The Contractor will assist OIC with data gathering and analysis related to implementing an obesity treatment benefit as described in ESSB 5167. The data gathering and analysis must include: a. Obtaining utilization and cost data from the WA-APCD and, if needed, Washington State health carriers as defined in RCW 48.43.005 that is sufficient to estimate the cost impact, as described in this section, of including an obesity treatment benefit in the commercial health plan market. The Contractor will be responsible for accessing the WAAPCD and/or developing a data call to carriers in consultation with OIC to obtain data necessary to complete the analysis. If a data call is necessary, it will be issued by OIC. b. The Contractor will analyze the data obtained from WA-APCD and any data obtained from carriers to conduct: A utilization and cost analysis of each of the following service components of obesity treatment o Intensive health, behavioral, and lifestyle treatment, o Metabolic and bariatric surgery, and o Food and Drug Administration-approved obesity medication. An analysis of the extent to which the services above and any related services are currently covered by commercial health plans in Washington state, and consumer cost-sharing associated with those services. c. Estimate the total annual cost of the benefit, per member per month cost, as well as any state fiscal impact, of implementing an obesity treatment benefit in the following markets, both separately and in the aggregate, for plan years 2028 through 2029: Individual Small Group Large Group Public Employees Benefit Plan (PEBB) School Employee Benefit Plan (SEBB)
