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HB 1766

Prohibiting certain contracting practices by a health carrier acting as a third-party administrator for self-insured coverage offered to public employees.

2025-2026 Regular Session Introduced by Nicole Macri and 7 co-sponsors

Bill restricts health carriers acting as third-party administrators for public employee self-insured plans from certain profit-driven contracting practices that create care-access conflicts of interest.

Public hearing in the House Committee on Health Care & Wellness at 1:30 PM.
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Bill Summary · HB 1766

Legislative bill overview

HB 1766 restricts health carriers that act as third-party administrators (TPAs) for self-insured public employee health plans from engaging in certain contracting practices. The bill aims to prevent conflicts of interest where TPAs might prioritize their own financial interests over plan members' access to care. This applies specifically to public employee health benefits in Washington state.

Why is this important

Self-insured plans for public employees represent significant healthcare spending and affect thousands of workers and their families. TPAs acting in dual roles—both administering claims and potentially benefiting financially from claim denials—create structural conflicts of interest that can limit coverage access. This bill addresses concerns that such arrangements may inflate costs or restrict care without adequate safeguards.

Potential points of contention

  • Cost implications: Healthcare carriers may argue that restrictions increase administrative costs, potentially raising premiums for public employers and employees
  • Market structure: Limiting TPA contracting practices could reduce available vendors, potentially forcing public employers to use fewer companies or renegotiate existing arrangements at higher rates
  • Definition ambiguity: The bill's specific prohibited practices aren't detailed in this summary, creating questions about what contracting terms would actually be forbidden and how broadly they apply

Compiled from official sources — confirm details with the bill’s official record.

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