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SEBB staff present proposed 2027 premiums; PIA program cited as major downward pressure on trends
Summary
Finance staff showed proposed 2027 employee premiums and employer medical contribution (EMC) methodology (EMC = 85% of UMP Achieve 2 bid rate), illustrated with 85% of $800 = $680, and said the Public Employee Access and Affordability program (Senate Bill 5,083 / RCW 41.05.028) materially reduced projected carrier rate trends for 2027.
Sarah Whitley, in finance, presented the proposed 2027 premium tables and explained how the employer medical contribution (EMC) is calculated as 85% of the UMP Achieve 2 bid rate. Using an $800 illustrative bid rate, she said, “85% of $800 is $680,” which is then subtracted from each plan's bid rate to derive employee premium contributions for single and tiered enrollments.
Whitley also walked the board through the Public Employee Access and Affordability (PIA) program enacted in 2025 (Senate Bill 5,083; staff cited RCW 41.05.028), which staff described as capping in‑network hospital facility reimbursement at 200% of Medicare beginning Jan. 1, 2027, setting minimum reimbursement floors for primary care and behavioral health at 150% of Medicare, and adding balance‑billing protections; staff said those reforms materially lowered projected 2027 carrier bid‑rate trends and underwrote the more modest year‑over‑year premium impacts presented.
