Apple health employer assess

AN ACT Relating to creating an apple health employer assessment 1
to fund the health care affordability account; amending RCW 2
43.71.130; and adding a new chapter to Title 74 RCW.3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. (1) Beginning in the calendar year 5
following the community engagement implementation year, an apple 6
health employer assessment is imposed on apple health employers. The 7
assessment equals the total member months for an apple health 8
employer during the preceding calendar year, multiplied by 100 9
percent of the medicaid fair share capitation amount.10
(2) The apple health employer assessment shall be collected on a 11
quarterly basis in a form and manner required by the employment 12
security department that is consistent with the collection of 13
premiums under chapter 50A.10 RCW. One-fourth of the apple health 14
employer assessment shall be remitted by the apple health employer to 15
the department each calendar quarter. 16
(3)(a) By March 15th of the calendar year following the community 17
engagement implementation year and by March 15th of every year 18
thereafter, the department of social and health services shall 19
calculate the apple health employer assessment for each apple health 20
employer with data provided by the other administering agencies.21
S-3854.2
SENATE BILL 6173
State of Washington 69th Legislature 2026 Regular Session
By Senators Alvarado, Robinson, Dhingra, Bateman, Frame, Stanford,
Pedersen, Lovelett, Trudeau, Hasegawa, Chapman, Cleveland, Conway,
Nobles, Orwall, Riccelli, Saldaña, Valdez, and C. Wilson
Read first time 01/15/26. Referred to Committee on Ways & Means.
p. 1 SB 6173
(b) The administering agencies shall enter into data-sharing 1
agreements to fulfill the requirements of this section.2
(4) By April 1st of the calendar year following the community 3
engagement implementation year and by April 1st every year 4
thereafter, the employment security department shall notify apple 5
health employers of their apple health employer assessment obligation 6
for the current calendar year, which shall be remitted to the 7
employment security department as provided in subsection (2) of this 8
section. 9
(5) Moneys collected under this section must be deposited in the 10
state health care affordability account under RCW 43.71.130. Moneys 11
in the account may be spent only after appropriation.12
(6) The definitions in this subsection apply to this section 13
unless the context clearly requires otherwise. 14
(a) "Administering agencies" means the employment security 15
department, department of social and health services, and the health 16
care authority. 17
(b) "Community engagement implementation year" means the first 18
calendar year in which the community engagement requirements under 42 19
U.S.C. Sec. 1396a are implemented in the state of Washington as 20
determined by the health care authority. 21
(c) "Employer" has the same meaning as provided in RCW 22
50A.05.010. 23
(d) "Employed" means a qualified individual who works not less 24
than 80 hours per month for an apple health employer.25
(e) "Medicaid fair share capitation rate" means the composite 26
capitation rate for the medicaid expansion population in the 27
community engagement implementation year, and each calendar year 28
thereafter, using the most recent managed care organization 29
capitation rates from the health care authority, as certified by the 30
contracted actuary. The medicaid fair share capitation rate includes 31
both the physical health rate component and the behavioral health 32
rate component. 33
(f) "Apple health employer" means an employer subject to the 34
premiums imposed under chapter 50A.10 RCW with one or more employed 35
qualified individuals concurrently enrolled in medicaid in the 36
preceding calendar year, as determined by the administering agencies. 37
An "apple health employer": 38
(i) Does not include: 39
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(A) Any employer with fewer than 100 employees employed in the 1
state; 2
(B) The federal government; 3
(C) The state, state institutions, and state agencies; and4
(D) Any unit of local government including, but not limited to, a 5
county, city, town, municipal corporation, quasi-municipal 6
corporation, or political subdivision. 7
(ii) In the case of a franchise, means the franchisor rather than 8
the franchisee. For the purpose of this subsection, "franchise," 9
"franchisee," and "franchisor" have the same meanings as defined in 10
chapter 19.100 RCW. 11
(g) "Member month" means each month a qualifying individual works 12
for an apple health employer. 13
(h) "Qualifying individual" means an individual enrolled in 14
medicaid who meets community engagement requirements under 42 U.S.C. 15
1396a, as determined by the health care authority.16
Sec. 2. RCW 43.71.130 and 2021 c 246 s 3 are each amended to 17
read as follows: 18
(1) The state health care affordability account is created in the 19
state treasury. Moneys in the account may be spent only after 20
appropriation. Expenditures from the account may only be used for 21
premium and cost-sharing assistance programs established in RCW 22
43.71.110 and for health care programs for low-income individuals.23
(2) The following funds must be deposited in the account:24
(a) Any grants, donations, or contributions of money collected 25
for purposes of the premium assistance or cost-sharing reduction 26
programs established in RCW 48.43.795; 27
(b) Any federal funds received by the health benefit exchange 28
pursuant to RCW 43.71.120; ((and))29
(c) Any additional funding specifically appropriated to the 30
account; and31
(d) Any revenue collected from the apple health employer 32
assessment as outlined in section 1 of this act. 33
NEW SECTION. Sec. 3. Section 1 of this act constitutes a new 34
chapter in Title 74 RCW.35
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