This bill establishes new requirements for nonprofit health insurance carriers in Washington regarding their surplus funds. By July 1, 2026, these carriers must report their surplus to the commissioner annually. The commissioner will then assess whether the surplus is excessive, defined as exceeding 600 percent of the carrier's risk-based capital (RBC) requirements. If deemed excessive, the carrier must pay three percent of the excessive surplus to the state health care affordability account to support a premium assistance program, unless they can demonstrate that such a payment would jeopardize their financial stability.

Additionally, the bill allows nonprofit health carriers to request a hearing to potentially reduce the required payment if they can provide compelling evidence of financial impairment. The commissioner is granted the authority to adopt rules for implementing these provisions. The act is set to take effect on January 1, 2026.