The bill establishes new regulations for nonprofit health insurance carriers in Washington, emphasizing their commitment to providing affordable health insurance and improving the health status of residents. It introduces a new section to chapter 48.43 RCW, which mandates that by October 1, 2026, the commissioner must assess whether a nonprofit health carrier's surplus is excessive. A surplus is deemed excessive if it exceeds 100 times the minimum net worth level specified in existing law. If a surplus is found to be excessive, the carrier is required to pay 10 percent of that surplus to the state health care affordability account to support a premium assistance program.

Additionally, the bill allows nonprofit health carriers to request a hearing if they believe the required payment would jeopardize their financial stability. The commissioner can reduce the payment amount only if the carrier provides compelling evidence of potential financial impairment. The bill also includes definitions for "excessive surplus" and "nonprofit health carrier," clarifying the scope of the regulations. Overall, the legislation aims to ensure that nonprofit health carriers contribute to the state's health care affordability efforts while maintaining their financial viability.