Senate Bill Report — SB 5262
- Issuer
- Congressional materials
- Document type
- Report
- Date
- 2025-01-30
- Case
- 2025 01 30 A32585 D276634 Bill Report 5262 Sba Bft 25
Summary
A Washington Senate Bill Report on SB 5262, as of January 28, 2025, prepared for the Senate Committee on Business, Financial Services & Trade on a bill correcting obsolete or erroneous references in statutes administered by the insurance commissioner. The background section describes provisions of the Washington Insurance Code, including one-time studies, refunds, motor vehicle insurance rates and charitable gift annuity businesses. The bill summary lists repeals of one-time studies and annual reporting requirements, a public records exception for annual statements from direct patient-provider primary care practices, and revised timeframes. It also describes hearing instrument coverage every 36 months per ear for plans issued or renewed on or after January 1, 2026. The report states there is no appropriation and several effective dates.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
Full text
SENATE BILL REPORT
SB 5262
As of January 28, 2025
Title: An act relating to correcting obsolete or erroneous references in statutes administered by
the insurance commissioner, by repealing defunct statutes and reports, aligning policy with
federal law and current interpretations, making timeline adjustments, protecting patient
data, and making technical corrections.
Brief Description: Correcting obsolete or erroneous references in statutes administered by the
insurance commissioner.
Sponsors: Senators Kauffman, Wilson, J., Nobles, Shewmake and Trudeau; by request of
Insurance Commissioner.
Brief History:
Committee Activity: Business, Financial Services & Trade: 1/30/25.
Brief Summary of Bill
• Repeals provisions relating to one-time studies and reports.
• Revises various timeframes in the Washington Insurance Code.
• Revises certain accounts, and makes technical changes.
• Creates a public records exception for annual statements submitted by
direct patient-provider primary care practices.
• Revises coverage mandates regarding maternity care and hearing aids
and associated services.
• Repeals requirements for insurers to consider certain factors in making
rates for motor vehicle insurance.
• Repeals certain annual reporting requirements for the Office of the
Insurance Commissioner and for health carriers.
This analysis was prepared by non-partisan legislative staff for the use of legislative
members in their deliberations. This analysis is not part of the legislation nor does it
constitute a statement of legislative intent.
Senate Bill Report -1- SB 5262
SENATE COMMITTEE ON BUSINESS, FINANCIAL SERVICES & TRADE
Staff: John Kim (786-7453)
Background: The Office of the Insurance Commissioner (OIC) administers the
Washington Insurance Code (code), which regulates insurance companies and insurance
professionals conducting business in the state.
Individual Health Insurance Market Stability Program. In 2017, a public records exemption
was created in the Public Records Act (PRA) for certain information submitted by health
carriers to the Federal Government as part of a risk adjustment or reinsurance program for
the purposes of developing or implementing an individual health insurance market stability
program. The exemption applied to materials obtained by the OIC as of December 31,
2019, and the OIC was required to conduct a one-time study.
Direct Patient-Provider Primary Care Practices. A direct patient-provider primary care
practice (direct practice) is a provider, group, or entity that furnishes primary care services
through direct agreements with patients or parents or legal guardians of patients; that does
not accept payment from regulated insurers or health plans; and that does not provide
specified services, procedures, or supplies.
Beginning in 2007, direct practices must submit to the OIC annual statements, currently
subject to public disclosure, specifying:
• the number of providers in each practice;
• total number of patients being served;
• the average direct fee being charged;
• providers' names; and
• the business address for each direct practice.
The OIC must annually report to the Legislature on direct practices, including, but not
limited to, participation trends, complaints received, voluntary data reported, and any
necessary modifications to current law.
Refunds by the Office of the Insurance Commissioner. Current law requires the OIC, upon
written request, to refund any tax, license fee, or other charge paid in error or in excess of a
legal obligation. A person may request a refund of taxes only within six years from the date
the taxes are paid and may request a refund of fees or charges only within 13 months of the
date the fees or charges are paid. To facilitate such refunds, the OIC may establish a
revolving fund out of legislatively appropriated funds.
Motor Vehicle Insurance Rates. In making rates for motor vehicle insurance, current law
requires, among other considerations:
• that an insurer's schedule of rates or rating plan submitted to the OIC provide for an
appropriate premium reduction for older insureds completing an accident prevention
Senate Bill Report -2- SB 5262
course;
• that due consideration be given to anticipated changes in losses attributable to
antitheft devices and the use of lights and lighting devices for increasing visibility;
and
• that due consideration be given to an anticipated change in losses attributable to the
use of seat belts, child restraints, and other lifesaving devices.
Fire Alarms and Smoke Detection Devices and the Impact on Residential Property
Insurance Rates. A 2019 state law required insurers of dwelling units to consider the impact
of fire alarms and smoke detection devices in making rates. The OIC was required to
submit a one-time report to the Legislature by December 31, 2020, on any credits or
discounts provided on insurance premiums for fire alarms and smoke detection devices
installed in dwelling units.
Protocols for Market Conduct Actions. A 2007 state law established a market conduct
oversight program within the OIC. The law required the OIC to adopt certain rules and
provide a report to the Legislature in the legislative session after the rules were adopted.
Charitable Gift Annuity Businesses. A charitable gift annuity is a contract between a donor
and a charity in which the donor makes a tax-advantaged donation of cash, securities, or
other assets to a single charity, which is set aside in a reserve account and invested. The
donor receives a fixed month or quarterly payout, typically supported by the investment
account, for the rest of the donor's life. At the end of the donor's life, the charity receives the
remainder of the gift.
The OIC may grant a certificate of exemption from most provisions of the code to any
insurer or educational, religious, charitable, or scientific institution conducting a charitable
gift annuity business that meets specified conditions. Among such conditions are a
minimum unrestricted net asset level and the annual filing with the OIC a financial report
and payment of a filing fee. The financial report is due within 60 days of the end of the
business' fiscal year and the filing fee is due on or before March 1 of each year.
Report on Geographic Access to Gender-Affirming Treatment. A 2022 state law created a
health plan coverage mandate for gender-affirming treatment. The OIC was required to
issue a report on geographic access to gender-affirming treatment across the state by
December 1, 2022, and update the report biannually, or twice a year.
Coverage of Maternity Services. A 1996 state law specified requirements for health carriers
providing coverage for maternity services. Among such requirements was that coverage for
the newly born child must be no less than the coverage of the child's mother for no less than
three weeks, even if there are separate hospital admissions.
Coverage of Hearing Aids by Individual and Small Employer Health Plans. Under the
federal Affordable Care Act, certain benefits, items, and services called Essential Health
Senate Bill Report -3- SB 5262
Benefits (EHBs) must be covered by all individual and small employer health plans
purchased after a certain date. A state must select its own EHB benchmark plan and use it
to determine its EHBs. A state that wishes to make changes to its EHB benchmark plan
must apply for federal approval.
A 2023 state law directed the OIC to review the state's EHB benchmark plan and decide
whether to request federal approval to modify the plan to include a number of benefits as
EHBs, but required that hearing instruments and associated services be included as EHBs if
the state plan was modified.
After completing requirements for an analysis, public meetings, and public comment, in
April 2024, the OIC applied for federal approval to revise the state's EHB benchmark plan
for plan years beginning on or after January 1, 2026. The application was approved by the
federal government in October 2024.
Under federal regulation, annual or lifetime dollar limits cannot be applied to EHBs.
Dental-Only Plans. A health carrier offering a dental-only plan must submit an annual data
statement to the OIC with specific information.
Insurance Fraud Program. A 2006 state law created an Insurance Fraud Program within the
OIC and specified that the annual cost of operating the program is funded from the OIC's
regulatory account, subject to legislative appropriation.
Medical Malpractice Closed Claim Reporting. A 2006 state law created closed claim
reporting requirements for insuring entities or self-insurers providing medical malpractice
insurance. The OIC must prepare aggregate statistical summaries of closed claims based on
submitted data and submit an annual report to the Legislature by June 30th. The OIC was
also required to report to the Legislature regarding model statistical reporting standards if
adopted by the National Association of Insurance Commissioners.
Guaranteed Asset Protection Waivers. A guaranteed asset protection waiver (GAP waiver)
is an agreement where a creditor agrees for a charge to cancel or waive all or part of the
amounts due that creditor on a borrower's motor vehicle finance agreement with that
creditor in the event of a total physical damage loss or unrecovered theft of the motor
vehicle. A 2009 state law adopted a model act regulating GAP waivers. Persons selling
GAP waivers must register with OIC and pay a $250 application fee, which is deposited in
the guaranteed asset protection waiver account.
Natural Disaster and Resiliency Work Group. A 2019 state law created a work group to
study and make recommendations on natural disaster and resiliency activities, chaired by
the OIC commissioner. The work group was required to submit a preliminary report to the
Legislature in 2019 and a final report by December 1, 2020.
Senate Bill Report -4- SB 5262
Annual Report on Health Carrier Data. A 2006 state law required each health carrier
offering a health benefit plan to annually submit to the OIC specified financial information.
Annual Report on Fixed Payment Insurance Products. A 2007 state law required the OIC to
collect information from insurers offering fixed payment insurance products and annually
report aggregated data including the number of groups purchasing the products, the number
of enrollees, and the number of consumer complaints filed.
Summary of Bill: Individual Health Insurance Market Stability Program. Provisions
relating to the one-time study and the associated public records exception are repealed.
Direct Patient-Provider Primary Care Practices. The bill creates a public records exception
for annual statements submitted by direct practices and the data reported in them. Such
information is confidential and exempt from public disclosure under the PRA.
The OIC's annual report to the Legislature and the data in it must be in aggregate form that
does not permit the identification of individual direct practices.
Refunds by the Office of the Insurance Commissioner. A person requesting a refund of
taxes to the OIC must do so within six years of the end of the calendar year for which the
taxes are owed, rather than six years from the date the taxes were paid.
The bill repeals the authority for the OIC to establish a revolving fund, out of legislatively
appropriated funds, to facilitate refunds.
Motor Vehicle Insurance Rates. The bill specifies that the premium reduction for older
insureds completing an accident prevention course applies to personal auto insurance only.
The bill repeals the requirement that antitheft devices; the use of lights and lighting devices
for increasing visibility; and the use of seat belts, child restraints, and other lifesaving
devices be used in making rates for motor vehicle insurance.
Fire Alarms and Smoke Detection Devices and Impact on Residential Property Insurance
Rates. The bill repeals a provision relating to the one-time study due in 2020.
Protocols for Market Conduct Actions. The bill repeals a provision relating to a one-time
report regarding adopted rules.
Charitable Gift Annuity Businesses. The bill revises the name of a term unrestricted net
assets to net assets without donor restrictions.
The annual filing fee for charitable gift annuity businesses is due within 60 days of the end
of its fiscal year rather than on March 1.
Senate Bill Report -5- SB 5262
The changes take effect January 1, 2026.
Report on Geographic Access to Gender-Affirming Treatment. The OIC is required to
update its report biennially, or every other year, rather than biannually, or twice a year.
Coverage of Maternity Services. The bill repeals the requirement that coverage for a newly
born child be no less than the coverage of the child's mother for no less than three weeks,
even if there are separate hospital admissions.
It changes a reference of advanced registered nurse practitioner to advanced practice
registered nurse to conform to a 2024 law changing the legal title for the profession.
Coverage of Hearing Aids by Individual and Small Employer Health Plans. For health
plans issued or renewed on or after January 1, 2026, a health carrier must cover hearing
instruments every 36 months per ear with hearing loss and may not establish any lifetime or
annual dollar limit on coverage for associated services for any individual, whether provided
in-network or out-of-network.
A health carrier may require prior authorization or adopt other appropriate utilization
controls in approving coverage for medically necessary hearing instruments.
Dental-Only Plans. The bill specifies that the annual data statement is limited to dental-only
plans in Washington and to Washington-specific data.
It specifies the OIC must make reported information available on its website, rather than in
a format that allows comparison among carriers through a searchable public website.
Insurance Fraud Program. The bill revises the account funding the Insurance Fraud Program
from the OIC's regulatory account to its fraud account.
Medical Malpractice Closed Claim Reporting. The bill repeals a requirement for the OIC to
prepare aggregate statistical summaries of closed claims and provides that the OIC must
complete its annual report by September 1 rather than June 30.
Provisions regarding the one-time report on model statistical reporting standards are
repealed.
Guaranteed Asset Protection Waivers. The bill revises the account in which application fees
are deposited from the guaranteed asset protection waiver account to the General Fund.
The guaranteed asset protection waiver account is repealed.
Natural Disaster and Resiliency Work Group. Provisions regarding the work group and one-
time study are repealed.
Senate Bill Report -6- SB 5262
Annual Report on Health Carrier Data. The bill repeals the requirement for health carriers to
annually submit specific financial information to the OIC.
Annual Report on Fixed Payment Insurance Products. The bill repeals the requirement for
the OIC to annually report on fixed payment insurance products.
Appropriation: None.
Fiscal Note: Available.
Creates Committee/Commission/Task Force that includes Legislative members: No.
Effective Date: The bill contains several effective dates. Please refer to the bill.
Senate Bill Report -7- SB 5262
File and source
- File
- 2025-01-30_a32585_d276634_bill-report-5262-sba-bft-25.pdf
- Size
- 17,959 bytes
- SHA-256
- 0da8a38570106f3f2c42a698c8b76000bfdc0d9373c727a0bc8bc1090960debd
- Original
- app.leg.wa.gov