Around the PIA Western Alliance States – Week of July 21, 2025

California — Work Comp Rate Increase Approved: For the first time since January of 2015, California’s work comp rates are going to rise. Commissioner Ricardo Lara has approved a hike of 8.7% that will take effect on September 1st.

That brings the pure premium rate to $1.52 per $100 of payroll.

It’s a drop from what the Workers’ Compensation Insurance Rating Bureau wanted. It submitted a request for an 11.2% increase.

Source link: Business Insurance — https://bit.ly/4m43JtJ

California — Commissioner Lara announces appointments to the CAARP Advisory Committee, the COIN Advisory Board, and the Curriculum Board: Insurance Commissioner Ricardo Lara announced several appointments to help continue driving forward the California Department of Insurance’s mission to protect California consumers. These appointments include reappointing members Nona Tirre to the California Automobile Assigned Risk Plan (CAARP) Advisory Committee and Maïté Irakoze Baur to the California Organized Investment Network (COIN) Advisory Board, as well as naming Cathy Little as the newest member of Curriculum Board.

“Consumers benefit when expert voices are at the table advocating for Californians’ best interests, and I am pleased to announce my reappointments to CAARP and COIN, and naming a new member to the Curriculum Board,” said Commissioner Lara. “I am grateful that these leaders in their communities have agreed to serve their fellow Californians to ensure greater transparency, fairness, and a robust insurance market.”

The Governor and California State Legislature created CAARP to provide auto insurance for motorists unable to obtain coverage in the private market due to their driving records or other extraordinary circumstances. One program within the plan -- the California Low Cost Auto Program -- aims to provide affordable liability insurance to income-eligible good drivers by assigning them to private insurers based upon the companies’ share of the state’s auto insurance market. The CAARP Advisory Committee provides policy advice to Commissioner Lara and the Department on matters affecting the operation of its programs.

The California Organized Investment Network (COIN) was established in 1996 within the Department to guide insurers on making financially sound investments that yield environmental benefits throughout California and social benefits within the State’s underserved communities. Commissioner Lara has prioritized COIN investments which drive affordable housing, support small businesses, combat climate change, and encourage investors to utilize diverse investment managers more. The COIN Advisory Board provides guidance to the Commissioner and the COIN program to meet its mission and chief priorities.

The Curriculum Board oversees the development of pre-licensing and continuing education curriculum for agents and brokers to uphold professional standards that protect consumers. This includes a list of preapproved courses of study as well as courses of study for professional designations. This Board also develops standards for providers and instructors who offer courses and other training to licensed agents and brokers.

The next CAARP Advisory Committee meeting will be held on August 19 and August 20, 2025, the next COIN Advisory Board meeting is August 14, 2025, and the next Curriculum Board meeting is July 17, 2025.

More details are available at: www.insurance.ca.gov/boards. Public members of the CAARP Advisory Committee receive $250 per meeting. All other positions are uncompensated.

California — Commissioner Lara expands mental health access with final landmark rulemaking to enforce California: Continuing the transformation in expanding access to mental health and substance use disorder treatment, California Insurance Commissioner Ricardo Lara enacted landmark regulations enforcing California’s Mental Health Parity Act. These regulations follow the passage of Senate Bill 855 (Chapter 151, Statutes of 2020), authored by Senator Scott Wiener, and commit to end decades of unfair and unequal treatment by health insurance companies that has disadvantaged many vulnerable Californians. The regulations also implement Assembly Bill 988 (Chapter 747, Statutes of 2022), authored by Assembly Member Rebecca Bauer-Kahan, and ensure that coverage for behavioral health crisis services under the AB 988 system are integrated into the requirements of SB 855.

The newly enacted regulations spell out rules that insurance companies must follow, requiring that health insurance cover health care services that are medically necessary to diagnose, prevent, and treat all mental health conditions, as well as substance use disorders, equal to coverage provided for other medical conditions. These regulations also establish a formal process for patients to file complaints so the California Department of Insurance (Department) can investigate claims denials and other unequal service by insurance companies.

“Mental health is human health, and we are making clear that treating mental health and substance use disorders should not be an afterthought,” said Commissioner Lara, who strongly supported SB 855. “At a time when access to this lifesaving care is being threatened at the federal level, California will not turn its back on the vulnerable who are under threat of losing the help they urgently need.”

The purpose of SB 855 was to modernize California’s mental health parity law to require health insurance companies cover treatment for all mental health and substance use disorders that are recognized by the national and international authorities, and to require health insurance companies to cover such treatment consistent with clinical standards that constitute generally accepted standards of mental health and substance use disorder treatment and care. Requiring health insurance companies to cover behavioral health crisis services under the AB 988 system in a manner consistent with these regulations is particularly important with the on-going opioid addiction crisis, because it ensures that all protections conferred by SB 855 apply equally to services mandated under AB 988. 

At a time when the federal Administration is eliminating specialized suicide prevention support for LGBTQ+ youth callers through the AB 988 system, gutting access to medically necessary gender affirming care to treat gender dysphoria, and forbidding states from covering treatment as an essential health benefit, these regulations reaffirm California’s values by protecting access to gender affirming care.

The Department’s new regulations require health insurance companies to align with the World Professional Association of Transgender Health guidelines for treatment of gender dysphoria for people of all ages, defined by the American Psychological Association (APA) as “discomfort or distress related to incongruence between a person’s gender identity, sex assigned at birth, gender identity, and/or primary and secondary sex characteristics.” In managing benefits, under these regulations, insurance companies must now use clinical practice guidelines from nonprofit specialty associations like the APA and follow accepted standards of care. The regulation further details the process that health insurance companies must use to arrange for care for an out-of-network health care provider or facility, if no in-network provider/facility is available.

Consumers may also contact the Department with any questions or concerns relating to their coverage for mental health and substance use disorders, including network adequacy and timely access. Under the regulations, consumers who believe that they were denied care in violation of the regulations can file a complaint with the Department by calling our hotline at (800) 927-4357, or online at insurance.ca.gov. These regulations now outline a process of administrative law to hold insurance companies accountable who are not following the law.

The rulemaking had the support of a coalition of advocates, including The Kennedy Forum and the Steinberg Institute, co-sponsors of SB 855 and AB 988, known as the Miles Hall Lifeline and Suicide Prevention Act.

“SB 855 was a landmark step forward in requiring insurers to treat mental health and substance use disorders on par with physical health conditions. But without strong enforcement, even the best laws can fall short,” said Tara Gamboa-Eastman, Director of Government Affairs of the Steinberg Institute. “These new regulations are essential to realizing the promise of parity. The Steinberg Institute is grateful for Commissioner Lara’s leadership in bringing together advocates, experts, and stakeholders to develop regulations that put Californians’ mental health needs front and center.”

“Californians deserve what that law has already promised: coverage for mental health care without delays, denials, and frustrating hurdles,” said Lauren Finke, Senior Director of Policy at The Kennedy Forum, a nonprofit that advances mental health parity in California and nationwide. “Alongside numerous partners and advocates, the California Department of Insurance has played a critical role in closing the gap between promise and practice, connecting more consumers to the care they need — and deserve. We’re gratified to see these nation leading enforcements, which we consider gold standards.”

Washington — Washington State Foreclosure Prevention Fee - Frequently Asked Questions: Expanding and Funding the Foreclosure Mediation Program (E2SSB 5686) becomes effective July 27, 2025. E2SSB 5686 amends the Deeds of Trust Act, chapter 61.24 RCW, to expand and fund the foreclosure mediation program that is overseen by the Department of Commerce. Section 8 of E2SSB 5686 requires the assessment and collection of a new Foreclosure Prevention Fee.

The Department of Commerce has published a Frequently Asked Questions (FAQ) document  in response to questions received regarding the new fee. This FAQ is subject to change with new questions being answered and current answers being refined. Please check the Department of Commerce’s Foreclosure Fairness Program website under the “Foreclosure Prevention Fee” dropdown menu for ongoing updates.

**Please share this information widely with your respective stakeholder groups**

Please do not hesitate to reach out with any question or concerns — foreclosuremediaton@commerce.wa.gov

Washington — Washington State Foreclosure Prevention Fee – Remittance Information: Expanding and Funding the Foreclosure Mediation Program (E2SSB 5686) becomes effective July 27, 2025. E2SSB 5686 amends the Deeds of Trust Act, chapter 61.24 RCW, to expand and fund the foreclosure mediation program that is overseen by the Department of Commerce. Section 8 of E2SSB 5686 requires the assessment and collection of a new Foreclosure Prevention Fee.

Detailed payment instructions and information regarding Individualized Agreements are now available on the Department of Commerce’s Foreclosure Fairness Program website under the “Foreclosure Prevention Fee” dropdown menu.

The remittance information can also be found in the links below:

Remittance Instructions – Foreclosure Prevention Fee — https://bit.ly/411ODwO

Electronic Funds Transfer Instructions — https://bit.ly/417OO9P

Individualized Agreement Application - Foreclosure Prevention Fee — https://bit.ly/4190qtc

Individualized Agreement Report - Foreclosure Prevention Fee — https://bit.ly/3IDXEpz

Please do not hesitate to reach out with any question or concerns — foreclosuremediaton@commerce.wa.gov

Washington — Ground Ambulance Services Rates Database Technical Update: During the 2024 Legislative Session, Senate Bill 5986 (SSB 5986) added ground ambulance balance billing protections to the Balance Billing Protection Act (BBPA). RCW 48.49.205 requires local governmental entities to submit their ground ambulance rates to the OIC for public posting.

OIC has updated the dataset to reflect the most current local government established and contracted rates. These are technical updates that correct errors.