The bill establishes new regulations regarding the surplus of nonprofit health insurance carriers in Washington State, emphasizing their commitment to providing affordable health insurance and improving public health. It mandates that by October 1, 2026, the commissioner must assess whether a nonprofit health carrier's surplus is excessive, defined as being 100 times the minimum net worth level specified in existing law. If deemed excessive, the carrier is required to pay 10 percent of the 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 to potentially reduce the required payment if they can demonstrate that the payment would jeopardize their financial stability. The commissioner has the authority to adopt rules for implementing these provisions. Overall, the bill aims to ensure that nonprofit health carriers contribute to the state's health care funding while maintaining their financial viability.