This bill consolidates the existing public employees' benefits board and school employees' benefits board into a single Washington employees and retirees benefits board (WERB) housed within the Washington state health care authority. It creates or amends multiple sections of chapter 41.05 RCW, adds new sections, and repeals numerous listed RCW provisions. The authority is given a governor‑appointed director and expanded administrative powers to operate public employee benefit plans, contract for claims administration, set premium contributions, centralize enrollment and claims data, and approve or deny employer group or tribal participation; the WERB is charged with designing benefit plans, setting eligibility criteria and premium subsidy limits, and may establish penalties for employing‑agency failures. The bill makes extensive fiscal and structural changes: it creates and clarifies several treasury accounts (public employees’ and retirees’ insurance account, salary reduction account, flexible spending administrative accounts, uniform medical and dental administration accounts, and a reserve fund), authorizes investment and transfers among accounts, and allows the authority to self‑fund, self‑insure, and contract for services. It directs the authority to implement a chronic care management program, to use evidence‑based measures and health information technology, and to centralize data and quarterly reviews with carriers. It establishes separate actuarial risk pools effective January 1, 2027 — including a Medicare‑eligible risk pool for individuals eligible for Medicare Parts A and B — and requires one‑time payments from certain employer groups that terminate participation after May 4, 2023. The bill also changes eligibility, coverage, and procedural rules: it consolidates definitions of state and school employees, protects certain pre‑2010 eligibility, prescribes detailed rules for seasonal and faculty eligibility and for school board member participation, requires dependent coverage to age 26 with narrow disability exceptions, and directs WERB to offer HSA options. It imposes specific coverage and utilization rules for clinical services and plan operations — for example, a chronic care/health home emphasis, telemedicine reimbursement parity and conditions, restrictions and timelines for prior authorization and medical necessity review for substance use disorder treatment, separate billing for immediate postpartum contraception devices, and availability of Medicare supplemental policies to certain enrollees. Several cross‑references and substantive sections (including section 34, section 36, and section 36(7)) and some definitions are not included in the provided text, so full operative details and the complete scope of certain changes cannot be confirmed from these extracts alone.

If enacted, the bill centralizes design and approval of public employee health benefits in a new Washington employees and retirees benefits board housed in the state health care authority and gives that authority broad control over premium setting, contracting, enrollment files, claims data, and employer billing. For employers and employer groups this likely means new or changed contribution obligations, new billing and one-time payment rules when contracts end, potential penalties for improper eligibility determinations, and regular data and reporting demands; the director of the authority will control multiple treasury accounts and can require quarterly utilization and claims reporting from carriers. For workers and beneficiaries the practical effects include consolidated eligibility rules (with detailed new rules for seasonal workers, faculty, judges, legislators, and school board members), a separate Medicare-only risk pool starting January 1, 2027 that will change how premiums and subsidies are calculated for Medicare-eligible retirees and survivors, expanded coverage and payment rules (telemedicine parity, limited prior authorization for certain SUD care, immediate postpartum contraception billing), and stronger emphasis on chronic care management and health homes. Key operational details and timing (for example the full duties and structure set out in the referenced sections establishing the board and certain cross-references) are not included in the available text, so exact implementation steps, budget impacts, and how some penalties or one-time payment formulas will be applied remain unclear.