RCW 41.05.050
Contributions for employees and dependents—Definitions.
(1) Every: (a) Department, division, or separate agency of state government; (b) county, municipal, school district, educational service district, or other political subdivisions; and (c) tribal governments as are covered by this chapter, shall provide contributions to insurance and health care plans for its employees and their dependents, the content of such plans to be determined by the authority. Contributions, paid by the county, the municipality, other political subdivision, or a tribal government for their employees, shall include an amount determined by the authority to pay such administrative expenses of the authority as are necessary to administer the plans for employees of those groups, except as provided in subsection (4) of this section.
(2) To account for increased cost of benefits for the state and for state employees, the authority may develop a rate surcharge applicable to participating counties, municipalities, other political subdivisions, and tribal governments.
(3) The contributions of any: (a) Department, division, or separate agency of the state government; (b) county, municipal, or other political subdivisions; (c) any tribal government as are covered by this chapter; and (d) school districts, educational service districts, and charter schools, shall be set by the authority, subject to the approval of the governor for availability of funds as specifically appropriated by the legislature for that purpose. Insurance and health care contributions for ferry employees shall be governed by RCW 47.64.270.
(4)(a) Until January 1, 2020, the authority shall collect from each participating school district and educational service district an amount equal to the composite rate charged to state agencies, plus an amount equal to the employee premiums by plan and family size as would be charged to employees, for groups of school district and educational service district employees enrolled in authority plans. The authority may collect these amounts in accordance with the school district or educational service district fiscal year, as described in RCW 28A.505.030.
(b)(i) For all groups of school district or educational service district employees enrolling in authority plans for the first time after September 1, 2003, and until January 1, 2020, the authority shall collect from each participating school district or educational service district an amount equal to the composite rate charged to state agencies, plus an amount equal to the employee premiums by plan and by family size as would be charged to employees, only if the authority determines that this method of billing the school districts and educational service districts will not result in a material difference between revenues from school districts and educational service districts and expenditures made by the authority on behalf of school districts and educational service districts and their employees. The authority may collect these amounts in accordance with the school district or educational service district fiscal year, as described in RCW 28A.505.030.
(ii) For all groups of educational service district employees enrolling in plans developed by the public employees' benefits board after January 1, 2020, and until January 1, 2024, the authority shall collect from each participating educational service district an amount equal to the composite rate charged to state agencies, plus an amount equal to the employee premiums by plan and by family size as would be charged to employees, only if the authority determines that this method of billing the educational service districts will not result in a material difference between revenues from educational service districts and expenditures made by the authority on behalf of educational service districts and their employees. The authority may collect these amounts in accordance with the educational service district fiscal year, as described in RCW 28A.505.030.
(c) Until January 1, 2020, if the authority determines at any time that the conditions in (b) of this subsection cannot be met, the authority shall offer enrollment to additional groups of school and educational service district employees on a tiered rate structure until such time as the authority determines there would be no material difference between revenues and expenditures under a composite rate structure for all school and educational service district employees enrolled in authority plans.
(d)(i) Beginning January 1, 2020, all school districts, represented employees of educational service districts, and charter schools shall commence participation in the school employees' benefits board program established under RCW 41.05.740. All school districts, represented employees of educational service districts, charter schools, and all school district employee groups participating in the public employees' benefits board plans before January 1, 2020, shall thereafter participate in the school employees' benefits board program administered by the authority. All school districts, represented employees of educational service districts, and charter schools shall provide contributions to the authority for insurance and health care plans for school employees and their dependents. These contributions must be provided to the authority for all eligible school employees eligible for benefits under RCW 41.05.740(6)(d), including school employees who have waived their coverage; contributions to the authority are not required for individuals eligible for benefits under RCW 41.05.740(6)(e) who waive their coverage.
(ii) Beginning January 1, 2024, all educational service districts shall participate in the school employees' benefits board program.
(e) For the purposes of this subsection, "tiered rates" means the amounts the authority must pay to insuring entities by plan and by family size.
(f) Notwithstanding this subsection and RCW 41.05.065(4), the authority may allow school districts and educational service districts enrolled on a tiered rate structure prior to September 1, 2002, and until January 1, 2020, to continue participation based on the same rate structure and under the same conditions and eligibility criteria.
(5) The authority shall transmit a recommendation for the amount of the employer contributions to the governor and the director of financial management for inclusion in the proposed budgets submitted to the legislature.
[ 2019 c 411 § 5; 2018 c 260 § 10; 2017 3rd sp.s. c 13 § 806; 2016 c 67 § 3; 2009 c 537 § 5; 2007 c 114 § 4; 2005 c 518 § 919; 2003 c 158 § 1. Prior: 2002 c 319 § 4; 2002 c 142 § 2; prior: 1995 1st sp.s. c 6 § 22; 1994 c 309 § 2; 1994 c 153 § 4; prior: 1993 c 492 § 216; 1993 c 386 § 7; 1988 c 107 § 18; 1987 c 122 § 4; 1984 c 107 § 1; 1983 c 15 § 20; 1983 c 2 § 9; prior: 1982 1st ex.s. c 34 § 2; 1981 c 344 § 6; 1979 c 151 § 55; 1977 ex.s. c 136 § 4; 1975-'76 2nd ex.s. c 106 § 4; 1975 1st ex.s. c 38 § 2; 1973 1st ex.s. c 147 § 3; 1970 ex.s. c 39 § 5.]
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.
Intent—Effective date—2007 c 114: See notes following RCW 41.05.011.
Effective date—2005 c 518: See note following RCW 28A.600.110.
Intent—2002 c 319: See note following RCW 41.04.208.
Effective date—1995 1st sp.s. c 6: See note following RCW 28A.400.410.
Intent—Effective dates—1994 c 153: 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.
Effective date—1993 c 386 §§ 3, 7, and 11: See note following RCW 41.04.205.
Intent—1993 c 386: See note following RCW 28A.400.391.
Severability—1983 c 2: See note following RCW 18.71.030.
Severability—1981 c 344: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1981 c 344 § 8.]
Effective date—Conditions prerequisite to implementing sections—1977 ex.s. c 136: "This 1977 amendatory act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect on July 1, 1977: PROVIDED, That if the state operating budget appropriations act does not contain the funds necessary for the implementation of this 1977 amendatory act in an appropriated amount sufficient to fully fund the employer's contribution to the state employee insurance benefits program which is established by the board in accordance with RCW 41.05.050 (2) and (3) as now or hereafter amended, sections 1, 5, and 6 of this 1977 amendatory act shall be null and void." [ 1977 ex.s. c 136 § 8.]
Effective date—Effect of veto—1973 1st ex.s. c 147: "This bill shall not take effect until the funds necessary for its implementation have been specifically appropriated by the legislature and such appropriation itself has become law. It is the intention of the legislature that if the governor shall veto this section or any item thereof, none of the provisions of this bill shall take effect." [ 1973 1st ex.s. c 147 § 10.]
Savings—1973 1st ex.s. c 147: "Nothing contained in this 1973 amendatory act shall be deemed to amend, alter or affect the provisions of Chapter 23, Laws of 1972, Extraordinary Session, and RCW 28B.10.840 through 28B.10.844 as now or hereafter amended." [ 1973 1st ex.s. c 147 § 13.]
Severability—1973 1st ex.s. c 147: "If any provision of this 1973 amendatory act, or its application to any person or circumstances is held invalid, the remainder of the act, or the application of the provision to other persons or circumstances is not affected." [ 1973 1st ex.s. c 147 § 9.]
Severability—1970 ex.s. c 39: "If any provision of this act, or its application to any person or circumstance is held invalid, the remainder of the act, or the application of the provision to other persons or circumstances is not affected." [ 1970 ex.s. c 39 § 14.]
Structure Revised Code of Washington
Title 41 - Public Employment, Civil Service, and Pensions
Chapter 41.05 - State Health Care Authority.
41.05.004 - Intent—Use of word "board."
41.05.008 - Duties of employing agencies.
41.05.009 - Determination of employee or school employee eligibility for benefits.
41.05.0091 - Eligibility exists prior to January 1, 2010.
41.05.013 - State purchased health care programs—Uniform policies—Report to the legislature.
41.05.014 - Applications, enrollment forms, and eligibility certification documents—Signatures.
41.05.015 - Medical director—Appointment of personnel.
41.05.017 - Provisions applicable to health plans offered under this chapter.
41.05.022 - State agent for purchasing health services—Single community-rated risk pool.
41.05.023 - Chronic care management program—Uniform medical plan—Definitions.
41.05.031 - Agencies to establish health care information systems.
41.05.033 - Shared decision-making demonstration project—Preference-sensitive care.
41.05.036 - Health information—Definitions.
41.05.037 - Nurse hotline, when funded.
41.05.039 - Health information—Secure access—Lead organization—Administrator's duties.
41.05.042 - Health information—Processes, guidelines, and standards.
41.05.046 - Health information—Conflict with federal requirements.
41.05.050 - Contributions for employees and dependents—Definitions.
41.05.055 - Public employees' benefits board—Members.
41.05.065 - Public employees' benefits board—Duties—Eligibility—Definitions—Penalties.
41.05.066 - Domestic partner benefits.
41.05.068 - Federal employer incentive program—Authority to participate.
41.05.085 - Retired state employee and retired or disabled school employee health insurance subsidy.
41.05.095 - Coverage for dependents under the age of twenty-six.
41.05.100 - Chapter not applicable to certain employees of Cooperative Extension Service.
41.05.110 - Chapter not applicable to officers and employees of state convention and trade center.
41.05.120 - Public employees' and retirees' insurance account—School employees' insurance account.
41.05.140 - Payment of claims—Self-insurance—Insurance reserve fund created.
41.05.165 - Rules—Insurance benefit reimbursement.
41.05.170 - Neurodevelopmental therapies—Employer-sponsored group contracts.
41.05.175 - Prescribed, self-administered anticancer medication.
41.05.177 - Prostate cancer screening—Required coverage.
41.05.180 - Mammograms—Insurance coverage.
41.05.183 - General anesthesia services for dental procedures—Public employee benefit plans.
41.05.185 - Diabetes benefits—State purchased health care.
41.05.188 - Eosinophilic gastrointestinal associated disorder—Elemental formula.
41.05.195 - Medicare supplemental insurance policies.
41.05.197 - Medicare supplemental insurance policies.
41.05.205 - Tricare supplemental insurance policy—Authority to offer—Rules.
41.05.225 - Blind licensees in the business enterprises program—Plan of health insurance.
41.05.240 - American Indian health care delivery plan.
41.05.280 - Department of corrections—Inmate health care.
41.05.295 - Dependent care assistance program—Health care authority—Powers, duties, and functions.
41.05.300 - Salary reduction agreements—Authorized.
41.05.310 - Salary reduction plan—Policies and procedures—Plan document.
41.05.320 - Salary reduction plan—Eligibility—Participation, withdrawal.
41.05.330 - Salary reduction plan—Accounts and records.
41.05.340 - Salary reduction plan—Termination—Amendment.
41.05.350 - Salary reduction plan—Rules.
41.05.360 - Salary reduction plan—Construction.
41.05.405 - Public option plans—Availability—Hospital contracts—Recommendations.
41.05.410 - Qualified health plans—Contract for—Requirements—Cost and quality data.
41.05.413 - Qualified health plans—Reimbursement limit—Waiver.
41.05.420 - Plan of health care coverage—Prescription insulin drug cost limits—Cost sharing.
41.05.430 - Plan of health care coverage—Immediate postpartum contraception devices.
41.05.520 - Pharmacy connection program—Notice.
41.05.525 - Treatment of opioid use disorder—Prior authorization.
41.05.527 - Opioid overdose reversal medication bulk purchasing and distribution program.
41.05.530 - Prescription drug assistance, education—Rules.
41.05.540 - State employee health program—Requirements—Report.
41.05.600 - Mental health services—Definition—Coverage required, when.
41.05.601 - Mental health services—Rules.
41.05.630 - Annual report of customer service complaints and appeals.
41.05.660 - Community health care collaborative grant program—Award and disbursement of grants.
41.05.670 - Chronic care management incentives—Provider reimbursement methods.
41.05.680 - Report—Chronic care management.
41.05.740 - School employees' benefits board.
41.05.742 - Single enrollment requirement.
41.05.744 - School employee eligibility during COVID-19 state of emergency.
41.05.745 - School employees' benefits board—Employee-paid, voluntary benefits—Optional benefits.
41.05.750 - Problem and pathological gambling treatment program.
41.05.751 - Problem gambling account.
41.05.760 - Recovery residences—Registry.
41.05.761 - Recovery residences—Technical assistance for residences seeking certification.
41.05.762 - Recovery residences—Revolving fund.
41.05.765 - Insulin drugs—Cap on enrollee's required payment amount—Cost-sharing requirements.
41.05.830 - Coverage for hearing instruments—Definitions.