Bill
SB 5808
Nonprofit health carriers must report surpluses, and if excess above 600% RBC, 3% of that excess goes to a state fund to support premium assistance programs.
SB 5808 (Funding health insurance premium assistance)
Overview
- Purpose: Create a funding mechanism for a health insurance premium assistance program by requiring nonprofit health carriers to report and potentially contribute a portion of their surplus to a state premium assistance fund.
- Status: First reading, referred to Ways & Means. Introduced April 8, 2025.
- Effective date: January 1, 2026.
- Legislative basis: Adds a new section to chapter 48.43 RCW; authorizes rules and establishes an administrative process administered by the state insurance commissioner.
Key provisions and changes
- Reporting of surplus (Sec. 2):
- By July 1, 2026, and annually thereafter, nonprofit health carriers must submit to the commissioner the amount of the carrier’s surplus.
- Determination of excessive surplus (Sec. 2):
- By October 1, 2026, and annually thereafter, the commissioner must determine whether a nonprofit health carrier’s surplus is excessive.
- Excessive surplus is defined as surplus above 600 percent of the carrier’s RBC (risk-based capital) requirements, per the RBC instructions.
- Payment to the state health care affordability account (Sec. 2):
- If surplus is determined excessive (with limited exceptions), within 90 days the nonprofit carrier must pay 3 percent of the excessive surplus to the commissioner for deposit into the state health care affordability account (to administer a premium assistance program under RCW 43.71.110 and 43.71.130).
- Hearing and possible reduction (Sec. 2):
- Within 30 days of an excess surplus determination, a carrier may request a hearing to seek a reduction in the required payment.
- The commissioner may reduce the payment only if the carrier shows clear and compelling evidence that paying the full amount would render the carrier financially impaired under Washington or other states where it does business.
- Hearings follow the procedures in RCW 34.05 (Administrative Procedure Act).
- Rules (Sec. 2):
- The commissioner may adopt rules to implement these provisions.
- Definitions (Sec. 2):
- Excessive surplus: surplus above 600% of RBC requirements.
- RBC: Risk-based capital.
- RBC instructions: As defined in RCW 48.43.300.
- Surplus: Assets minus liabilities.
- Administrative references (Sec. 2):
- Payments go to the state health care affordability account, contributing to premium assistance program administration per existing RCWs cited.
Affected entities and impacts
- Primary affected parties: nonprofit health carriers operating in Washington under RCW 48.43.
- State authorities: Washington State Office of the Insurance Commissioner enforces the reporting, determination, and payment requirements; may adopt implementing rules.
- Public program impact: Funds collected (3% of excessive surplus) feed the state health care affordability account to support premium assistance programs for health insurance costs.
Procedural and timeline notes
- Reporting deadline: July 1 of each year, starting in 2026.
- Determination deadline: October 1 of each year, starting in 2026.
- Payment deadline: Within 90 days of determination for excessive surplus.
- Hearing window: Within 30 days of determination to request a reduction.
- Rulemaking: Commissioner to adopt implementing rules.
- Effective date: January 1, 2026.
Bottom line
SB 5808 establishes a mechanism to fund health insurance premium assistance by requiring nonprofit health carriers to report surplus, identifying an excessive surplus threshold (600% RBC), and directing 3% of excess surplus to a state account for premium assistance, with a carrier hearing process to mitigate financial impairment. The program is intended to support access to affordable coverage in Washington, subject to legislative progress and rulemaking.
Compiled from official sources — confirm details with the bill’s official record.
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