The Washington Insurance Commissioner has filed a request for a postponement in the remaining legal challenges to the Commissioner’s denial of association health plan rates. The agency will regroup after administrative law Judge Finkle ruled that the Commissioner had no authority to demand that association health plans be rated for the association as a whole rather than for each member employer.
The Commissioner will reconsider the denial of 2014 association health plan rates in the following cases:
– Associated Industries Management Services et al., 15-0064
– Building Industry Association ofWashington Health Insurance Trust, 15-0075
– Business Health Trust et al., 15-0133
– Cambia Health Solutions, 15-0071, 15-0078, 15-0084, 15-0114
– Master Builders Association ofK.ing and Snohomish Counties et al., 15-0062
– Moda Health Plan Inc. et al., 15-0063
– Northwest Financial Associations’ Employee Benefit Trust, 15-0087
– Northwest Marine Trade Association and NMT A Trust, 15-0079
– Premera Blue Cross, 15-0113
– Washington Biotechnology and Biomedical Assn Health Trust, 15-0107
– Washington Clean Technology Alliance Health Trust, 15-0110
– Washington Counties Insurance Fund, 15-0034
– Washington State Farm Bureau Health Care Trust, 15-0111
The Commissioner requested a “stay of the briefing schedules for 60 days” from the time previously set by the judge. The Commissioner will review the filings in light of the judge’s decision. The Commissioner has three basic choices:
- He can approve the rates as originally filed.
- He can disapprove the rates on grounds consistent with the judge’s opinion (e.g., allow rating at the employer level but find some other problem with the rates).
- He can approve the rates but find that the association fails to satisfy “bona fide” standards under Department of Labor ERISA rulings.
It’s the third choice that has everyone anxiously awaiting news from the agency.
While the rating issue has been resolved, many employers and insurance producers don’t know whether the “not obviously bona fide” association health plans will be shut down. Past the half-way mark for 2015, employers still don’t know whether the plan they bought last year met regulatory standards, let alone whether this year’s plan satisfies health care reform requirements.
The most common lament from producers who walked away from the association health plan markets is this:
“How long can we expect to lose business to fake association health plans that seem to make up rates as they go along?”
