PROPOSED RULES
Original Notice.
Preproposal statement of inquiry was filed as WSR 01-19-095 [01-18-095].
Title of Rule: WAC 182-12-118 Insurance eligibility for surviving dependents of emergency service personnel killed in the line of duty.
Purpose: Add a new section to chapter 182-12 WAC, to include eligibility for surviving dependents of emergency service personnel killed in the line of duty as enacted by the 2001 legislature.
Statutory Authority for Adoption: Chapter 41.05 RCW.
Statute Being Implemented: RCW 41.05.160.
Summary: In 2001, the legislature amended RCW 41.05.011 to define "emergency service personnel killed in the line of duty (RCW 41.05.011(14)) and RCW 41.05.080 to include such persons in PEBB-sponsored coverage at the rate charged to retired or disabled employees on a self-pay basis. These amendments apply to surviving spouses and dependent children of emergency service personnel killed in the line of duty after January 1, 1998.
Reasons Supporting Proposal: WAC 182-12-118 provides details and procedures for applying for this coverage.
Name of Agency Personnel Responsible for Drafting and Implementation: Barbara Scott, Health Care Authority, (360) 923-2642; and Enforcement: MaryAnne Lindeblad, Health Care Authority, (360) 923-2640.
Name of Proponent: Health Care Authority, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: The 2001 legislature amended RCW 41.05.011 and 41.05.080 to include "surviving dependents of emergency service personnel killed in the line of duty," as eligible members for participation in PEBB-sponsored medical and dental coverage.
Originally, it seemed appropriate to amend WAC 182-12-119, however, upon further examination it was determined that a separate rule would make it easer for affected persons to find the requirements.
The proposed new section to chapter 182-12 WAC defines eligibility and establishes rules for the surviving dependent's participation in the program.
Proposal Changes the Following Existing Rules: The proposed rule extends eligibility to surviving dependents that are not identified as eligible individuals under the existing rule.
No small business economic impact statement has been prepared under chapter 19.85 RCW. Not required. The Joint Administrative Rules Review Committee has not requested the filing of a small business economic impact statement, and there will be no costs to small businesses.
RCW 34.05.328 does not apply to this rule adoption.
Hearing Location: Health Care Authority, Executive Conference Room, 4th Floor, 600 Woodland Square Loop, Lacey, WA, on November 27, 2001, at 1:00 p.m. This will be a teleconference hearing. Please call Cyndi Presnell at (360) 923-2802 for the teleconference number.
Assistance for Persons with Disabilities: Contact Nikki Johnson by November 21, 2001, TDD (888) 923-5622, or (360) 923-2805.
Submit Written Comments to: Barbara Scott, Health Care Authority, 676 Woodland Square Loop S.E., Olympia, WA 98504-2684, fax (360) 923-2602, by close of business on November 27, 2001.
Date of Intended Adoption: November 28, 2001.
October 24, 2001
Cyndi L. Presnell
for Melodie H. Bankers
Rules Coordinator
OTS-5286.1
NEW SECTION
WAC 182-12-118
Insurance eligibility for surviving
dependents of emergency service personnel killed in the line of
duty.
Surviving dependents of emergency service personnel who
were killed in the line of duty on or after January 1, 1998, are
eligible to participate in medical and dental coverage
administered by the health care authority and sponsored by the
public employee's benefits board.
(1) This rule applies to the dependents of emergency service personnel "killed in the line of duty" as determined consistent with Title 51 RCW by the department of labor and industries.
(2) "Emergency service personnel" is defined as law enforcement officers, fire fighters and reserve officers, fire fighters as defined in RCW 41.26.030 and 41.24.010.
(3) "Surviving dependent" is defined as:
(a) A lawful spouse or ex-spouse as defined in RCW 41.26.162; and
(b) Dependent children. The term "children" includes unmarried natural children, stepchildren and legally adopted children under the age of twenty or under the age of twenty-four for a dependent student attending high school or an accredited secondary school full-time. Disabled dependents as defined in RCW 41.26.020(7) are eligible at any age.
(4) Premium rates will be subsidized consistent with rates established by the health care authority for non-Medicare retirees under RCW 41.05.022 and for Medicare-eligible retirees under RCW 41.05.085.
(5) Surviving dependents that are Medicare-eligible must enroll in both parts A and B of Medicare.
(6) The surviving dependent must send a completed enrollment application to the health care authority no later than sixty days after:
(a) The last day of any coverage extended by the employing agency of the emergency service employee who died in the line of duty; or
(b) The last day of coverage extended through the Consolidated Omnibus Budget Reconciliation Act (COBRA) from any employing agency.
(7) Surviving dependents must choose one of the following two options for maintaining eligibility for participation under public employee's benefits board sponsored medical and dental coverage:
(a) Enroll in coverage:
(i) Enrollment in a medical plan is required.
(ii) Enrollment in dental coverage is optional. Once enrolled in dental the member must maintain enrollment in a dental plan for a minimum of two years before dental can be dropped.
(iii) Dental only coverage is not available.
(b) Waive enrollment:
(i) Surviving dependents may waive enrollment in public employee's benefits board sponsored medical and dental coverage if they are enrolled in employer sponsored medical through their employment.
(ii) Surviving dependents may enroll in public employee's benefits board sponsored medical and dental when their employer sponsored coverage ends. Proof of their continuous enrollment in employer sponsored coverage must be submitted with their application for enrollment to the health care authority within sixty days of the date that their coverage ended.
(8) Enrollees may change their medical or dental plan selection during the annual open enrollment period held by the health care authority. In addition to the annual open enrollment period, enrollees may change plans if they move out of their plan's service area or into a service area where a plan that was not previously offered is now available.
(9) Surviving dependents will forfeit their right to enroll in public employee's benefits board sponsored medical and dental coverage if they:
(a) Do not make application to the health care authority before the date specified in subsection (6) of this section; or
(b) Do not maintain continuous medical coverage during the waiver period enrollment for public employee's benefits board sponsored medical, as provided in subsection (7)(a)(ii) of this section.
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