Washington Office of the Insurance Commissioner

The first meeting of the Obesity Treatment Analysis Advisory Group focused on administrative and foundational elements for the group's work. Key agenda items included logistics such as meeting recordings being posted on the OIC website and the establishment of a dedicated webpage. Introductions were made for the Milliman and WSIPP teams, followed by introductions from the advisory group members. A major discussion point involved a review of ESSB 5167, which mandates the Office of the Insurance Commissioner (OIC) to analyze the cost of including obesity treatment benefits in various health plans. The review detailed the required analysis components, including intensive health/behavioral treatment, bariatric surgery, and FDA-approved obesity medication, as well as reporting requirements to the governor and legislature by September 30, 2026. The roles of contracted entities, Milliman (actuarial analysis) and WSIPP (effect analysis), were clarified. Finally, the agenda concluded with input solicitation regarding future meetings and next steps.

The meeting served as the second session for the Obesity Treatment Analysis Advisory Group. Key discussion points included updates on the current project status, confirming that both Millman and WISP analyses are in progress and on target with the work plan deadlines, leading up to a final report submission in September 2026. The session included a detailed overview of WISP's methodology, which involves a benefits-only estimation using a general formula for net present value, omitting treatment costs. The literature review process was explained, detailing two streams: a clinical review focusing on peer-reviewed literature concerning cost savings, intervention effectiveness, and adherence thresholds (e.g., weight loss percentages), and a supplemental review for non-clinically based assumptions, such as gray literature data. The methodology for screening literature, which involves defining in-scope interventions (bariatric surgery, FDA-approved weight loss drugs, and intensive lifestyle treatments), and assessing study quality (e.g., study design, control groups, funding source) was also presented.

The first meeting of the Obesity Treatment Analysis Advisory Group commenced to discuss the analysis mandated by Engrossed Substitute Senate Bill 5167, Section 145. This analysis requires the Office of the Insurance Commissioner (OIC), in consultation with the Healthcare Authority, to evaluate the cost of including an obesity treatment benefit in commercial health plans and public employee benefits programs. The scope includes intensive health, behavioral, and lifestyle treatment, metabolic and bariatric surgery, and FDA-approved obesity medications. OIC has contracted with Milleman for actuarial analysis and the Washington State Institute for Public Policy (WISP) for analysis of treatment effects on weight loss and diabetes. The work plan involves gathering current coverage data from carriers, developing an analysis plan, and conducting literature review to determine projections for plan years 2028 through 2029. Advisory group members introduced themselves, sharing their expertise related to obesity treatment from various sectors including policy, actuarial science, endocrinology, pharmacy benefits management, and healthcare advocacy.

The public hearing was convened to discuss the proposed rule titled Fire Loss Reporting, identified by the docket number R2025-03, which was published in the Washington State Register under WSR25-09-084. The purpose of this rule making is to implement the requirements of Second Substitute Senate Bill 5419, mandating that insurers report fire losses directly to the Insurance Commissioner's Office (OIC) instead of the Washington State Patrol. The proposed rule adds a new subsection to WAC 284-20-010, directing authorized insurers to the OIC website for reporting instructions. Representatives from the Northwest Insurance Council and NAMIC provided testimony, expressing concern about the reporting instructions being outside the formal rule text, allowing potential future unilateral changes by the department, and seeking clarification on whether using the ISO claim search feature satisfies the new reporting requirements.

The meeting of the Wildfire Mitigation and Resiliency Standards Work Group focused on finalizing and addressing several questions to compile a report. Key discussion points included aligning state wildfire property mitigation standards, enhancing community wildfire mitigation efforts, sharing risk data, improving hazard and risk transparency for insurance consumers, and establishing a retrofit grant program. The group reviewed a recommendation survey, addressed areas of strong agreement and disagreement, and discussed the construction and timeline of the report to the legislature.