Health carrier surpluses

AN ACT Relating to funding for health insurance premium 1
assistance; adding a new section to chapter 48.43 RCW; creating a new 2
section; and providing an effective date. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. (1) The legislature finds that nonprofit 5
health insurance carriers in the state are required to:6
(a) Be committed to a nonprofit corporate structure;7
(b) Provide individuals, businesses, and other groups with 8
affordable and accessible health insurance; and 9
(c) Recognize a responsibility to contribute to the improvement 10
of the overall health status of the residents of the jurisdictions in 11
which they operate. 12
(2) The legislature further finds that access to health insurance 13
and public services play a critical role in improving the health 14
status of Washington residents. 15
NEW SECTION. Sec. 2. A new section is added to chapter 48.43 16
RCW to read as follows: 17
(1) By July 1, 2026, and annually thereafter, nonprofit health 18
carriers must submit to the commissioner the amount of the carrier's 19
surplus. 20
S-2604.2
SENATE BILL 5808
State of Washington 69th Legislature 2025 Regular Session
By Senator Robinson
Read first time 04/08/25. Referred to Committee on Ways & Means.
p. 1 SB 5808
(2)(a) By October 1, 2026, and annually thereafter, the 1
commissioner must determine whether a nonprofit health carrier's 2
surplus is excessive. 3
(b) The surplus of a nonprofit health carrier must be determined 4
to be excessive if the surplus is greater than 600 percent of the 5
nonprofit health carrier's RBC requirements, in accordance with the 6
formula set forth in the RBC instructions. 7
(3) Except when a reduction in payment is permitted under 8
subsection (4) of this section, if the commissioner determines the 9
surplus of a nonprofit health carrier to be excessive, within 90 days 10
of the determination the nonprofit health carrier must pay three 11
percent of the excessive surplus to the commissioner's office for 12
deposit into the state health care affordability account created in 13
RCW 43.71.130 to administer a premium assistance program, as 14
established in RCW 43.71.110. 15
(4)(a) Within 30 days of a determination by the commissioner that 16
a nonprofit health carrier's surplus is excessive, a nonprofit health 17
carrier may request a hearing by the commissioner to consider a 18
reduction in the required amount of excessive surplus payment to the 19
fund. 20
(b) The commissioner may only reduce a nonprofit health carrier's 21
payment to the fund if the nonprofit health carrier presents clear 22
and compelling evidence to the commissioner that the required amount 23
of excessive surplus payment would render the nonprofit health 24
carrier financially impaired under the laws of this state or any 25
other state in which the nonprofit health carrier is authorized to do 26
business. 27
(c) The hearing must be conducted in accordance with chapter 28
34.05 RCW. 29
(5) The commissioner may adopt rules to implement this section.30
(6) The definitions in this subsection apply throughout this 31
section unless the context clearly requires otherwise.32
(a) "Excessive surplus" means the amount of a nonprofit health 33
carrier's surplus above 600 percent of the nonprofit health carrier's 34
RBC requirements, as determined in subsection (2) of this section.35
(b) "RBC" means risk-based capital. 36
(c) "RBC instructions" has the same meaning as in RCW 48.43.300.37
(d) "Surplus" means the amount by which a nonprofit health 38
carrier's assets exceed its liabilities. 39
p. 2 SB 5808
NEW SECTION. Sec. 3. This act takes effect January 1, 2026.1
--- END ---
p. 3 SB 5808