Around the PIA Western Alliance States – Week of August 3, 2026

Published August 4, 2026 at 2:46 PM · News Releases and Bulletins

Alaska — The 2027 National Council on Compensation Insurance, Inc. Worker’s Compensation Prospective Loss Cost Filing: Under Alaska Statute (AS) 21.39.043, the director of the Division of Insurance is required to hold an administrative hearing to discuss whether a workers’ compensation prospective loss cost filing meets the requirements of AS 21.39 and whether the filing should be approved, disapproved, or modified, in whole or in part.

In accordance with AS 21.39.043, a hearing will be held on September 16th, 2026, in conference room 1560 located on the 15th floor of the Atwood Building, 550 West Seventh Avenue, Anchorage, Alaska. The hearing will begin at 10:00 a.m. and end no later than 12:00 p.m.

Join on a video conferencing device — https://bit.ly/4xoArvN

Tenant key: 260748889@t.plcm.vc

Video ID: 116 035 342 2

An interested party may participate in the hearing process as follows:

inspect the filing and supporting information and examine witnesses;

present written or oral testimony or evidence at the hearing;

apply for subpoenas to be issued by the director to compel attendance of witnesses and the production of evidence.

Under AS 21.39.043, an “interested party” is defined to mean:

an employer association;

an employee or labor association;

a producer;

a producer association;

an insurer member or subscriber of the rating organization; and

other persons who are substantially affected by the loss cost filing.

An interested party who plans to present testimony at the hearing should provide notice of participation to the division in advance of the hearing date. To assist in having a productive hearing, the division requests that written testimony and evidence or requests for modifications to the filing that will be presented at the hearing be submitted to the division and to the National Council on Compensation Insurance, Inc. (NCCI) on or before September 10, 2026.

Testimony or evidence presented at the hearing must be limited to whether the filing’s prospective loss costs meet the requirements of AS 21.39 and may include a recommendation for approval, disapproval, or modification.

Before the hearing, a member or subscriber to NCCI may submit interrogatories directly to NCCI, including requests for additional supporting information concerning the filing. A copy of any requests sent directly to NCCI should also be sent to the division.

A member or subscriber to NCCI may obtain copies of all public documents related to the loss cost filing directly from NCCI. Other interested parties may obtain copies of all public documents from the division.

After the hearing, the director will leave the hearing record open for 10 days, during which time interested parties may submit additional written testimony and documentary evidence concerning the loss cost filing and members or subscribers may submit proposed modifications to the filing.

All such correspondence and documentation must be received by the division no later than 5:00 p.m., September 28, 2026.

All comments, written testimony, requests for modification, notice of participation, and other communication with the division related to this hearing should reference the 2027 NCCI Loss Cost Filing and be sent via email to Director of Insurance Heather Carpenter at: heather.carpenter@alaska.gov

If you are a person with a disability who needs special accommodation in order to participate in the process, please contact Ira Blankenship via email at ira.blankenship@alaska.gov no later than September 9, 2026, to ensure that any necessary accommodations can be provided.

After the hearing, subject to the procedures under AS 21.39.043, the director will issue an order regarding the filing.

Notice of Public Meeting: https://bit.ly/4bwJwKq

<image002.png>

California — An Agent ALERT: This alert from Insurance Commissioner Ricardo Lara regarding “FAIR Plan growth slows below 2% as California’s insurance market continues to show signs of recovery.”

Click here to see the review content: https://content.govdelivery.com/attachments/CAINSUR/2026/08/03/file_attachments/3734869/FAIR%20Plan%20growth%20slows%20below%202%25%20as%20California%E2%80%99s%20insurance%20market%20continues%20to%20show%20signs%20of%20recovery%20-%20080326.pdf

Idaho — DOI Publishes Preliminary Qualified Health Plan Insurance Rates for 2027: The Idaho Department of Insurance (DOI) has received preliminary premium rates from health insurance carriers for Qualified Health Plans to be sold starting January 2027. The DOI is seeking public comments before rates are finalized.

The DOI is reviewing premium rate submissions from health insurance carriers for 2027’s individual and small group Qualified Health Plans. These proposed health insurance premium rates are published on the DOI website at https://doi.idaho.gov/consumers/health-insurance/idaho-rate-review/. The average proposed change in premium by location, metal level, and the corresponding 2027 rates by plan, as well as the carriers’ explanations for the changes, are available for public review and comment. Health carriers filed an average individual plan rate change of 13%, and an average small group plan rate change of 12%.

By law, the DOI only has the authority to determine the rates “unreasonable” if the requests are not adequately justified by actuarial standards of practice. Final rates will be publicly available October 1, 2026, at the same web address. Idaho’s 2027 increases are similar to the national average, demonstrating the continued stability of Idaho’s market. Idaho is in year four of the five-year Health Innovation 1332 waiver, which lowered individual market rates in 2026 by 18% compared to what they would have been without the waiver. In 2027, Idaho’s Health Innovation 1332 waiver will maintain individual health insurance premiums 16% lower than they would be without the waiver.

“The continued effect of the 1332 waiver, combined with the Governor and Legislature’s efforts to minimize cost drivers, has helped Idaho maintain more stable and competitive rates over the past several years,” said Idaho Department of Insurance Director Dean Cameron. “Although the increasing cost of medical care continues to drive premiums higher, Idaho’s rates are expected to remain lower than most other states.”

The 1332 waiver and the Idaho High Risk Reinsurance Pool have helped keep Idaho’s individual health insurance market highly competitive and healthy. Idaho consumers can expect to choose from 7 health carriers and 144 plans on the marketplace for 2027 (visit yourhealthidaho.org). Very few states have as many carriers or options.

Comments, questions, or ideas can be submitted via online form at https://bit.ly/4hfhqqM or mailed to the following:

2027 Rate Comments

Idaho Department of Insurance

PO Box 83720

Boise ID 83720-0043

The DOI encourages consumers to carefully review all their options with a licensed insurance agent once the final rates are published.

Idaho — To Insurers Licensed to Write Commercial or Property Insurance: Revised Nonrenewal and Cancellation Notice Requirements for Commercial and Standard Fire Policies, Effective January 1, 2027

This bulletin advises insurers of the revised policyholder notice periods for nonrenewals and cancellations of policies subject to Idaho Code §§ 41-1842 and 41-2401, as enacted by Idaho House Bill 562 (2026). Idaho House Bill 562 (2026) amends Idaho Code § 41-1842 (Commercial Insurance – Cancellation – Nonrenewal) and Idaho Code § 41-2401 (Standard Fire Policy).

For commercial property, commercial liability, and commercial multiperil policies subject to § 41-1842, the notice period for nonrenewal is sixty (60) days before the expiration date, and the notice period for a for-cause cancellation under § 41-1842(3)(a)(ii) through (vii) is sixty (60) days. The ten (10) day notice period for cancellation due to nonpayment of premium is unchanged, as are the thirty (30) day notice for premium or coverage changes under § 41-1842(5) and the thirty (30) day notice for cancellation of a policy within its first sixty (60) days under § 41-1842(3)(a).

For standard fire policies subject to § 41-2401, which include all personal homeowners, dwelling fire, and renters coverage, the notice period for nonrenewal or cancellation is sixty (60) days. The ten (10) day notice period for cancellation due to nonpayment of premium is unchanged. Also added to § 41-2401 is a notice-content requirement: both the sixty (60) day nonrenewal notice and the sixty (60) day cancellation notice must be accompanied by a statement of the reason for the nonrenewal or cancellation. The Department interprets this requirement to mean that the stated reason must identify the specific basis for the company's decision with enough particularity to inform the policyholder why the action is being taken. A general reference to underwriting or company guidelines, without more detail, does not satisfy this requirement.

These revised notice periods apply to policies issued or renewed with an effective date of issuance or renewal on or after January 1, 2027. Insurers must file conforming forms with the Department before January 1, 2027.

This Bulletin is not new law but is an agency interpretation of existing law, except as authorized by law or as incorporated into a contract. Requests for additional information or other inquiries regarding this Bulletin can be directed to the Rates and Forms team: (208) 334-4250.

Idaho — To Disability/Health Insurance Carriers in Group or Individual Markets: Third Party Payments of Premiums or Cost Sharing for Health Benefit Plans and Medicare Supplement Plans (Reissuance of Bulletin 16-04)

Neither Idaho Insurance Code nor federal law generally prohibits health insurance carriers from accepting third party payments of premiums or cost sharing (such as deductibles, coinsurance, and copayments), nor do they generally require carriers to accept such payments from every third party. In limited circumstances, however, carriers are required to accept third party payments.

This bulletin clarifies when carriers must accept third party payments toward a policyholder’s or certificate holder’s (“insured’s”) insurance premium or cost sharing; as well as when out-of-pocket expenses paid by a third party must be credited toward the insured’s deductible and out-of-pocket maximum accumulators.

Idaho Code § 41‑348(2) limits third party payments made by “service providers” as defined, prohibiting the practice of providers “waiving, rebating, giving, paying, or offering to waive, rebate, give or pay all or part of a claimant's deductible or claim for casualty, disability insurance, worker's compensation insurance, health insurance or property insurance.”

Federal regulation at 45 CFR § 156.1250, requires carriers offering Qualified Health Plans (QHPs) to accept and apply third party payments of premiums or cost sharing from the following entities:

a Ryan White HIV/AIDS Program;

an Indian tribe, tribal organization, or urban Indian organization; and

local, state or federal government programs, including grantees directed by a government program to make payments on its behalf.

The Department extends this requirement to all carriers offering health benefit plans, as defined at Idaho Code §§ 41‑4703(13) and 41‑5203(13), because a plan that refuses such payments would be unfairly prejudicial to an insured and subject to disapproval under Idaho Code § 41‑1813(2).

In addition, carriers are required to accept payments on behalf of an insured from the following third parties:

individuals such as family and friends,

religious institutions and other not-for-profit organizations when:

the assistance is provided on the basis of the insured’s financial need;

the third party is not a healthcare provider; and

the third party is not financially interested.

“Financially interested” third parties include organizations that receive the majority of their funding from entities with a pecuniary interest in the payment of health insurance claims, or organizations that are subject to direct or indirect control of entities with a pecuniary interest in the payment of health insurance claims.

When a third party from whom the carrier is required to accept payment under this bulletin makes a cost sharing payment, the carrier must credit that payment toward the insured's deductible and out-of-pocket maximum accumulators as if the insured had made the payment directly.

Any payment made directly by the insured must be accepted by the carrier and the insured cannot be required to certify or verify the source of the funds.

Medicare supplement insurance policies are not included in the statutory definition of health benefit plans, but carriers must accept payments from third parties toward Medicare supplement policies as long as such payments do not violate the anti-kickback provisions of the Social Security Act (§ 1128B codified at 42 USC § 1320a‑7b).

A health benefit plan that limits third party payments must have the limitation as part of the insured’s contract, and the language must be no more restrictive than the minimum standard described in this bulletin. Upon rejecting or otherwise refusing to treat a third party payment as a payment from the insured, the carrier must inform the insured in writing of the reason for doing so and of the insured’s right to file a complaint with the Department.

This bulletin establishes the minimum circumstances under which a carrier must accept and credit third party payments. It does not authorize or require a carrier to accept or reject any payment outside those circumstances, and it does not relieve a carrier of any obligation under other applicable state or federal law, including the guaranteed availability requirements of 45 CFR § 147.104 and the nondiscrimination requirements of 42 USC § 18116.

Idaho — To Disability/Health Insurance Carriers in Individual and Small Group Markets. Pediatric Dental Coverage and Reasonable Assurance (Reissuance of Bulletin 14‑02)

This guidance applies to all essential health benefits (EHB) compliant individual and small group health benefit policies whether sold through Your Health Idaho (YHI), the Idaho health insurance exchange, or sold outside of YHI.

Section 1302 of the Affordable Care Act (ACA) requires all comprehensive health insurance plans to cover the ten EHB categories, which include pediatric oral (dental) care. Section 1302(b)(4)(F) of the ACA provides an exception for qualified health plans (QHPs) to exclude pediatric oral care, only if at least one exchange-certified stand-alone dental plan (SADP) is available in the service area of the QHP.

The final federal rule on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, issued February 25, 2013, confirms that the pediatric dental care exception applies only to QHPs. It states that “the [ACA] does not provide for the exclusion of a pediatric dental EHB outside of the Exchange as it does in section 1302(b)(4)(F) of the Affordable Care Act for QHPs.” The rule further states that QHPs purchased outside an exchange may exclude coverage of the pediatric dental care EHB only if, prior to issuance, the QHP carrier is “reasonably assured that an individual has obtained such coverage through an Exchange-certified stand-alone dental plan… [which] ensures full coverage of EHB.” See 78 Fed. Reg. at 12853.

With the intent to ensure overall fairness and efficiency of the individual and small group health insurance markets, the Idaho Department of Insurance (Department) will apply these provisions as follows.

Applicable to QHPs when sold through Your Health Idaho

Section 1302(b)(4)(F) of the ACA allows the exclusion of pediatric dental care EHB as long as there is at least one SADP available through YHI in the rating area where the plan is being offered. Consequently, there is no additional reasonable assurance requirement for QHPs purchased through YHI. The consumer is not required to purchase separate pediatric dental care EHB coverage, and the QHP’s carrier must not delay enrollment in the plan due to lack of pediatric dental care coverage.

Applicable to QHPs when sold outside of Your Health Idaho

The final EHB rule allows for a carrier selling a QHP off-exchange to exclude the pediatric dental care EHB in its QHP if it is reasonably assured that the consumer has an exchange-certified SADP. See 78 Fed. Reg. at 12853. To meet this standard, the Department will consider the inclusion of clear disclosure language on enrollment forms/application for individuals, employers, and employees as evidence that the carrier is reasonably assured of other exchange-certified SADP coverage. The Department recommends disclosure language similar to:

“The policy you are applying for does not include coverage for pediatric dental care, which is considered an essential health benefit under the Affordable Care Act. Pediatric dental care is available in the market and can be purchased as a stand-alone product. Please contact your insurance agent, your health insurance company, or Your Health Idaho if you wish to purchase a stand-alone dental care product.”

Without the disclosure, a QHP purchased outside of YHI which excludes the pediatric dental care EHB would not meet the requirement to offer all ten EHB categories. A carrier should not ask consumers to inform them of other pediatric dental coverage, and a carrier must not require that the consumer purchase such coverage.

Applicable to non-QHPs

Under the final 2013 Program Integrity Rule, “a [non-SADP] plan sold to consumers exclusively outside of the Exchange could not obtain QHP certification,” therefore, a plan sold only outside of YHI is a “non-QHP.” See 78 Fed. Reg. at 37044. Neither the ACA nor the EHB rule provides an allowance for non-QHPs to exclude the pediatric dental care EHB. Non-QHPs must provide coverage of all EHB categories, and non-QHPs are not eligible for the “reasonable assurance” allowance.

Oregon — Division of Financial Regulation proposes revised rates; saves consumers and businesses $30 million: The Division of Financial Regulation (DFR) responded to 2027 health insurance rate requests filed for the individual and small group markets with reductions that could save consumers approximately $30 million for plan year 2027.

In the individual market, DFR decreased the average rate increase from 17.5 percent to 16 percent, while in the small group it reduced insurers’ increase from an average of 17 percent to 15.5 percent, some receiving reductions of up to 8 percent.

While plans and prices change each year, the individual market continues to experience uncertainty, primarily due to the loss of the federal enhanced premium tax credits, which Congress chose not to extend in 2025. Those tax credits helped make health insurance plans more affordable for nearly 120,000 Oregonians. Gov. Tina Kotek previously warned of significant premium increases, in a letter to Congress, along with 17 other governors. Gov. Kotek urged Congress to extend the tax credits to help protect the people of Oregon. Additionally, insurance companies identified the underlying reasons for the rate increases for plan year 2027, which included the loss of two insurance companies in the individual market, heightened medical costs, and tariff pressures on durable medical equipment and pharmaceuticals. Many of the same cost pressures were identified in the small group market.

The Oregon Reinsurance Program continues to help stabilize the market and lower the rate increases. This year the reinsurance program lowered rates by an average of 9.7 percent, minimizing price increases felt by consumers. Reinsurance lowered rates for the ninth straight year. Oregon has resubmitted a renewal request to the federal government to maintain this program. The Oregon Legislature adopted Gov. Kotek’s 2025-27 funding plan, which continued revenue streams that keep the reinsurance program stable. Rates for the individual market in Oregon have come in lower than other states in part because of the reinsurance program.

“Increasing insurance rates are part of the rising cost of living felt by many Oregonians,” said Oregon Insurance Commissioner TK Keen. “Consequently, I’m proud of the work my dedicated team here at DFR has done to protect Oregonians’ pocketbooks by scrutinizing the proposed increases further and appropriately turning the dial downward.”

You can see all the adjusted rate proposals on the DFR website for individual and small group. DFR will announce its final rate decisions for the 2027 plan year in early September.

Consumers seeking information and assistance with individual market plans can reach out to the Oregon Health Insurance Marketplace at oregonhealthcare.gov or by phone at 855‑268‑3767 (toll‑free).

Oregon — The Oregon Division of Financial Regulation recently announced the following proposed rulemaking: Filing Caption: List of Prosthetic and Orthotic Devices under ORS743A.145

Rules Proposed: 836-052-1000

Rules Summary: Establishes list of prosthetic and orthotic devices; prohibits internal or separate limits or caps on prosthetic and orthotic devices, other than the lifetime policy maximum, when permitted by law; defines when coverage for prosthetic and orthotic device is provided through a managed care organization.

Filed: July 14, 2026

Hearing date/time: August 26, 2026, 10:30 AM

Last Day and Time to Offer Comment to Agency: September 2, 2026, 5:00 PM

Oregon — The Oregon Division of Financial Regulation recently announced the following proposed rulemaking: Filing Caption: Prescription Drug Price Transparency program updates

Rules Proposed: 836-200-0505, 836-200-0515, 836-200-0520, 836-200-0530, 836-200-0531, 836-200-0532, 836-200-0533, 836-200-0535, 836-200-0545, 836-200-0555

Rules Summary: These proposed changes add a clarifying definition for “drug;” correct internal references; revert annual price increase reporting from voluntary to mandatory per a recent court judgment; clarify language about the timing of data reporting; add examples of factors that may contribute to price increases; update the threshold for reporting new prescription drugs; and add minor data collection points to allow for DPT program staff verification.

Filed: July 29, 2026

Hearing date/time: August 26, 2026, 9:30 AM

Last Day and Time to Offer Comment to Agency: September 2, 2026, 5:00 PM

Washington — Notice of Mental Health Parity Rulemaking prepublication draft: We released a pre-publication draft for the Mental Health Parity rulemaking (R 2025-13). The commissioner is considering rulemaking (R 2025-13) due to the recent passage of E2SHB 1432 (2025) and other changes in law. Multiple provisions of health care and insurance regulations in the Washington Administrative Code (WAC) may need to be updated by the OIC to be consistent with the legislation passed and codified in the Revised Code of Washington (RCW).

The comment period for this rule began at 12:00 a.m. on August 4, 2026, and will close at 11:59 p.m. on August 18, 2026. Please send comments to rulescoordinator@oic.wa.gov.

For more information, including the prepublication draft, please visit the rule webpage.