The Washington Insurance Commissioner’s Office (OIC) responded to my public disclosure request and released the settlement agreement signed by the Business Health Trusts (BHT) and Commissioner Kreidler on September 28, 2015. The Agreement includes two exhibits. Exhibit A which alphabetically lists employers in each of the 13 different associations comprising BHT and Exhibit B which lists employers insured through the trusts sorted alphabetically by trust.
According to the settlement agreement, these exhibits were provided as “Exhibits A and B to the Declaration of Emmy Jordan In Support of Plaintiffs’ Reply In Support of Plaintiffs’ Motion for Summary Judgment.” The reference made concerns documents filed by BHT in the Seattle federal court case (No. 2:14-cv-01918-RSL). Emmy Jordan stated in the declaration:
I am a Trustee for Business Health Trust, the third party administrator and named fiduciary for thirteen (13) industry-specific Health Benefit Trusts. I am also the Senior Vice President Programs and Partnerships for Seattle Metropolitan Chamber of Commerce.
A review of these two exhibits reveals some employers appearing on one list but not the other. Thus, I am unable to conclude whether the lists draw from distinct databases for each of the respective associations or whether the lists constitute membership versus insurance coverage. For example, Arlington Machine and Welding appears in Exhibit B with the End-Line Manufacturing Industry Health Trust but not in Exhibit A with the End-Line Manufacturing.
Bottom Line
Insurance Commissioner Kreidler agreed not to disapprove health plan rate and form filings made by insurance carriers on behalf of the 13 trusts –
…for the 2015 or future plan years, on the grounds that the sponsors of the trusts fail to satisfy the definition of “employer” under the Employee Retirement Income Security Act of 1974 (BRISA), 29 U.S.C. § 1002(5),provided that the 2015 and future filings comply with the requirements in the Office ofthe Insurance Commissioner’s rules and filing instructions; each filing includes the current membership lists for each association and each trust; the bylaws and trust documents are not materially changed in a way that diminishes or limits member control of any trust; there is no intervening binding, valid, and relevant change in the applicable law or, there is no intervening Final Agency Action.
Final Agency Action means a reviewable final order issued by the U.S. Department of Labor (“DOL”), pursuant to ERISA, 29 U.S.C. §§ 1131-1151 or a final order issued by a federal court with jurisdiction over the Plaintiffs, relating to the Plaintiffs’ status under 29 U.S.C. 1002(5). [at 2]
For their part, BHT agreed:
To continue to provide current Membership Lists for the 13 industry groups, and the 13 Trusts, like those attached as Exhibits A and B to the Declaration of Emmy Jordan In Support of Plaintiffs’ Reply In Support of Plaintiffs’ Motion for Summary Judgment, for submission with any association health plan filing submitted on behalf of one of the 13 Trusts. [at 2]
The reason for the settlement? Apparently, BHT gave the Insurance Commissioner “additional information, that was not submitted by Premera, including the employers who are members of the 13 associations or groups that created and continue to sponsor the 13 Trusts, and the employers who are members of the 13 Trusts, to the OIC in the course of this litigation.”
Darn it, all of this litigation could have been avoided if only the right piece of paper had been filed with the Commissioner.
