HB 1627

In Committee

House

Health plans/annual services

Providing enrollees flexibility in obtaining services covered annually or on a multiyear basis.

Introduced (completed)
2
Committee (current stage)
3
Floor Vote (not started)
4
Opposite Chamber (not started)
5
Governor (not started)
6
Signed (not started)

This status may be delayed. See Action History below for the latest updates.

How does a bill become law?

Introduced: The bill is filed and assigned a number.
Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
Governor: The Governor reviews the bill and decides whether to sign or veto it.
Signed: The bill has been signed into law.

Introduced: January 26, 2025

Last Action: January 12, 2026

Status: H HC/Wellness

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AI Analysis

This analysis was generated by AI and may contain errors. It is not legal advice. Always refer to the official bill text for authoritative information.

People & CommunitiesPeople-leaningCorporate & Wealthy Interests

This bill requires health insurers to let enrollees get certain annual or multiyear services (like mammograms or dental cleanings) up to one month earlier than the standard interval—without charging more for those services. It applies to all health, dental, and vision plans starting in 2026, and updates how state employee health plans are regulated.

For annual services (e.g., mammograms, dental cleanings), health plans must allow enrollees to receive the service at least one month before the 12-month mark without increasing cost-sharing.
For biennial or longer-interval services (e.g., certain eye exams or screenings), plans must allow services at least one month before the scheduled interval (e.g., before 24 months) with the same cost-sharing as if done on schedule.
Applies to all health plans, including dental-only and vision-only plans, issued or renewed on or after January 1, 2026.
Requires health carriers to apply the same copays, coinsurance, and deductibles regardless of whether the service is done just before or after the standard interval.
Expands coverage rules under RCW 48.43.500 et al. to include the new flexibility requirement, and incorporates this new rule into the state employee health plan statutes (RCW 41.05.017).

Who is affected

State employees, retirees, and dependents covered under state health plans — Employees and retirees enrolled in state-sponsored health, dental, or vision plans will gain more flexibility in timing of annual or multiyear services (e.g., mammograms, dental cleanings) without facing higher out-of-pocket costs.
Individual and small-group health plan enrollees — Individuals and families purchasing health, dental, or vision insurance through the individual or small-group markets will be able to receive covered preventive or routine services slightly earlier than once-per-year or once-per-two-years without paying higher copays or coinsurance.
Health insurance carriers — Health insurance companies (carriers) that issue or renew plans in Washington must adjust their coverage rules to allow earlier timing of certain services while maintaining the same cost-sharing as if the service were done at the standard interval.
Healthcare providers — Healthcare providers (e.g., dentists, optometrists, physicians) may see changes in scheduling patterns for routine services, as patients may request appointments slightly earlier than previously allowed.

Effective: January 1, 2026Fiscal impact: Minimal fiscal impact expected, as the bill does not create new spending or revenue but may slightly increase utilization of covered services—potentially offset by earlier preventive care reducing long-term costs.

Model: Intel/Qwen3-Coder-Next-int4-AutoRoundGenerated: Mar 19, 2026, 11:31 PM

Pro/Con Analysis

Stronger case for benefits

Potential Benefits (4)

Enrollees gain practical flexibility to schedule preventive care (e.g., mammograms, dental cleanings) around personal circumstances, travel, or provider availability without facing a gap in coverage or out-of-pocket penalties.
HealthcarePeopleRef: Sec. 1: '...allow an enrollee to obtain the covered service at least one month before 12 months have elapsed...'
Prevents insurers from imposing higher copays or coinsurance for services received slightly early, protecting consumers from unexpected financial burdens that might otherwise discourage timely preventive care.
FinancialPeopleRef: Sec. 1: '...apply the same cost-sharing requirements that would have been applied if the service occurred after 12 months had elapsed.'
Extends flexibility to multiyear services (e.g., eye exams), allowing individuals to align care with their actual health needs rather than rigid calendar intervals, which may improve long-term health outcomes.
HealthcarePeopleRef: Sec. 1: 'For any covered service that a health carrier covers biennially or at another multiyear frequency...'
Standardizes consumer rights across state employee plans and private markets, ensuring that state workers and their families receive the same scheduling flexibility as other insured Washingtonians.
Rights & LibertiesLean peopleRef: Sec. 2: '...are subject to the provisions of RCW 48.43.500... and section 1 of this act...'

Potential Concerns (3)

Mandating identical cost-sharing for early services removes the financial incentive for insurers to manage utilization, potentially leading to higher premium rates for all policyholders to cover the increased volume of claims.
FinancialLean industryRef: Sec. 1: '...apply the same cost-sharing requirements that would have been applied if the service occurred after 12 months had elapsed.'
Healthcare providers may face operational inefficiencies and scheduling conflicts as patients cluster appointments in the final month of their eligibility window, potentially reducing capacity for new patients or those with urgent needs.
Business & EmploymentLean industryRef: Sec. 1: '...allow an enrollee to obtain the covered service at least one month before 12 months have elapsed...'
Administrative burden on insurance carriers increases as they must update plan documents, member communications, and claims processing systems to distinguish between 'early' and 'on-time' services while applying identical cost-sharing rules.
Business & EmploymentLean industryRef: Sec. 1: 'For health plans, including dental only and vision only plans...'

Who Is Most Affected

Health Insurance EnrolleesPositive Impact
Gain the ability to schedule preventive services more conveniently without financial penalty, improving access to care and reducing barriers to routine health maintenance.
Health Insurance CarriersNegative Impact
Must update plan terms, claims systems, and member communications to accommodate the new timing flexibility, resulting in modest administrative costs and potential premium adjustments.
Healthcare ProvidersMixed Impact
May experience shifts in appointment scheduling patterns, with potential for increased demand in specific time windows, requiring adjustments to staffing and capacity planning.
State Employees and RetireesPositive Impact
Benefit from the same flexibility as private market enrollees, ensuring equitable access to preventive services under state-sponsored health plans.