Revised Code of Washington
Chapter 41.05 - State Health Care Authority.
41.05.080 - Participation in insurance plans and contracts—Retired, disabled, or separated employees—Certain surviving spouses, state registered domestic partners, and dependent children.

RCW 41.05.080
Participation in insurance plans and contracts—Retired, disabled, or separated employees—Certain surviving spouses, state registered domestic partners, and dependent children.

(1) Under the qualifications, terms, conditions, and benefits set by the public employees' benefits board:
(a) Retired or disabled state employees, retired or disabled school employees, retired or disabled employees of county, municipal, or other political subdivisions, or retired or disabled employees of tribal governments covered by this chapter may continue their participation in insurance plans and contracts after retirement or disablement;
(b) Separated employees may continue their participation in insurance plans and contracts if participation is selected immediately upon separation from employment;
(c) Surviving spouses, surviving state registered domestic partners, and dependent children of emergency service personnel killed in the line of duty may participate in insurance plans and contracts.
(2) Rates charged surviving spouses and surviving state registered domestic partners of emergency service personnel killed in the line of duty, retired or disabled employees, separated employees, spouses, or dependent children who are not eligible for parts A and B of medicare shall be based on the experience of the community-rated risk pool established under RCW 41.05.022.
(3) Rates charged to surviving spouses and surviving state registered domestic partners of emergency service personnel killed in the line of duty, retired or disabled employees, separated employees, spouses, or children who are eligible for parts A and B of medicare shall be calculated from a separate experience risk pool comprised only of individuals eligible for parts A and B of medicare; however, the premiums charged to medicare-eligible retirees and disabled employees shall be reduced by the amount of the subsidy provided under RCW 41.05.085.
(4) Surviving spouses, surviving state registered domestic partners, and dependent children of emergency service personnel killed in the line of duty and retired or disabled and separated employees shall be responsible for payment of premium rates developed by the authority which shall include the cost to the authority of providing insurance coverage including any amounts necessary for reserves and administration in accordance with this chapter. These self pay rates will be established based on a separate rate for the employee, the spouse, state registered domestic partners, and the children.
(5) The term "retired state employees" for the purpose of this section shall include but not be limited to members of the legislature whether voluntarily or involuntarily leaving state office.

[ 2018 c 260 § 15; 2015 c 116 § 5. Prior: 2009 c 523 § 1; 2009 c 522 § 9; 2007 c 114 § 6; 2001 c 165 § 3; 1996 c 39 § 22; 1994 c 153 § 7; 1993 c 386 § 11; 1977 ex.s. c 136 § 6; 1975-'76 2nd ex.s. c 106 § 6; 1973 1st ex.s. c 147 § 7; 1970 ex.s. c 39 § 8.]
NOTES:

Intent—Effective date—2007 c 114: See notes following RCW 41.05.011.


Effective date—Application—2001 c 165: See note following RCW 41.05.011.


Effective dates—1996 c 39: See note following RCW 41.32.010.


Intent—Effective dates—1994 c 153: See notes following RCW 41.05.011.


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.


Effective date—Conditions prerequisite to implementing sections—1977 ex.s. c 136: See note following RCW 41.05.050.


Effective date—Effect of veto—Savings—Severability—1973 1st ex.s. c 147: See notes following RCW 41.05.050.


Severability—1970 ex.s. c 39: See note following RCW 41.05.050.

Structure Revised Code of Washington

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."

41.05.006 - Purpose.

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.

41.05.011 - Definitions.

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.

41.05.018 - Transfer of certain behavioral health-related powers, duties, and functions from the department of social and health services.

41.05.021 - State health care authority—Director—Cost control and delivery strategies—Health information technology—Managed competition—Rules.

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.

41.05.026 - Contracts—Proprietary data, trade secrets, actuarial formulas, statistics, cost and utilization data—Exemption from public inspection—Executive sessions.

41.05.031 - Agencies to establish health care information systems.

41.05.033 - Shared decision-making demonstration project—Preference-sensitive care.

41.05.035 - Exchange of health information—Pilot—Advisory board, discretionary—Administrator's authority.

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.

41.05.074 - Public employees—Prior authorization standards and criteria—Health plan requirements—Definitions.

41.05.075 - Employee benefit plans—Contracts with insuring entities—Performance measures—Financial incentives—Health information technology.

41.05.080 - Participation in insurance plans and contracts—Retired, disabled, or separated employees—Certain surviving spouses, state registered domestic partners, and dependent children.

41.05.085 - Retired state employee and retired or disabled school employee health insurance subsidy.

41.05.090 - Continuation of coverage of employee, spouse, or covered dependent ineligible under state plan—Exceptions.

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.

41.05.123 - Flexible spending administrative account—Salary reduction account—School employees' benefits board flexible spending and dependent care administrative account—School employees' benefits board salary reduction account.

41.05.130 - State health care authority administrative account—School employees' insurance administrative account.

41.05.140 - Payment of claims—Self-insurance—Insurance reserve fund created.

41.05.143 - Uniform medical plan benefits administration account—Uniform dental plan benefits administration account—School employees' benefits board medical benefits administrative account—School employees' benefits board dental benefits administrat...

41.05.160 - Rules.

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.

41.05.220 - Community and migrant health centers—Maternity health care centers—People of color—Underserved populations.

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.

41.05.400 - Plan of health care coverage—Available funds—Components—Eligibility—Administrator's duties.

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.

41.05.526 - Withdrawal management services—Substance use disorder treatment services—Prior authorization—Utilization review—Medical necessity review.

41.05.527 - Opioid overdose reversal medication bulk purchasing and distribution program.

41.05.528 - Standard set of criteria—Medical necessity for substance use disorder treatment—Substance use disorder levels of care—Rules.

41.05.530 - Prescription drug assistance, education—Rules.

41.05.533 - Medication synchronization policy required for health benefit plans covering prescription drugs—Requirements—Definitions.

41.05.540 - State employee health program—Requirements—Report.

41.05.550 - Prescription drug assistance foundation—Nonprofit and tax-exempt corporation—Definitions—Liability.

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.

41.05.650 - Community health care collaborative grant program—Grants—Administrative support—Eligibility.

41.05.651 - Rules—2009 c 299.

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.

41.05.690 - Performance measures committee—Membership—Selection of performance measures—Benchmarks for purchasing decisions—Public process for evaluation of measures.

41.05.700 - Reimbursement of health care services provided through telemedicine or store and forward technology—Audio-only telemedicine.

41.05.730 - Ground emergency medical transportation services—Medicaid reimbursement—Calculation—Federal approval—Department's duties.

41.05.735 - Ground emergency medical transportation services—Medicaid reimbursement—Intergovernmental transfer program—Federal approval—Authority's duties.

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.

41.05.820 - Qualified requirement for health carrier in insurance holding company to offer silver and gold health plans.

41.05.830 - Coverage for hearing instruments—Definitions.

41.05.840 - Universal health care commission.

41.05.890 - Certain health care and financial related data provided to authority—Exempt from disclosure.

41.05.900 - Short title.

41.05.901 - Implementation—Effective dates—1988 c 107.