The bill reenacts and amends statutory definitions in RCW 48.200.020 and RCW 41.05.017, adds new sections to chapter 48.200 RCW and chapter 48.43 RCW, and creates an additional new section. Sections 1 through 4 of the act take effect January 1, 2026. The new provisions apply to contracts entered into or renewed on or after the effective date of the relevant section. Substantively, the act imposes new restrictions on vision benefit managers and on health carriers or limited health care service contractors that offer vision coverage. It prohibits practices including paying different reimbursement amounts among tiers of contracting providers of the same licensed profession in the same health plan, reimbursing providers licensed under chapter 18.53 RCW at lower rates than ophthalmologists licensed under chapters 18.57 or 18.71 for the same covered vision services or materials, requiring contracting providers to buy services or materials from suppliers in which the manager or carrier has a financial interest, requiring providers to accept fees set by the manager or carrier unless the items are covered, forcing providers to join a vision benefit manager’s network or participate with other specified plans or regulated discount plans as a condition of participating in a specific health plan, and imposing different credentialing standards for providers licensed under chapter 18.53 RCW than for ophthalmologists. The bill also caps enrollee cost sharing for covered vision services or materials at 50% of the provider reimbursement, with an exception to preserve health savings account tax treatment under IRS rules. The act also reenacts and amends RCW 41.05.017 to make public employee medical insurance plans subject to a specified list of provisions (including numerous sections of chapters 48.43 and 48.200 and chapter 48.49), and it authorizes the insurance commissioner to adopt rules necessary to implement the act. Important text is incomplete in the provided excerpts: the new section added to chapter 48.43 RCW is only partly shown, the bill references “covered vision services” and “covered vision materials” without providing definitions in the extracted text, sections 1 and 2 content is not present here, the content of section 3 is not included, and the effective date for the entire act beyond Sections 1–4 is not stated in the excerpts.

If enacted, the bill will stop health carriers, limited health care service contractors, and vision benefit managers from forcing eye-care providers to buy lenses or frames from companies the payer or manager owns, from setting provider fees for noncovered items, or from making providers join a separate vision benefit manager network or other plans as a condition of participating in a health plan. It also caps patient cost sharing for covered vision services or materials at 50% of what the provider is paid (with an exception to preserve HSA tax benefits), bans different credentialing rules for providers licensed under chapter 18.53 RCW versus ophthalmologists, and makes these rules apply to contracts entered into or renewed on or after January 1, 2026 for Sections 1–4; the insurance commissioner can write rules to implement the changes. The groups most affected are health carriers, limited health care service contractors that sell vision-only plans, affiliated vision benefit managers, and contracting vision providers (including those licensed under chapter 18.53 and ophthalmologists). Payers will lose some leverage to require preferred suppliers, to unilaterally set fees for noncovered items, and to force broad network participation, which may increase administrative work and limit certain cost-control tools. Providers will have more freedom to choose suppliers and avoid forced network arrangements and could see improved negotiation leverage or different payment mixes, while enrollees should face limits on high copayments for covered vision care. The text provided leaves out complete definitions of "covered vision services/materials," the full list of related provisions, and other sections of the act, so some operational details and scope remain unclear.