notwithstanding any other provisions of this chapter or rules or procedures adopted by the authority, the authority shall make available to retired or disabled employees who are enrolled in parts A and B of medicare one or more medicare supplemental insurance policies that conform to the requirements of chapter 48.66 RCW. The policies shall be chosen in consultation with the public employees' benefits board. These policies shall be made available to retired or disabled state employees; retired or disabled school district employees; retired employees of employer groups eligible for coverage available under the authority; or surviving spouses or surviving state registered domestic partners of emergency service personnel killed in the line of duty.
[ 2023 c 13 § 6; 2015 c 116 § 7; 2009 c 523 § 2; 2007 c 114 § 7; 2005 c 47 § 1; 1993 c 492 § 222.]
NOTES:
Finding—Intent—2023 c 13: See note following RCW 41.05.011.
Intent—Effective date—2007 c 114: See notes following RCW 41.05.011.
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.197 - Medicare supplemental insurance policies.

RCW 41.05.197
Medicare supplemental insurance policies.
The medicare supplemental insurance policies authorized under RCW 41.05.195 shall be made available to any resident of the state who:
(1) Is enrolled in parts A and B of medicare; and
(2) Is not eligible to purchase coverage as a retired or disabled employee under RCW 41.05.195. State residents purchasing a medicare supplemental insurance policy under this section shall be required to pay the full cost of any such policy.
[ 2005 c 47 § 2; 1993 c 492 § 223.]
NOTES:
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.220 - Community and migrant health centers—Maternity health care centers—People of color—Underserved populations.

RCW 41.05.220
Community and migrant health centers—Maternity health care centers—People of color—Underserved populations.
(1) State general funds appropriated to the department of health for the purposes of funding community health centers to provide primary health and dental care services, migrant health services, and maternity health care services shall be transferred to the state health care authority. Any related administrative funds expended by the department of health for this purpose shall also be transferred to the health care authority. The health care authority shall exclusively expend these funds through contracts with community health centers to provide primary health and dental care services, migrant health services, and maternity health care services. The director of the health care authority shall establish requirements necessary to assure community health centers provide quality health care services that are appropriate and effective and are delivered in a cost-efficient manner. The director shall further assure that community health centers have appropriate referral arrangements for acute care and medical specialty services not provided by the community health centers.
(2) The authority, in consultation with the department of health, shall work with community and migrant health clinics and other providers of care to underserved populations, to ensure that the number of people of color and underserved people receiving access to managed care is expanded in proportion to need, based upon demographic data.
[ 2023 c 51 § 15; 1998 c 245 § 38; 1993 c 492 § 232.]
NOTES:
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.225 - Blind licensees in the business enterprises program—Plan of health insurance.

RCW 41.05.225
Blind licensees in the business enterprises program—Plan of health insurance.
(1) The public employees' benefits board shall offer a plan of health insurance to blind licensees who are actively operating facilities and participating in the business enterprises program established in RCW 74.18.200 through 74.18.230, and maintained by the department of services for the blind. The plan of health insurance benefits must be the same or substantially similar to the plan of health insurance benefits offered to state employees under this chapter. Enrollment will be at the option of each individual licensee or vendor, under rules established by the public employees' benefits board.
(2) All costs incurred by the state or the public employees' benefits board for providing health insurance coverage to active blind vendors, excluding family participation, under subsection (1) of this section may be paid for from net proceeds from vending machine operations in public buildings under RCW 74.18.230.
(3) Money from the business enterprises program under the federal Randolph-Sheppard Act may not be used for family participation in the health insurance benefits provided under this section. Family insurance benefits are the sole responsibility of the individual blind vendors.
[ 2018 c 260 § 18; 2002 c 71 § 1.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.295 - Dependent care assistance program—Health care authority—Powers, duties, and functions.

RCW 41.05.295
Dependent care assistance program—Health care authority—Powers, duties, and functions.
(1) All powers, duties, and functions of the department of retirement systems pertaining to the dependent care assistance program are transferred to the health care authority.
(2)(a) All reports, documents, surveys, books, records, files, papers, or written material in the possession of the department of retirement systems pertaining to the powers, functions, and duties transferred shall be delivered to the custody of the health care authority. All funds, credits, or other assets held in connection with the powers, functions, and duties transferred shall be assigned to the health care authority.
(b) Whenever any question arises as to the transfer of any funds, books, documents, records, papers, files, or other tangible property used or held in the exercise of the powers and the performance of the duties and functions transferred, the director of financial management shall make a determination as to the proper allocation and certify the same to the state agencies concerned.
(3) All rules and all pending business before the department of retirement systems pertaining to the powers, functions, and duties transferred shall be continued and acted upon by the health care authority. All existing contracts and obligations shall remain in full force and shall be performed by the health care authority.
(4) The transfer of the powers, duties, and functions of the department of retirement systems shall not affect the validity of any act performed before January 1, 2009.
(5) Nothing contained in this section may be construed to alter any existing collective bargaining unit or the provisions of any existing collective bargaining agreement until the agreement has expired or until the bargaining unit has been modified by action of the public employment relations commission as provided by law.
[ 2008 c 229 § 1.]
NOTES:
Effective date—2008 c 229: "This act takes effect January 1, 2009." [ 2008 c 229 § 15.]
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.300 - Salary reduction agreements—Authorized.

RCW 41.05.300
Salary reduction agreements—Authorized.
(1) The state of Washington may enter into salary reduction agreements with employees and school employees pursuant to the internal revenue code, for the purpose of making it possible for employees and school employees to select on a "before-tax basis" certain taxable and nontaxable benefits. The purpose of the salary reduction plan established in this chapter is to attract and retain individuals in governmental service by permitting them to enter into agreements with the state to provide for benefits pursuant to 26 U.S.C. Sec. 125, 26 U.S.C. Sec. 129, and other applicable sections of the internal revenue code.
(2) Nothing in the salary reduction plan constitutes an employment agreement between the participant and the state, and nothing contained in the participant's salary reduction agreement, the plan, this section, or RCW 41.05.123, 41.05.310 through 41.05.360, and 41.05.295 gives a participant any right to be retained in state employment.
[ 2018 c 260 § 19; 2008 c 229 § 3; 1995 1st sp.s. c 6 § 11.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.310 - Salary reduction plan—Policies and procedures—Plan document.

RCW 41.05.310
Salary reduction plan—Policies and procedures—Plan document.
The authority shall have responsibility for the formulation and adoption of a plan, policies, and procedures designed to guide, direct, and administer the salary reduction plan. For the plan year beginning January 1, 1996, the director may establish a premium only plan. Expansion of the salary reduction plan or cafeteria plan during subsequent plan years shall be subject to approval by the director of the office of financial management.
(1) A plan document describing the benefits offered under the salary reduction plan shall be adopted and administered by the authority. The authority shall represent the state in all matters concerning the administration of the plan. The state, through the authority, may engage the services of a professional consultant or administrator on a contractual basis to serve as an agent to assist the authority or perform the administrative functions necessary in carrying out the purposes of RCW 41.05.123, 41.05.300 through 41.05.350, and 41.05.295.
(2) The authority shall formulate and establish policies and procedures for the administration of the salary reduction plan that are consistent with existing state law, the internal revenue code, and the regulations adopted by the internal revenue service as they may apply to the benefits offered to participants under the plan.
(3) Every action taken by the authority in administering RCW 41.05.123, 41.05.300 through 41.05.350, and 41.05.295 shall be presumed to be a fair and reasonable exercise of the authority vested in or the duties imposed upon it. The authority shall be presumed to have exercised reasonable care, diligence, and prudence and to have acted impartially as to all persons interested unless the contrary be proved by clear and convincing affirmative evidence.
[ 2023 c 51 § 16; 2008 c 229 § 4; 1995 1st sp.s. c 6 § 12.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.320 - Salary reduction plan—Eligibility—Participation, withdrawal.

RCW 41.05.320
Salary reduction plan—Eligibility—Participation, withdrawal.
(1) Elected officials and permanent employees and school employees are eligible to participate in the salary reduction plan and reduce their salary by agreement with the authority. The authority may adopt rules to: (a) Limit the participation of employing agencies and their employees in the plan; and (b) permit participation in the plan by temporary employees and school employees.
(2) Persons eligible under subsection (1) of this section may enter into salary reduction agreements with the state.
(3)(a) An eligible person may become a participant of the salary reduction plan for a full plan year with annual benefit plan selection for each new plan year made before the beginning of the plan year, as determined by the authority, or upon becoming eligible.
(b) Once an eligible person elects to participate in the salary reduction plan and determines the amount his or her gross salary shall be reduced and the benefit plan for which the funds are to be used during the plan year, the agreement shall be irrevocable and may not be amended during the plan year except as provided in (c) of this subsection. Prior to making an election to participate in the salary reduction plan, the eligible person shall be informed in writing of all the benefits and reductions that will occur as a result of such election.
(c) The authority shall provide in the salary reduction plan that a participant may enroll, terminate, or change his or her election after the plan year has begun if there is a significant change in a participant's status, as provided by 26 U.S.C. Sec. 125 and the regulations adopted under that section and defined by the authority.
(4) The authority shall establish as part of the salary reduction plan the procedures for and effect of withdrawal from the plan by reason of retirement, death, leave of absence, or termination of employment. To the extent possible under federal law, the authority shall protect participants from forfeiture of rights under the plan.
(5) Any reduction of salary under the salary reduction plan shall not reduce the reportable compensation for the purpose of computing the state retirement and pension benefits earned by the public employee pursuant to chapters 41.26, 41.32, 41.35, 41.37, 41.40, and 43.43 RCW.
[ 2023 c 51 § 17; 2018 c 260 § 20; 2008 c 229 § 5; 2007 c 492 § 6; 1995 1st sp.s. c 6 § 13.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.330 - Salary reduction plan—Accounts and records.

RCW 41.05.330
Salary reduction plan—Accounts and records.
The authority shall keep or cause to be kept full and adequate accounts and records of the assets, obligations, transactions, and affairs of a salary reduction plan created under RCW 41.05.300.
[ 2008 c 229 § 7; 1995 1st sp.s. c 6 § 14.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.340 - Salary reduction plan—Termination—Amendment.

RCW 41.05.340
Salary reduction plan—Termination—Amendment.
(1) The state may terminate the salary reduction plan at the end of the plan year or upon notification of federal action affecting the status of the plan.
(2) The authority may amend the salary reduction plan at any time if the amendment does not affect the rights of the participants to receive eligible reimbursement from the participants' accounts.
[ 2008 c 229 § 8; 1995 1st sp.s. c 6 § 15.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.350 - Salary reduction plan—Rules.

RCW 41.05.350
Salary reduction plan—Rules.
The authority shall adopt rules necessary to implement RCW 41.05.123, 41.05.300 through 41.05.340, and 41.05.295.
[ 2008 c 229 § 9; 1995 1st sp.s. c 6 § 16.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.360 - Salary reduction plan—Construction.

RCW 41.05.360
Salary reduction plan—Construction.
RCW 41.05.123, 41.05.300 through 41.05.350, and 41.05.295 shall be construed to effectuate the purposes of 26 U.S.C. Sec. 125 and other applicable sections of the internal revenue code as required.
[ 2008 c 229 § 10; 1995 1st sp.s. c 6 § 17.]
NOTES:
Effective date—2008 c 229: See note following RCW 41.05.295.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
2023 Revised Code of Washington › Title 41 - Public Employment, Civil Service, and Pensions › Chapter 41.05 - State Health Care Authority. › 41.05.413 - Qualified health plans—Reimbursement limit—Waiver.

RCW 41.05.413
Qualified health plans—Reimbursement limit—Waiver.
The director may, in his or her sole discretion, waive the requirements of RCW 41.05.410(2)(g) if he or she finds that:
(1) A health carrier offering a qualified health plan under RCW 41.05.410 is unable to form a provider network that meets the network access standards adopted by the insurance commissioner due to the requirements of RCW 41.05.410(2)(g); and
(2) The health carrier is able to achieve actuarially sound premiums that are ten percent lower than the previous plan year through other means.
[ 2023 c 51 § 19; 2019 c 364 § 4.]
NOTES: