Revised Code of Washington
Chapter 41.05 - State Health Care Authority.
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...

RCW 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 administration account.

(1) The uniform medical plan benefits administration account is created in the custody of the state treasurer. Only the director or the director's designee may authorize expenditures from the account. Moneys in the account shall be used exclusively for contracted expenditures for uniform medical plan claims administration, data analysis, utilization management, preferred provider administration, and activities related to benefits administration where the level of services provided pursuant to a contract fluctuate as a direct result of changes in uniform medical plan enrollment. Moneys in the account may also be used for administrative activities required to respond to new and unforeseen conditions that impact the uniform medical plan, but only when the authority and the office of financial management jointly agree that such activities must be initiated prior to the next legislative session.
(2) Receipts from amounts due from or on behalf of uniform medical plan enrollees for expenditures related to benefits administration, including moneys disbursed from the public employees' and retirees' insurance account, shall be deposited into the account. The account is subject to allotment procedures under chapter 43.88 RCW, but no appropriation is required for expenditures. All proposals for allotment increases shall be provided to the house of representatives appropriations committee and to the senate ways and means committee at the same time as they are provided to the office of financial management.
(3) The uniform dental plan benefits administration account is created in the custody of the state treasurer. Only the director or the director's designee may authorize expenditures from the account. Moneys in the account shall be used exclusively for contracted expenditures related to benefits administration for the uniform dental plan as established under RCW 41.05.140. Receipts from amounts due from or on behalf of uniform dental plan enrollees for expenditures related to benefits administration, including moneys disbursed from the public employees' and retirees' insurance account, shall be deposited into the account. The account is subject to allotment procedures under chapter 43.88 RCW, but no appropriation is required for expenditures.
(4) The school employees' benefits board medical benefits administrative account is created in the custody of the state treasurer. Only the director or the director's designee may authorize expenditures from the account. Moneys in the account shall be used exclusively for school employees' benefits board contracted expenditures related to claims administration, data analysis, utilization management, preferred provider administration, and other activities related to benefits administration for self-insured medical plans. Receipts from amounts due from or on behalf of enrollees for expenditures related to benefits administration, including moneys disbursed from the school employees' insurance account, shall be deposited into the account. The account is subject to allotment procedures under chapter 43.88 RCW, but no appropriation is required for expenditures.
(5) The school employees' benefits board dental benefits administration account is created in the custody of the state treasurer. Only the director or the director's designee may authorize expenditures from the account. Moneys in the account shall be used exclusively for school employees' benefits board contracted expenditures related to benefits administration for the self-insured dental plan as established under RCW 41.05.140. Receipts from amounts due from or on behalf of the self-insured dental plan enrollees for expenditures related to benefits administration, including moneys disbursed from the school employees' insurance account, shall be deposited into the account. The account is subject to allotment procedures under chapter 43.88 RCW, but no appropriation is required for expenditures.

[ 2022 c 157 § 11; 2018 c 260 § 27; 2017 3rd sp.s. c 13 § 811; 2007 c 507 § 1; 2000 2nd sp.s. c 1 § 901.]
NOTES:

Intent—2017 3rd sp.s. c 13: See note following RCW 28A.150.410.


Severability—2000 2nd sp.s. c 1: "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." [ 2000 2nd sp.s. c 1 § 1047.]


Effective date—2000 2nd sp.s. c 1: "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 2, 2000]." [ 2000 2nd sp.s. c 1 § 1048.]

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.