Around the PIA Western Alliance States – Week of January 5, 2026

California — New laws sponsored by Commissioner Lara to strengthen consumer protections and wildfire resilience: Beginning January 1, 2026, nine new laws sponsored by Insurance Commissioner Ricardo Lara and the California Department of Insurance will go into effect, delivering stronger consumer protections for all Californians.

These new laws establish a wildfire safety grant program, expand insurance discounts, speed up claim payouts for wildfire survivors, extend non-renewal protections to businesses, strengthen the financial stability of the FAIR Plan, and modernize outdated insurance laws to improve transparency and accountability.

“The recent wildfires in Southern California exposed deep weaknesses in a 30-year-old framework of insurance regulation and enforcement. These new laws are part of a broader solution to put consumers in command by giving them more options, more transparency, and faster recoveries on their own terms,” said Commissioner Lara. “Protecting consumers is my top priority. I am grateful for the continued partnerships with the Governor and state legislators who helped champion these important measures.”

A lawmaker by training – having served in both the State Assembly and State Senate –Commissioner Lara brings a deep understanding of how laws, policies, data, and practices intersect. He has consistently applied this perspective to modernize insurance oversight and strengthen consumer protections statewide since his first day as Insurance Commissioner.

The following laws will go into effect on January 1, 2026 (unless otherwise noted):

Wildfire Safety

·      The California Safe Homes Act (AB 888), authored by Assembly Member Lisa Calderon, protects homes and access to insurance by establishing a new grant program within the Department of Insurance to assist qualifying residents in obtaining new or replacement fire-safe roofs and implementing fire-safe mitigation measures within five feet of their homes—known as “Zone Zero.” This program will cover part or all the costs and will be included in community-wide safety initiatives.

These mitigation measures are among the most impactful yet costly, and homeowners have consistently communicated their desire to undertake this work but lack the financial means. The California Safe Homes Act will help provide financial assistance for these essential projects.

·      The California Wildfire Public Model Act (SB 429), authored by Senator Dave Cortese, enhances community safety and education by allowing the Department of Insurance to issue grants for establishing the nation’s first publicly available wildfire loss catastrophe model. The public model will facilitate assessments of wildfire risk, educate the public, and ensure greater transparency so communities and homeowners can plan effectively. This new law builds on recommendations from the Cal Poly Humboldt-led Public Wildfire Model Strategy Group.

·      The Insurance and Wildfire Safety Act (AB 1), authored by Assembly Member Damon Connolly, enhances insurance discounts by requiring the Department of Insurance to regularly review its groundbreaking Safer from Wildfires regulations, ensuring this law reflects advancements in science, safety, and mitigation. This regular review will ensure that these regulations meet the needs of consumers and the industry, providing maximum benefits to homeowners and essential support to communities most vulnerable to wildfires.

Consumer Protection

·      Eliminate “The List” Act (SB 495), authored by Senator Ben Allen, requires insurance companies to pay 60 percent of contents coverage limits, capped at $350,000, to wildfire survivors who experience a total loss without needing to submit a detailed inventory list. It also grants consumers at least 100 days to provide proof of loss to their insurance company following a declared state of emergency. Furthermore, the new law will establish specific data collection authority to help the Department of Insurance understand long-term trends in risk management and the integration of information related to climate-driven risks that significantly impact insurance availability.

·      The Business Insurance Protection Act (SB 547), jointly authored by Senators Sasha Renée Pérez and Susan Rubio, builds on the Wildfire Safety and Recovery Act of 2018 (SB 824, authored by then-Senator Lara), which has protected millions of homeowners by prohibiting non-renewals of residential property insurance for one year. This new law extends this existing protection by broadening the insurance moratorium to now include commercial policies, covering businesses, homeowners’ associations (HOAs), condominiums, affordable housing units, and non-profits, among other covered entities.

·      The FAIR Plan Stability Act (AB 226), jointly authored by Assembly Members Lisa Calderon and David Alvarez, enhances consumer safeguards by allowing the FAIR Plan, if authorized by the Insurance Commissioner, to access catastrophic bonds through the California Infrastructure and Economic Development Bank and enter into a line of credit or loan agreements with one or more lenders. This new law provides additional financial support for the state’s insurer of last resort, ensuring timely payment of consumer claims in the event of a major disaster.

·      Annual Insurance Omnibus (AB 487), authored by the Assembly Insurance Committee, clarifies existing law, removes outdated code sections, and establishes new laws developed in collaboration with the Department of Insurance and stakeholders. It benefits the Department and Californians by improving clarity, efficiency, and fairness in regulation.

Health Care

·      Increasing Consumer Protections in Student Health Insurance (AB 594), authored by Assembly Member José Luis Solache, allows students who are no longer enrolled at a university to withdraw from their health insurance coverage and cease paying premiums, makes changes regarding notices that must be given to schools and students when an insurer wants to increase its rates, and institutes a penalty if insurers fail to timely file their rate changes with the Department of Insurance. This new law will go into effect on July 1, 2026.

·      Infertility Treatment Health Care Coverage (SB 729), authored by Senator Caroline Menjivar, requires insurance coverage for fertility and infertility care under disability insurance policies and large group health plans. This protects Californians’ access to in-vitro fertilization (IVF), and updates the definition of infertility to be inclusive of LGBTQ+ family planning experiences, despite any federal action to limit this coverage. This law applies to large and small group health care service plan contracts and disability insurance policies issued, amended, or renewed on or after the bill’s implementation dates. As signed by the Governor in 2024, SB 729 was to take effect on July 1, 2025, but an enacted California State Budget trailer bill delayed implementation to January 1, 2026. For CalPERS, the mandate begins on July 1, 2027.

Oregon — The Oregon Division of Financial Regulation recently announced the following permanent rulemaking: ID 13-2025: Adopt requirement for consumer-friendly summary document in rate filings

Rule: 836-053-0480

Summary: Adopt required consumer friendly summary document for rate filings.

Filed: December 15, 2025

Effective: January 1, 2026

 ID_13-2025TrackedChanges.pdf

For more information on this recently adopted rule, please visit the division's website: https://bit.ly/3Z4wcpK

Oregon — The Oregon Division of Financial Regulation recently announced the following temporary rulemaking: ID 14-2025: Adoption of Quantitative Network Adequacy Standards for 2026 Health Benefit Plans

Rule: 836-053-0300

Summary: Updates the purpose and applicability of network adequacy rules to include health benefit plans issued or renewed on or after January 1, 2026.

Rule: 836-053-0310

Summary: Updates definitions to include terms necessary for the implementation of network adequacy standards, including "Nationally recognized standard," "Telemedicine," and county classifications.

Rule: 836-053-0345

Summary: Adopts quantitative network adequacy access standards for health benefit plans, establishing specific appointment wait time limits and travel time and distance benchmarks consistent with federal standards for Qualified Health Plans.

Filed: December 16, 2025

Effective: January 1, 2026 through June 29, 2026

Oregon — New Consumer Protection Laws: Several new consumer protection laws took effect at midnight on Jan. 1, 2026. The Division of Financial Regulation (DFR), part of the Oregon Department of Consumer and Business Services – the state’s largest consumer protection and business regulatory agency – is releasing an easy-to-follow guide on the new laws.

Senate Bill 605 prohibits health care providers from reporting medical debt to consumer reporting agencies and prohibits consumer reporting agencies from including medical debt on credit reports.

SB 692 requires the Oregon Health Plan and commercial health benefit plans to cover perinatal services, including services provided by doulas, lactation consultants, and lactation educators.

SB 699 expands an existing requirement for health insurance companies to cover prosthetic and orthotic devices in a variety of ways, such as by requiring coverage of devices medically necessary to perform physical exercises to maximize full-body function, including running, biking, swimming, and strength training.

SB 822 strengthens Oregon’s protections for access to health care services under a health benefit plan in a number of ways. It establishes quantifiable and enforceable standards for access to in-network covered services without unreasonable delay, requires that health plan networks account for the needs of diverse communities, and expands the existing law’s protections to cover state-regulated health benefit plans offered by large employers.

SB 1137 requires health benefit plans to cover autologous breast reconstruction procedures. These procedures use the patient’s own tissue either instead of or in addition to implants. The legislation also requires health insurance companies to cover these services out of network if in-network access is inadequate.

House Bill 2130 makes a variety of updates to the laws governing the Oregon Insurance Guaranty Association, which helps cover claims in the event of insurer insolvency when the insurance company no longer has enough funds to meet its obligations. Most significantly for consumers, the law doubles the limit for covered claims from $300,000 to $600,000, which will substantially reduce the risk of uncovered losses in the rare event of a claim against an insolvent insurer.

HB 2564 enhances Oregon’s health insurance rate review process for individual and small group health benefit plans by requiring health insurance companies to include a consumer-friendly summary document as part of their rate filings, to better enable public engagement with the rate review process. It also streamlines the process by removing unnecessary and redundant administrative steps.

HB 3064 requires health benefit plan coverage for a range of U.S. Food and Drug Administration-approved therapies to treat the symptoms of perimenopause, menopause, and postmenopause.

HB 3243 is intended to prevent surprise out-of-network ambulance bills. It prohibits ground ambulance service providers from balance billing an enrollee for covered ground ambulance services if the enrollee has paid the in-network cost-sharing amount. In turn, health benefit plans are required to reimburse ground ambulance services organizations at specified rates.

Washington — Captive insurer regulatory updates proposed rule posted: We have released the proposed rule language on R 2025-14, captive insurer regulatory updates. The rule would implement House Bill 1842, which allows public utility districts to form, own, or use captive insurers. The commissioner is also considering rulemaking to give captive insurers more flexibility in their audited financial statement submissions and to clarify their reporting requirements.

We scheduled a public hearing on the rule:

When: Feb. 18, 2025 at 11:00 a.m.

Where: Virtual via Zoom, please register in advance

Comments on the proposed rule language are due by Feb. 19, 2026, at 11:59 p.m. Please send them to rulescoordinator@oic.wa.gov

For more information, including the proposed rule language (CR-102), please visit the rule's webpage.

Washington — OIC adopts final rule on carrier/provider contract terminations (SSB 5579): We adopted a rule regarding provider contract expirations and terminations (R 2025-10) on December 23, 2025. The rule takes effect January 23, 2026.

The rule implements Substitute Senate Bill (SSB) 5579 (RCW 48.43.732). This new law regulates public statements and notices by health carriers and health care providers regarding potential provider contract terminations.

This rule is necessary to implement SSB 5579 and ensure that interested organizations understand their rights and obligations under the new law.

For the final enrollee and patient standard notice templates under SSB 5579, please visit OIC’s network access filing webpage.

For more information, including the adopted rule (CR-103) and the concise explanatory statement, please visit the rule's webpage.

Washington — OIC adopts final rule on health care benefit managers: We adopted the health care benefit manager rule (R 2025-11) on December 24, 2025. The rule takes effect on January 24, 2026. 

The CR-103 (final rule) implements provisions of E2SSB 5213 (Chapter 242, Laws of 2024, codified at RCW 48.200) that go into effect January 1, 2026. This law regulates the business practices of health care benefit managers (HCBMs), including pharmacy benefit managers (PBMs).

The final rule allows the Office of the Insurance Commissioner (OIC) to continue effective oversight of HCBMs. The final rule ensures that affected entities understand their rights and obligations under these new provisions.

For more information, including the adopted rule (CR-103) and the concise explanatory statement, please visit the rule's webpage.

Washington — Applications open for $2.5M in Washington state disaster assistance: Governor Bob Ferguson is urging people whose homes were damaged December’s historic flooding to apply for $2.5 million in state assistance to help with their immediate needs.

The funding is part of the $3.5 million unlocked with Governor Ferguson’s disaster declaration. The first $1 million was distributed in Disaster Cash Assistance by the Department of Social and Health Services to those most in need. The funding was distributed over five days to more than 2,600 households. More information about recovery assistance, including how to replace food lost in the flooding that was purchased using food benefits, is available at floodrecovery.wa.gov.

“While we work to apply for federal assistance to obtain more extensive relief, this flexible state funding will help people deal with their immediate in the aftermath of this crisis,” Governor Ferguson said. “We are doing all we can to help our communities recover from this historic disaster.”

Those who suffered damage during the storm are encouraged to submit an Unmet Needs Assessment Form. Impacted individuals should visit SAHelp.org and enter their zip code to start the process. After filling out the form, case managers will determine eligibility for Household Needs Grants, which help cover costs associated with recovery to include short-term housing, small home repairs, and food replacement. The Salvation Army is partnering with the state to help people find assistance. In-person assistance is available at Disaster Assistance Centers (DACs), listed below.

Those who may be eligible for a Household Needs Grants must:

Live in an eligible county – Currently King, Snohomish, Skagit, or Whatcom;

Earn 80 percent or less of the area median gross income, as defined by the S. Department of Housing and Urban Development; and

Show that their primary residence was destroyed or seriously damaged (water has reached the electrical outlets on the home’s first floor) by flooding events between December 5 and December 22, 2025.

The state may add more eligible counties as damage assessments are completed. Grants are based on household size, up to the maximums listed below:

Important Information About Applying:

Unmet Needs Assessment Forms are submitted through SAHelp.org, by phone, or in person at Disaster Assistance Centers (DACs) in local areas. Submitting the form does not automatically mean an individual or household will receive state funding. Additional verification will be required.

After the form is submitted, a Salvation Army Disaster Case Manager will contact the resident to review their situation and identify available recovery assistance. This support may include local, state, federal, nonprofit, and donated resources.

How to Apply:

Online: Salvation Army website at SAHelp.org

By phone: 833-719-4981

In person: visit a Disaster Assistance Center in the county in which a resident lives

Those who submit the form will be asked to provide supporting documents to complete their application. Click here to see a list of acceptable documentation.

At the same time, local and state officials are working with the Federal Emergency Management Agency (FEMA) to complete a Joint Preliminary Damage Assessment for Individual and Public Assistance. This process will verify damages and determine whether the state has met various indicators required for FEMA’s Individual and Public Assistance programs. If indicators are met, the governor could request a federal Major Disaster Declaration, which would open the door to additional help for both individual households and public agencies and infrastructure.

Disaster Assistance Center locations:

King County:

Auburn Library (1102 Auburn Way S) – Friday, Jan. 2 (10 a.m. to 6 p.m.) and Saturday, Jan. 3 (1 p.m. to 6 p.m.)

King County Library System Administrative Office (960 Newport Way NW, Issaquah) – Sunday, Jan. 4 (11 a.m. to 6 p.m.)

Carnation Library (4804 Tolt Ave) – Monday, Jan. 5 (11 a.m. to 5 p.m.)

Snohomish County:

Volunteers of America Western Washington (VOA-WW) and Snohomish County are hosting a disaster assistance and resource center.

VOA-WW Sky Valley Center (617 1st St, Sultan) - Sunday, January 11 (10 a.m. to 3 p.m.); Tuesday, January 13 (2 p.m. to 8 p.m.); Wednesday, January 14 (2 p.m. to 8 p.m.)

Additional Disaster Assistance Center locations are planned for Skagit and Whatcom counties the second week of January. More information to come.

Washington — Workplace Changes for 2026: Washington’s minimum wage is now $17.13 per hour. That’s a 2.8% hike and up from last year’s $16.66. The Department of Labor and Industries also reminds employers that 14 and 15 year olds workers must be paid 85% of the state’s minimum wage. That is now $14.56 an hour.

Local government are also allowed to raise the minimum wage requirements in their jurisdictions.

Overtime requirements for exempt workers has also changed. In 2026 employers must pay overtime-exempt workers 2.5 times the minimum wage if they work overtime.

Source link: Insurance Journal — https://bit.ly/49kFOBC

Washington — Registering and identifying umpires in auto appraisals: We adopted the registering and identifying umpires in auto appraisals rule (R2025-04) on December 31, 2025. The rule takes effect on January 31, 2026. The Legislature passed Engrossed Senate Bill 5721 relating to consumer protections for automobile insurance coverage. The new law requires the insurance commissioner to register competent and disinterested umpires who will be identified to auto appraisers if they are unable to agree on an umpire to resolve their loss dispute.

For more information, including the adopted rule CR-103 and the concise explanatory statement, please visit the rule's webpage.