RCW 48.92.095 — Washington Code / Title 48 / Chapter 92 / Section 095
RCW 48.92.095: Premium taxes—Imposition—Obligations—Member's liability.
Status: in_force

Premium taxes and taxes on premiums paid for coverage of risks resident or located in this state by a purchasing group or any members of the purchasing groups must be: (1) Imposed at the same rate and subject to the same interest, fines, and penalties as those applicable to premium taxes and taxes on premiums paid for similar coverage from authorized insurers, as defined under chapter 48.05 RCW, or unauthorized insurers, as defined and provided for under chapter 48.15 RCW, by other insurers; and (2) The obligation of the insurer; and if not paid by the insurer, then the obligation of the purchasing group; and if not paid by the purchasing group, then the obligation of the insurance producer for the purchasing group; and if not paid by the insurance producer for the purchasing group, then the obligation of each of the purchasing group's members. The liability of each member of the purchasing group is several, not joint, and is limited to the tax due in relation to the premiums paid by that member.
RCW 48.16.010 — Washington Code / Title 48 / Chapter 16 / Section 010
RCW 48.16.010: Deposits of insurers—In general.
Status: in_force

The commissioner shall accept deposits of securities or funds by insurers as follows: (1) Deposits in amount as required to be made as prerequisite to a certificate of authority to transact insurance in this state. (2) Deposits of domestic or alien insurers in amount as required to be made by the laws of other states as prerequisite for authority to transact insurance in such other states. (3) Deposits in amounts as result from application of the retaliatory provision, RCW 48.14.040 . (4) Deposits in other additional amounts permitted to be made by this code.
RCW 46.29.150 — Washington Code / Title 48 / Chapter 29 / Section 150
RCW 46.29.150: Payment upon judgment.
Status: in_force

The payment of a judgment arising out of an accident or the payment upon such judgment of an amount equal to the maximum amount which could be required for deposit under this chapter shall, for the purposes of this chapter, release the judgment debtor from the liability evidenced by such judgment.Title insurers and their property shall be taxed by this state in accordance with the general laws relating to taxation, and not otherwise.
RCW 48.31.100 — Washington Code / Title 48 / Chapter 31 / Section 100
RCW 48.31.100: Foreign or alien insurers—Conservation, ancillary proceedings.
Status: in_force

(1) An order to conserve the assets of a foreign or alien insurer must direct the commissioner immediately to take possession of the property of the insurer within this state and to conserve it, subject to the further direction of the court. (2) Whenever a domiciliary receiver is appointed for a foreign or alien insurer in its domiciliary state that is also a reciprocal state, as defined in RCW 48.99.010 , the court shall on application of the commissioner appoint the commissioner as the ancillary receiver in this state, subject to the provisions of the uniform insurers liquidation act.
RCW 48.102.180 — Washington Code / Title 48 / Chapter 102 / Section 180
RCW 48.102.180: Unfair trade practices.
Status: in_force

The legislature finds that the practices covered by this chapter are matters vitally affecting the public interest for the purpose of applying the consumer protection act, chapter 19.86 RCW. A violation of this chapter is not reasonable in relation to the development and preservation of business and is an unfair or deceptive act in trade or commerce and an unfair method of competition for the purpose of applying the consumer protection act, chapter 19.86 RCW.
RCW 48.111.090 — Washington Code / Title 48 / Chapter 111 / Section 090
RCW 48.111.090: Commissioner may conduct investigations.
Status: in_force

(1) The commissioner may conduct investigations of home heating fuel service contract providers, administrators, home heating fuel service contract sellers, insurers, and other persons to enforce this chapter and protect home heating fuel service contract holders in this state. Upon request of the commissioner, the contract provider shall make all accounts, books, and records concerning home heating fuel service contracts sold by the contract provider available to the commissioner that are necessary to enable the commissioner to determine compliance or noncompliance with this chapter. (2) The commissioner may take actions under RCW 48.02.080 or 48.04.050 that are necessary or appropriate to enforce this chapter and the commissioner's rules and orders, and to protect home heating fuel service contract holders in this state.
RCW 48.200.240 — Washington Code / Title 48 / Chapter 200 / Section 240
RCW 48.200.240: Contract with third party—Prohibited practices.
Status: in_force

An entity that contracts with an independent third party to conduct audits may not: (1) Agree to compensate the independent third party based on a percentage of the amount of overpayments recovered; or (2) Disclose information obtained during an audit except to the contracting entity, the pharmacy subject to the audit, or the holder of the policy or certificate of insurance that paid the claim.
RCW 48.87.060 — Washington Code / Title 48 / Chapter 87 / Section 060
RCW 48.87.060: Administering a plan.
Status: in_force

The commissioner may select an insurer to administer a plan established under this chapter. The insurer must be admitted to transact the business of insurance of the state of Washington.
RCW 48.46.033 — Washington Code / Title 48 / Chapter 46 / Section 033
RCW 48.46.033: Unregistered activities—Acts committed in this state—Sanctions.
Status: in_force

(1) As used in this section, "person" has the same meaning as in RCW 48.01.070 . (2) For the purpose of this section, an act is committed in this state if it is committed, in whole or in part, in the state of Washington, or affects persons or property within the state and relates to or involves a health maintenance agreement. (3) Any person who knowingly violates RCW 48.46.027 (1) is guilty of a class B felony punishable under chapter 9A.20 RCW. (4) Any criminal penalty imposed under this section is in addition to, and not in lieu of, any other civil or administrative penalty or sanction otherwise authorized under state law. (5)(a) If the commissioner has cause to believe that any person has violated the provisions of RCW 48.46.027 (1), the commissioner may: (i) Issue and enforce a cease and desist order in accordance with the provisions of RCW 48.02.080 ; and/or (ii) Assess a civil penalty of not more than twenty-five thousand dollars for each violation, after providing notice and an opportunity for a hearing in accordance with chapters 34.05 and 48.04 RCW. (b) Upon failure to pay a civil penalty when due, the attorney general may bring a civil action on behalf of the commissioner to recover the unpaid penalty. Any amounts collected by the commissioner must be paid to the state treasurer for the account of the general fund.
RCW 48.29.149 — Washington Code / Title 48 / Chapter 29 / Section 149
RCW 48.29.149: Form and rate filings by rating organization—Deviation.
Status: in_force

Every member or subscriber to a rating organization shall adhere to the filings made on its behalf by such rating organization. Deviations from the rating organization's filings are permitted only when filed with the commissioner in accordance with this title. A copy of the deviation filing must be sent simultaneously to such rating organization.
RCW 48.43.220 — Washington Code / Title 48 / Chapter 43 / Section 220
RCW 48.43.220: Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
Status: in_force

(1) No nonrenewals, cancellations, or revisions of ceded reinsurance agreements need be reported under RCW 48.43.200 if the nonrenewals, cancellations, or revisions are not material. For purposes of RCW 48.43.200 through 48.43.225 , a material nonrenewal, cancellation, or revision is one that affects: (a) More than fifty percent of a certified health plan's total reserve credit taken for business ceded, on an annualized basis, as indicated in the certified health plan's most recent annual statement; (b) More than ten percent of a certified health plan's total cession when it is replaced by one or more unauthorized reinsurers; or (c) Previously established collateral requirements, when they have been reduced or waived as respects one or more unauthorized reinsurers representing collectively more than ten percent of a total cession. (2) However, a filing is not required if the certified health plan's total reserve credit taken for business ceded represents, on an annualized basis, less than ten percent of the statutory reserve requirement prior to any cession.
RCW 48.90.170 — Washington Code / Title 48 / Chapter 90 / Section 170
RCW 48.90.170: Costs of investigation or review of plan.
Status: in_force

All reasonable costs of any investigation or review by the commissioner of an association's plan of organization and operation, or any changes or modifications thereof, including the dissolution of a plan, shall be paid by the association before issuance of any approval required under this chapter.
RCW 48.20.025 — Washington Code / Title 48 / Chapter 20 / Section 025
RCW 48.20.025: Schedule of rates for individual health benefit plans—Loss ratio—Definitions.
Status: in_force

(1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise. (a) "Claims" means the cost to the insurer of health care services, as defined in RCW 48.43.005 , provided to a policyholder or paid to or on behalf of the policyholder in accordance with the terms of a health benefit plan, as defined in RCW 48.43.005 . This includes capitation payments or other similar payments made to providers for the purpose of paying for health care services for a policyholder. (b) "Claims reserves" means: (i) The liability for claims which have been reported but not paid; (ii) the liability for claims which have not been reported but which may reasonably be expected; (iii) active life reserves; and (iv) additional claims reserves whether for a specific liability purpose or not. (c) "Declination rate" for an insurer means the percentage of the total number of applicants for individual health benefit plans received by that insurer in the aggregate in the applicable year which are not accepted for enrollment by that insurer based on the results of the standard health questionnaire administered pursuant to *RCW 48.43.018 (2)(a). (d) "Earned premiums" means premiums, as defined in RCW 48.43.005 , plus any rate credits or recoupments less any refunds, for the applicable period, whether received before, during, or after the applicable period. (e) "Incurred claims expense" means claims paid during the applicable period plus any increase, or less any decrease, in the claims reserves. (f) "Loss ratio" means incurred claims expense as a percentage of earned premiums. (g) "Reserves" means: (i) Active life reserves; and (ii) additional reserves whether for a specific liability purpose or not. (2) An insurer must file supporting documentation of its method of determining the rates charged for its individual health benefit plans. At a minimum, the insurer must provide the following supporting documentation: (a) A description of the insurer's rate-making methodology; (b) An actuarially determined estimate of incurred claims which includes the experience data, assumptions, and justifications of the insurer's projection; (c) The percentage of premium attributable in aggregate for nonclaims expenses used to determine the adjusted community rates charged; and (d) A certification by a member of the American academy of actuaries, or other person approved by the commissioner, that the adjusted community rate charged can be reasonably expected to result in a loss ratio that meets or exceeds the loss ratio standard of seventy-four percent, minus the premium tax rate applicable to the insurer's individual health benefit plans under RCW 48.14.020 .
RCW 48.110.900 — Washington Code / Title 48 / Chapter 110 / Section 900
RCW 48.110.900: Date of application to service contracts.
Status: in_force

This chapter applies to all service contracts, other than on motor vehicles, sold or offered for sale ninety or more days after July 25, 1999. This chapter applies to all service contracts on motor vehicles and protection products sold or offered for sale after September 30, 2006.
RCW 48.205.060 — Washington Code / Title 48 / Chapter 205 / Section 060
RCW 48.205.060: Wellness programs—Marketing—Requirements.
Status: in_force

(1) A pet insurer and insurance producer may not: (a) Market a wellness program as pet insurance; or (b) Market a wellness program during the sale, solicitation, or negotiation of pet insurance. (2) If a wellness program is sold by either a pet insurer or an insurance producer, or both: (a) The purchase of the wellness program may not be a requirement to the purchase of pet insurance; (b) The costs of the wellness program must be separate and identifiable from any pet insurance policy sold by either a pet insurer, an insurance producer, or both; (c) The terms and conditions for the wellness program must be separate from any pet insurance policy sold by either a pet insurer, an insurance producer, or both; (d) The products or coverages available through the wellness program may not duplicate products or coverages available through the pet insurance policy; (e) The advertising of the wellness program may not be misleading and must be in accordance with this section; (f) Either a pet insurer or an insurance producer, or both, must clearly disclose the following to consumers, printed in 12-point boldface type: (i) That wellness programs are not insurance; and (ii) The address and customer service telephone number of either the pet insurer or the insurance producer of record, or both. (3) Coverages included in the pet insurance policy contract described as "wellness" benefits are insurance. (4) If any wellness program undertakes to indemnify another or pay a specified amount upon determinable contingencies, it is transacting in the business of insurance and is subject to the insurance code. This definition is not intended to classify a contract directly between a service provider and a pet owner that only involves the two parties as being the business of insurance unless other indications of insurance also exist.
RCW 48.43.093 — Washington Code / Title 48 / Chapter 43 / Section 093
RCW 48.43.093: Health carrier coverage of emergency medical services—Requirements—Conditions.
Status: in_force

(1)(a) A health carrier shall cover emergency services provided to a covered person if a prudent layperson acting reasonably would have believed that an emergency medical condition existed. In addition, a health carrier shall not require prior authorization of emergency services if a prudent layperson acting reasonably would have believed that an emergency medical condition existed. With respect to care obtained from a nonparticipating hospital emergency department or behavioral health emergency services provider, a health carrier shall cover emergency services. In addition, a health carrier shall not require prior authorization of emergency services. (b) A health carrier shall cover emergency services without limiting what constitutes an emergency medical condition solely on the basis of diagnosis codes. Any determination of whether the prudent layperson standard has been met must be based on all pertinent documentation and be focused on the presenting symptoms and not solely on the final diagnosis. (2) Coverage of emergency services may be subject to applicable in-network copayments, coinsurance, and deductibles, as provided in chapter 48.49 RCW. (3) Nothing in this section is to be construed as prohibiting a health carrier from: (a) Requiring notification of stabilization or inpatient admission within the time frame specified in its contract with the hospital or behavioral health emergency services provider or as soon thereafter as medically possible but no less than twenty-four hours; or (b) Requiring a hospital or emergency behavioral health emergency services provider to make a documented good faith effort to notify the covered person's health carrier within 48 hours of stabilization, or by the end of the business day following the day the stabilization occurs, whichever is later, if the covered person needs to be stabilized. If a health carrier requires such notification, the health carrier shall provide access to an authorized representative seven days a week to receive notifications. (4) Except to the extent provided otherwise in this section, follow-up care that is a direct result of the emergency must be obtained in accordance with the health plan's usual terms and conditions of coverage. All other terms and conditions of coverage may be applied to emergency services.
RCW 48.43.305 — Washington Code / Title 48 / Chapter 43 / Section 305
RCW 48.43.305: Report of RBC levels—Distribution of report—Formula for determination—Commissioner may make adjustments.
Status: in_force

(1) Every domestic carrier shall, on or prior to the filing date of March 1st, prepare and submit to the commissioner a report of its RBC levels as of the end of the calendar year just ended, in a form and containing such information as is required by the RBC instructions. In addition, every domestic carrier shall file its RBC report: (a) With the NAIC in accordance with the RBC instructions; and (b) With the insurance commissioner in any state in which the carrier is authorized to do business, if the insurance commissioner has notified the carrier of its request in writing, in which case the carrier shall file its RBC report not later than the later of: (i) Fifteen days from the receipt of notice to file its RBC report with that state; or (ii) The filing date. (2) A carrier's RBC shall be determined in accordance with the formula set forth in the RBC instructions. The formula shall take into account (and may adjust for the covariance between): (a) The risk with respect to the carrier's assets; (b) The risk of adverse insurance experience with respect to the carrier's liabilities and obligations; (c) The interest rate risk with respect to the carrier's business; and (d) All other business risks and such other relevant risks as are set forth in the RBC instructions; determined in each case by applying the factors in the manner set forth in the RBC instructions. (3) An excess of capital over the amount produced by the risk-based capital requirements contained in RCW 48.43.300 through 48.43.370 and the formulas, schedules, and instructions referenced in RCW 48.43.300 through 48.43.370 is desirable in the business of insurance. Accordingly, carriers should seek to maintain capital above the RBC levels required by RCW 48.43.300 through 48.43.370 . Additional capital is used and useful in the insurance business and helps to secure a carrier against various risks inherent in, or affecting, the business of insurance and not accounted for or only partially measured by the risk-based capital requirements contained in RCW 48.43.300 through 48.43.370 . (4) If a domestic carrier files an RBC report that in the judgment of the commissioner is inaccurate, then the commissioner shall adjust the RBC report to correct the inaccuracy and shall notify the carrier of the adjustment. The notice shall contain a statement of the reason for the adjustment.
RCW 48.23.010 — Washington Code / Title 48 / Chapter 23 / Section 010
RCW 48.23.010: Scope of chapter.
Status: in_force

This chapter applies to contracts of life insurance and annuities other than group life insurance, group annuities, and, except for RCW 48.23.260 , 48.23.270 , and 48.23.340 , other than industrial life insurance. However, Title 48 RCW does not apply to charitable gift annuities issued by a board of a state university, regional university, or a state college, nor to the issuance thereof.
RCW 48.44.021 — Washington Code / Title 48 / Chapter 44 / Section 021
RCW 48.44.021: Calculation of premiums—Members of a purchasing pool—Adjusted community rating method—Definitions.
Status: in_force

(1) Premiums for health benefit plans for individuals who purchase the plan as a member of a purchasing pool: (a) Consisting of five hundred or more individuals affiliated with a particular industry; (b) To whom care management services are provided as a benefit of pool membership; and (c) Which allows contributions from more than one employer to be used towards the purchase of an individual's health benefit plan; shall be calculated using the adjusted community rating method that spreads financial risk across the entire purchasing pool of which the individual is a member. Such rates are subject to the following provisions: (i) The health care service contractor shall develop its rates based on an adjusted community rate and may only vary the adjusted community rate for: (A) Geographic area; (B) Family size; (C) Age; (D) Tenure discounts; and (E) Wellness activities. (ii) The adjustment for age in (c)(i)(C) of this subsection may not use age brackets smaller than five-year increments which shall begin with age twenty and end with age sixty-five. Individuals under the age of twenty shall be treated as those age twenty. (iii) The health care service contractor shall be permitted to develop separate rates for individuals age sixty-five or older for coverage for which medicare is the primary payer, and coverage for which medicare is not the primary payer. Both rates are subject to the requirements of this subsection. (iv) The permitted rates for any age group shall be no more than four hundred twenty-five percent of the lowest rate for all age groups on January 1, 1996, four hundred percent on January 1, 1997, and three hundred seventy-five percent on January 1, 2000, and thereafter. (v) A discount for wellness activities shall be permitted to reflect actuarially justified differences in utilization or cost attributed to such programs. (vi) The rate charged for a health benefit plan offered under this section may not be adjusted more frequently than annually except that the premium may be changed to reflect: (A) Changes to the family composition; (B) Changes to the health benefit plan requested by the individual; or (C) Changes in government requirements affecting the health benefit plan. (vii) For the purposes of this section, a health benefit plan that contains a restricted network provision shall not be considered similar coverage to a health benefit plan that does not contain such a provision, provided that the restrictions of benefits to network providers result in substantial differences in claims costs. This subsection does not restrict or enhance the portability of benefits as provided in RCW 48.43.015 . (viii) A tenure discount for continuous enrollment in the health plan of two years or more may be offered, not to exceed ten percent. (2) Adjusted community rates established under this section shall not be required to be pooled with the medical experience of health benefit plans offered to small employers under RCW 48.44.023 . (3) As used in this section and RCW 48.44.023 , "health benefit plan," "small employer," "adjusted community rates," and "wellness activities" mean the same as defined in RCW 48.43.005 .
RCW 48.46.080 — Washington Code / Title 48 / Chapter 46 / Section 080
RCW 48.46.080: Annual statement—Filings—Contents—Fee—Penalty for failure to file—Accuracy required.
Status: in_force

(1) Every domestic health maintenance organization shall annually, on or before the first day of March, file with the commissioner a statement verified by at least two of the principal officers of the health maintenance organization showing its financial condition as of the last day of the preceding calendar year. (2) Such annual report shall be in such form as the commissioner shall prescribe and shall include: (a) A financial statement of such organization, including its balance sheet and receipts and disbursements for the preceding year, which reflects at a minimum; (i) All prepayments and other payments received for health care services rendered pursuant to health maintenance agreements; (ii) Expenditures to all categories of health care facilities, providers, insurance companies, or hospital or medical service plan corporations with which such organization has contracted to fulfill obligations to enrolled participants arising out of its health maintenance agreements, together with all other direct expenses including depreciation, enrollment, and commission; and (iii) Expenditures for capital improvements, or additions thereto, including but not limited to construction, renovation, or purchase of facilities and capital equipment; (b) The number of participants enrolled and terminated during the report period. Every employer offering health care benefits to their employees through a group contract with a health maintenance organization shall furnish said health maintenance organization with a list of their employees enrolled under such plan; (c) The number of doctors by type of practice who, under contract with or as an employee of the health maintenance organization, furnished health care services to consumers during the past year; (d) A report of the names and addresses of all officers, directors, or trustees of the health maintenance organization during the preceding year, and the amount of wages, expense reimbursements, or other payments to such individuals for services to such organization. For partnership and professional service corporations, a report shall be made for partners or shareholders as to any compensation or expense reimbursement received by them for services, other than for services and expenses relating directly for patient care; (e) Such other information relating to the performance of the health maintenance organization or the health care facilities or providers with which it has contracted as reasonably necessary to the proper and effective administration of this chapter, in accordance with rules and regulations; and (f) Disclosure of any financial interests held by officers and directors in any providers associated with the health maintenance organization or any provider of the health maintenance organization. (3) The commissioner may for good reason allow a reasonable extension of the time within which such annual statement shall be filed. (4) In addition to the requirements of subsections (1) and (2) of this section, every health maintenance organization that is registered in this state shall annually, on or before March 1st of each year, file with the national association of insurance commissioners a copy of its annual statement, along with those additional schedules as prescribed by the commissioner for the preceding year. The information filed with the national association of insurance commissioners shall be in the same format and scope as that required by the commissioner and shall include the signed jurate page and the actuarial certification. Any amendments and addendums to the annual statement filing subsequently filed with the commissioner shall also be filed with the national association of insurance commissioners. (5) Coincident with the filing of its annual statement and other schedules, each health maintenance organization shall pay a reasonable fee directly to the national association of insurance commissioners in an amount approved by the commissioner to cover the costs associated with the analysis of the annual statement. (6) Foreign health maintenance organizations that are domiciled in a state that has a law substantially similar to subsection (4) of this section are considered to be in compliance with this section. (7) In the absence of actual malice, members of the national association of insurance commissioners, their duly authorized committees, subcommittees, and task forces, their delegates, national association of insurance commissioners employees, and all other persons charged with the responsibility of collecting, reviewing, analyzing, and dissimilating the information developed from the filing of the annual statement shall be acting as agents of the commissioner under the authority of this section and shall not be subject to civil liability for libel, slander, or any other cause of action by virtue of their collection, review, analysis, or dissimilation of the data and information collected for the filings required under this section. (8) The commissioner may suspend or revoke the certificate of registration of any health maintenance organization failing to file its annual statement or pay the fees when due or during any extension of time therefor which the commissioner, for good cause, may grant. (9) No person shall knowingly file with any public official or knowingly make, publish, or disseminate any financial statement of a health maintenance organization which does not accurately state the health maintenance organization's financial condition.
RCW 48.08.070 — Washington Code / Title 48 / Chapter 08 / Section 070
RCW 48.08.070: Participating policies.
Status: in_force

(1) Any domestic stock insurer may, if its charter so provides, issue policies entitled to participate from time to time in the earnings of the insurer through dividends. (2) Any classification of its participating policies and of risks assumed thereunder which the insurer may make shall be reasonable. No dividend shall be paid which is inequitable or which unfairly discriminates as between such classifications or as between policies within the same classification. (3) No such insurer shall issue in this state both participating and nonparticipating policies for the same class of risks; except, that both participating and nonparticipating life insurance policies may be issued if the right or absence of the right to participate is reasonably related to the premium charged. (4) Dividends to participating life insurance policies issued by such insurer shall be paid only out of its surplus funds as defined in subsection (5) of RCW 48.08.030 . Dividends to participating policies for other kinds of insurance shall be paid only out of that part of such surplus funds which is derived from any realized net profits from the insurer's business. (5) No dividend, otherwise earned, shall be made contingent upon the payment of renewal premium on any policy.
RCW 48.44.300 — Washington Code / Title 48 / Chapter 44 / Section 300
RCW 48.44.300: Podiatric medicine and surgery—Benefits not to be denied.
Status: in_force

Benefits shall not be denied under a contract for any health care service performed by a holder of a license issued under chapter 18.22 RCW if (1) the service performed was within the lawful scope of the person's license, and (2) the contract would have provided benefits if the service had been performed by a holder of a license issued under chapter 18.71 RCW. There shall not be imposed upon one class of doctors providing health care services as defined by this chapter any requirement that is not imposed upon all other doctors providing the same or similar health care services within the scope of their license. The provisions of this section are intended to be procedural to the extent that they do not impair the obligation of any existing contract.
RCW 48.46.062 — Washington Code / Title 48 / Chapter 46 / Section 062
RCW 48.46.062: Schedule of rates for individual agreements—Loss ratio—Definitions.
Status: in_force

(1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise. (a) "Claims" means the cost to the health maintenance organization of health care services, as defined in RCW 48.43.005 , provided to an enrollee or paid to or on behalf of the enrollee in accordance with the terms of a health benefit plan, as defined in RCW 48.43.005 . This includes capitation payments or other similar payments made to providers for the purpose of paying for health care services for an enrollee. (b) "Claims reserves" means: (i) The liability for claims which have been reported but not paid; (ii) the liability for claims which have not been reported but which may reasonably be expected; (iii) active life reserves; and (iv) additional claims reserves whether for a specific liability purpose or not. (c) "Declination rate" for a health maintenance organization means the percentage of the total number of applicants for individual health benefit plans received by that health maintenance organization in the aggregate in the applicable year which are not accepted for enrollment by that health maintenance organization based on the results of the standard health questionnaire administered pursuant to *RCW 48.43.018 (2)(a). (d) "Earned premiums" means premiums, as defined in RCW 48.43.005 , plus any rate credits or recoupments less any refunds, for the applicable period, whether received before, during, or after the applicable period. (e) "Incurred claims expense" means claims paid during the applicable period plus any increase, or less any decrease, in the claims reserves. (f) "Loss ratio" means incurred claims expense as a percentage of earned premiums. (g) "Reserves" means: (i) Active life reserves; and (ii) additional reserves whether for a specific liability purpose or not. (2) A health maintenance organization must file supporting documentation of its method of determining the rates charged for its individual agreements. At a minimum, the health maintenance organization must provide the following supporting documentation: (a) A description of the health maintenance organization's rate-making methodology; (b) An actuarially determined estimate of incurred claims which includes the experience data, assumptions, and justifications of the health maintenance organization's projection; (c) The percentage of premium attributable in aggregate for nonclaims expenses used to determine the adjusted community rates charged; and (d) A certification by a member of the American academy of actuaries, or other person approved by the commissioner, that the adjusted community rate charged can be reasonably expected to result in a loss ratio that meets or exceeds the loss ratio standard of seventy-four percent, minus the premium tax rate applicable to the carrier's individual health benefit plans under RCW 48.14.0201 .
RCW 48.36A.100 — Washington Code / Title 48 / Chapter 36A / Section 100
RCW 48.36A.100: Formation of domestic society—Procedures and requirements.
Status: in_force

A domestic society organized on or after January 1, 1988, shall be formed as follows, but not until it has and continues to maintain unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340 : (1) Seven or more citizens of the United States, a majority of whom are citizens of this state, who desire to form a fraternal benefit society, may make, sign, and acknowledge before some officer competent to take acknowledgment of deeds, articles of incorporation, in which shall be stated: (a) The proposed corporate name of the society, which shall not so closely resemble the name of any society or insurance company as to be misleading or confusing; (b) The purposes for which it is being formed and the mode in which its corporate powers are to be exercised. The purposes shall not include more liberal powers than are granted by this chapter; (c) The names and residences of the incorporators and the names, residences, and official titles of all the officers, trustees, directors, or other persons who are to have and exercise the general control of the management of the affairs and funds of the society for the first year or until the ensuing election at which all the officers shall be elected by the supreme governing body, which election shall be held not later than one year from the date of issuance of the permanent certificate of authority. (2) The articles of incorporation, duly certified copies of the society's bylaws and rules, copies of all proposed forms of certificates, applications therefor, and circulars to be issued by the society, and a bond conditioned upon the return to applicants of the advanced payments if the organization is not completed within one year shall be filed with the commissioner, who may require further information as the commissioner deems necessary. The bond with sureties approved by the commissioner shall be in an amount, not less than three hundred thousand dollars nor more than one million five hundred thousand dollars as required by the commissioner. All documents filed are to be in the English language. If the purposes of the society conform to the requirements of this chapter and all provisions of the law have been complied with, the commissioner shall so certify, retain, and file the articles of incorporation and furnish the incorporators a preliminary certificate of authority authorizing the society to solicit members as hereinafter provided. (3) No preliminary certificate of authority granted under the provisions of this section shall be valid after one year from its date or after a further period, not exceeding one year, as may be authorized by the commissioner upon cause shown, unless the five hundred applicants required by subsection (4) of this section have been secured and the organization has been completed under this chapter. The articles of incorporation and all other proceedings thereunder shall become null and void in one year from the date of the preliminary certificate of authority, or at the expiration of the extended period, unless the society shall have completed its organization and received a certificate of authority to do business under this chapter. (4) Upon receipt of a preliminary certificate of authority from the commissioner, the society may solicit members for the purpose of completing its organization, shall collect from each applicant the amount of not less than one regular monthly premium in accordance with its table of rates, and shall issue to each applicant a receipt for the amount collected. No society shall incur any liability other than for the return of the advance premium, nor issue any certificate, nor pay, allow, or offer or promise to pay or allow, any benefit to any person until: (a) Actual bona fide applications for benefits have been secured on not less than five hundred applicants, and any necessary evidence of insurability has been furnished to and approved by the society; (b) At least ten subordinate lodges have been established into which the five hundred applicants have been admitted; (c) There has been submitted to the commissioner, under oath of the president or secretary, or corresponding officer of the society, a list of the applicants, giving their names, addresses, date each was admitted, name and number of the subordinate lodge of which each applicant is a member, amount of benefits to be granted, and premiums therefor; and (d) It has been shown to the commissioner, by sworn statement of the treasurer, or corresponding officer of the society, that at least five hundred applicants have each paid in cash at least one regular monthly premium and the total amount of collected premiums equals at least one hundred fifty thousand dollars. The advance premiums shall be held in trust during the period of organization and if the society has not qualified for a certificate of authority within one year, the premiums shall be returned to the applicants. (5) The commissioner may make such examination and require such further information as the commissioner deems advisable. Upon presentation of satisfactory evidence that the society has complied with all the provisions of this chapter, the commissioner shall issue to the society a certificate of authority to that effect and that the society is authorized to transact business pursuant to the provisions of this chapter. The certificate of authority shall be prima facie evidence of the existence of the society at the date of the certificate. The commissioner shall cause a record of the certificate of authority to be made. A certified copy of the record may be given in evidence with like effect as the original certificate of authority. (6) Any incorporated society authorized to transact business in this state at the time this chapter becomes effective shall not be required to reincorporate. (7) The commissioner may, by rule, require domestic fraternal societies to have and maintain a larger amount of surplus than the minimum amount of capital and surplus prescribed under RCW 48.05.340 , based upon the type, volume, and nature of insurance business transacted, consistent with the principles of risk-based capital modified to recognize the special characteristics of fraternal benefit societies.
RCW 48.30.020 — Washington Code / Title 48 / Chapter 30 / Section 020
RCW 48.30.020: Anticompact law.
Status: in_force

(1) No person shall either within or outside of this state enter into any contract, understanding or combination with any other person to do jointly or severally any act or engage in any practice for the purpose of (a) controlling the rates to be charged for insuring any risk or any class of risks in this state; or (b) unfairly discriminating against any person in this state by reason of his or her plan or method of transacting insurance, or by reason of his or her affiliation or nonaffiliation with any insurance organization; or (c) establishing or perpetuating any condition in this state detrimental to free competition in the business of insurance or injurious to the insuring public. (2) This section shall not apply relative to ocean marine and foreign trade insurances. (3) This section shall not be deemed to prohibit the doing of things permitted to be done in accordance with the provisions of chapter 48.19 RCW of this code. (4) Whenever the commissioner has knowledge of any violation of this section he or she shall forthwith order the offending person to discontinue such practice immediately or show cause to the satisfaction of the commissioner why such order should not be complied with. If the offender is an insurer or a licensee under this code and fails to comply with such order within thirty days after receipt thereof, the commissioner may forthwith revoke the offender's certificate of authority or licenses.
RCW 48.20.152 — Washington Code / Title 48 / Chapter 20 / Section 152
RCW 48.20.152: Standard provision No. 13—Change of beneficiary.
Status: reserved

There shall be a provision as follows: CHANGE OF BENEFICIARY: Unless the insured makes an irrevocable designation of beneficiary, the right to change of beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy. (The first clause of this provision, relating to the irrevocable designation of beneficiary, may be omitted at the insurer's option.)
RCW 48.35.030 — Washington Code / Title 48 / Chapter 35 / Section 030
RCW 48.35.030: Deposit required—Duration.
Status: in_force

The deposit required by this chapter must be for the benefit, security, and protection of the policyholders or creditors, or both, of the insurer in the United States. It shall be maintained as long as there is outstanding any liability of the insurer arising out of its insurance transactions in the United States.
RCW 48.46.110 — Washington Code / Title 48 / Chapter 46 / Section 110
RCW 48.46.110: Name restrictions—Discrimination—Recovery of costs of health care services participant not entitled to.
Status: in_force

(1) No health maintenance organization may refer to itself in its name or advertising with any of the words: "insurance", "casualty", "surety", "mutual", or any other words descriptive of the insurance, casualty, or surety business, or deceptively similar to the name or description of any insurance or surety corporation or health care service contractor or other health maintenance organization doing business in this state. (2) No health maintenance organization, nor any health care facility or provider with which such organization has contracted to provide health care services, shall discriminate against any person from whom or on whose behalf, payment to meet the required charge is available, with regard to enrollment, disenrollment, or the provision of health care services, on the basis of such person's race, color, sex, religion, place of residence if there is reasonable access to the facility of the health maintenance organization, socioeconomic status, or status as a recipient of medicare under Title XVIII of the Social Security Act, 42 U.S.C. section 1396, et seq. (3) Where a health maintenance organization determines that an enrolled participant has received health care services to which such enrolled participant is not entitled under the terms of his or her health maintenance agreement, neither such organization, nor any health care facility or provider with which such organization has contracted to provide health care services, shall have recourse against such enrolled participant for any amount above the actual cost of providing such service, if any, specified in such agreement, unless the enrolled participant or a member of his or her family has given or withheld information to the health maintenance organization, the effect of which is to mislead or misinform the health maintenance organization as to the enrolled participant's right to receive such services.
RCW 17.21.220 — Washington Code / Title 48 / Chapter 21 / Section 220
RCW 17.21.220: Application of chapter to governmental entities—Public operator license required—Exemption—Liability.
Status: in_force

(1) All state agencies, municipal corporations, and public utilities or any other governmental agencies are subject to this chapter and its rules. (2) It is unlawful for any employee of a state agency, municipal corporation, public utility, or any other government agency to use or to supervise the use of any restricted use pesticide, or any pesticide by means of an apparatus, without having obtained a public operator license from the director. Application for a public operator license must be accompanied by a fee of forty-three dollars. The fee does not apply to public operators licensed and working in the health vector field. The public operator license is valid only when the operator is acting as an employee of a government agency. (3) The jurisdictional health officer or his or her duly authorized representative is exempt from this licensing provision when applying pesticides that are not restricted use pesticides to control pests other than weeds. (4) Agencies, municipal corporations, and public utilities are subject to legal recourse by any person damaged by such application of any pesticide, and action may be brought in the county where the damage or some part of the damage occurred.(1) Every insurer entering into or renewing group or blanket disability insurance policies governed by this chapter shall offer optional coverage for home health care and hospice care for persons who are homebound and would otherwise require hospitalization. Such optional coverage need only be offered in conjunction with a policy that provides payment for hospitalization as a part of health care coverage. Persons seeking such services for palliative care in conjunction with treatment or management of serious or life-threatening illness need not be homebound in order to be eligible for coverage under this section. (2) Home health care and hospice care coverage offered under subsection (1) of this section shall conform to the following standards, limitations, and restrictions in addition to those set forth in chapter 70.126 RCW: (a) The coverage may include reasonable deductibles, coinsurance provisions, and internal maximums; (b) The coverage should be structured to create incentives for the use of home health care and hospice care as an alternative to hospitalization; (c) The coverage may contain provisions for utilization review and quality assurance; (d) The coverage may require that home health agencies and hospices have written treatment plans approved by a physician licensed under chapter 18.57 or 18.71 RCW, and may require such treatment plans to be reviewed at designated intervals; (e) The coverage shall provide benefits for, and restrict benefits to, services rendered by home health and hospice agencies licensed by the department of social and health services; (f) Hospice care coverage shall provide benefits for terminally ill patients for an initial period of care of not less than six months and may provide benefits for an additional six months of care in cases where the patient is facing imminent death or is entering remission if certified in writing by the attending physician; (g) Home health care coverage shall provide benefits for a minimum of one hundred thirty health care visits per calendar year. However, a visit of any duration by an employee of a home health agency for the purpose of providing services under the plan of treatment constitutes one visit; (h) The coverage may be structured so that services or supplies included in the primary contract are not duplicated in the optional home health and hospice coverage. (3) The insurance commissioner shall adopt any rules necessary to implement this section. (4) The requirements of this section shall not apply to contracts or policies governed by chapter 48.66 RCW. (5) An insurer, as a condition of reimbursement, may require compliance with home health and hospice certification regulations established by the United States department of health and human services.
RCW 48.35.020 — Washington Code / Title 48 / Chapter 35 / Section 020
RCW 48.35.020: Deposit required—Amount.
Status: in_force

(1) An alien insurer may use this state as a state of entry to transact insurance in the United States by maintaining in this state a deposit of assets in a solvent trust company or other solvent financial institution having trust powers domiciled in this state and so designated by the commissioner. The commissioner's designated depositories are authorized to receive and hold a deposit of assets. A deposit so held is at the expense of the insurer. A solvent financial institution domiciled in this state, the deposits of which are insured by the federal deposit insurance corporation and which is a member of the federal reserve system, may be designated as the commissioner's depository to receive and hold a deposit of assets. (2) The deposit, together with other trust deposits of the insurer held in the United States for the same purpose, must be in an amount not less than the higher of deposits required of an alien insurer under RCW 48.05.090 or five hundred thousand dollars and consist of eligible assets as set forth in RCW 48.16.030 . (3) The deposit may be referred to as "trusteed assets."
RCW 48.43.195 — Washington Code / Title 48 / Chapter 43 / Section 195
RCW 48.43.195: Contraceptive drugs—Twelve-month refill coverage.
Status: in_force

(1) A health benefit plan issued or renewed on or after January 1, 2018, that includes coverage for contraceptive drugs must provide reimbursement for a twelve-month refill of contraceptive drugs obtained at one time by the enrollee, unless the enrollee requests a smaller supply or the prescribing provider instructs that the enrollee must receive a smaller supply. The health plan must allow enrollees to receive the contraceptive drugs on-site at the provider's office, if available. Any dispensing practices required by the plan must follow clinical guidelines for appropriate prescribing and dispensing to ensure the health of the patient while maximizing access to effective contraceptive drugs. (2) Nothing in this section prohibits a health plan from limiting refills that may be obtained in the last quarter of the plan year if a twelve-month supply of the contraceptive drug has already been dispensed during the plan year. (3) For purposes of this section, "contraceptive drugs" means all drugs approved by the United States food and drug administration that are used to prevent pregnancy, including, but not limited to, hormonal drugs administered orally, transdermally, and intravaginally.
RCW 48.20.435 — Washington Code / Title 48 / Chapter 20 / Section 435
RCW 48.20.435: Option to cover dependents under age twenty-six.
Status: in_force

(1) Each disability insurance contract that is not grandfathered and that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six. (2) Each grandfathered disability insurance contract that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six unless the child is eligible to enroll in an eligible health plan sponsored by the child's employer or the child's spouse's employer. (3) As used in this section, "grandfathered" has the same meaning as "grandfathered health plan" in RCW 48.43.005 .
RCW 48.17.390 — Washington Code / Title 48 / Chapter 17 / Section 390
RCW 48.17.390: Independent, public, or crop adjusters—Separate licenses.
Status: in_force

(1)(a) The commissioner may license: (i) An individual or business entity as an independent adjuster or as a public adjuster; (ii) An individual as a crop adjuster; and (b) Separate licenses shall be required for each type of adjuster. (2) An individual or business entity may be concurrently licensed under separate licenses as an independent adjuster and as a public adjuster. (3) An individual may be concurrently licensed under separate licenses as an independent adjuster, a public adjuster, or a crop adjuster. (4) The full license fee shall be paid for each such license.
RCW 48.32.070 — Washington Code / Title 48 / Chapter 32 / Section 070
RCW 48.32.070: Plan of operation.
Status: in_force

(1)(a) The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon approval in writing by the commissioner. (b) If the association fails to submit a suitable plan of operation within ninety days following May 21, 1971 or if at any time thereafter the association fails to submit suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this chapter. Such rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner. (2) All member insurers shall comply with the plan of operation. (3) The plan of operation shall: (a) Establish the procedures whereby all the powers and duties of the association under RCW 48.32.060 will be performed. (b) Establish procedures for handling assets of the association. (c) Establish the amount and method of reimbursing members of the board of directors under RCW 48.32.050 . (d) Establish procedures by which claims may be filed with the association and establish acceptable forms of proof of covered claims. Notice of claims to the receiver or liquidator of the insolvent insurer shall be deemed notice to the association or its agent and a list of such claims shall be periodically submitted to the association or similar organization in another state by the receiver or liquidator. (e) Establish regular places and times for meetings of the board of directors. (f) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors. (g) Provide that any member insurer aggrieved by any final action or decision of the association may appeal to the commissioner within thirty days after the action or decision. (h) Establish the procedures whereby selections for the board of directors will be submitted to the commissioner. (i) Contain additional provisions necessary or proper for the execution of the powers and duties of the association. (4) The plan of operation may provide that any or all powers and duties of the association, except those under RCW 48.32.060 subsections (1)(c) and (2)(c), are delegated to a corporation, association, or other organization which performs or will perform functions similar to those of this association, or its equivalent, in two or more states. Such a corporation, association or organization shall be reimbursed as a servicing facility would be reimbursed and shall be paid for its performance of any other functions of the association. A delegation under this subsection shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.
RCW 48.46.370 — Washington Code / Title 48 / Chapter 46 / Section 370
RCW 48.46.370: Coverage not denied for disability.
Status: in_force

No health maintenance organization may deny coverage to a person solely on account of the presence of any disability. Nothing in this section may be construed as limiting a health maintenance organization's authority to deny or otherwise limit coverage to a person when the person because of a medical condition does not meet the essential eligibility requirements established by the health maintenance organization for purposes of determining coverage for any person.
RCW 48.212.005 — Washington Code / Title 48 / Chapter 212 / Section 005
RCW 48.212.005: Intent.
Status: in_force

The intent of this chapter is to promote the public interest, support the availability of supplemental long-term care coverage, establish standards for supplemental long-term care coverage, facilitate public understanding and comparison of supplemental long-term care contract benefits, protect persons insured under supplemental long-term care insurance policies and certificates, protect applicants for supplemental long-term care policies from unfair or deceptive sales or enrollment practices, and provide for flexibility and innovation in the development of supplemental long-term care insurance coverage.
RCW 48.43.001 — Washington Code / Title 48 / Chapter 43 / Section 001
RCW 48.43.001: Intent.
Status: in_force

It is the intent of the legislature to ensure that all enrollees in managed care settings have access to adequate information regarding health care services covered by health carriers' health plans, and provided by health care providers and health care facilities. It is only through such disclosure that Washington state citizens can be fully informed as to the extent of health insurance coverage, availability of health care service options, and necessary treatment. With such information, citizens are able to make knowledgeable decisions regarding their health care.
RCW 48.09.400 — Washington Code / Title 48 / Chapter 09 / Section 400
RCW 48.09.400: Definitions.
Status: in_force

The definitions in this section apply throughout this subchapter unless the context clearly requires otherwise. (1) "Board" means the board of directors of a converting mutual insurer. (2) "Conversion" means a process by which a domestic mutual insurer is converted to a domestic stock insurer as part of a reorganization. (3) "Converted stock insurer" means a domestic stock insurer into which a domestic mutual insurer is converted as part of a reorganization. (4) "Converting mutual insurer" means a domestic mutual insurer that is converting to a domestic stock insurer as part of a reorganization. (5) "Effective date" means, with respect to a plan, the date on which the plan or a part of the plan becomes effective as set forth in an order of the commissioner. (6) "Eligible member" means a member of the converting mutual insurer whose insurance policy is in force as of the date on which the board adopts the plan or on some other date that the plan specifies as the record date and that the commissioner approves. (7) "Intermediate stock holding company" means a corporation that satisfies all of the following: (a) The corporation was incorporated under chapter 23B.02 RCW; (b) A mutual holding company holds directly or indirectly at least a majority of the corporation's voting stock; and (c) The corporation holds directly or indirectly at least a majority of the voting stock of a converted stock insurer. (8) "Member" means: (a) With respect to a domestic mutual insurer, a member as described in RCW 48.09.110 ; or (b) With respect to a mutual holding company, any holder of one or more policies of insurance, other than a policy of reinsurance, issued by the converted stock insurer resulting from a reorganization involving the organization of a mutual holding company and, if permitted under the articles of incorporation or bylaws of the mutual holding company, may include any holder of one or more policies of insurance, other than a policy of reinsurance, issued by any other insurer that is a direct or indirect subsidiary or affiliate of the mutual holding company. (9) "Membership interest" means: (a) With respect to a converting mutual insurer, interest as set forth in RCW 48.09.120 ; or (b) With respect to a mutual holding company on and after the effective date of the plan, any right that a member of the mutual holding company may hold by virtue of membership in the mutual holding company arising under the articles of incorporation and bylaws of the mutual holding company, including the right to vote for the board. (10) "Mutual holding company" means a corporation that is formed and existing under the laws of this state and pursuant to the reorganization of a mutual insurance company. (11) "Plan" means a plan of reorganization. (12) "Reorganization" means a process by which a domestic mutual insurer is converted to a domestic stock insurer and a mutual holding company is organized. (13)(a) "Voting stock" means stock of any class or any percentage ownership interest having voting power for the election of directors, trustees, or management. (b) "Voting stock" includes stock having voting power only by reason of the happening of a contingency.
RCW 48.41.160 — Washington Code / Title 48 / Chapter 41 / Section 160
RCW 48.41.160: Pool policy requirements—Continued coverage—Rate changes—Continuation—Statement of intent to discontinue pool coverage.
Status: in_force

(1) On or before December 31, 2007, the pool shall cancel all existing pool policies and replace them with policies that are identical to the existing policies except for the inclusion of a provision providing for a guarantee of the continuity of coverage consistent with this section. As a means to minimize the number of policy changes for enrollees, replacement policies provided under this subsection also may include the plan modifications authorized in RCW 48.41.100 , 48.41.110 , and 48.41.120 . (2) A pool policy shall contain a guarantee of the individual's right to continued coverage, subject to the provisions of subsections (4), (5), (7), and (8) of this section. (3) The guarantee of continuity of coverage required by this section shall not prevent the pool from canceling or nonrenewing a policy for: (a) Nonpayment of premium; (b) Violation of published policies of the pool; (c) Failure of a covered person who becomes eligible for medicare benefits by reason of age to apply for a pool medical supplement plan, or a medicare supplement plan or other similar plan offered by a carrier pursuant to federal laws and regulations; (d) Failure of a covered person to pay any deductible or copayment amount owed to the pool and not the provider of health care services; (e) Covered persons committing fraudulent acts as to the pool; (f) Covered persons materially breaching the pool policy; or (g) Changes adopted to federal or state laws when such changes no longer permit the continued offering of such coverage. (4)(a) The guarantee of continuity of coverage provided by this section requires that if the pool replaces a plan, it must make the replacement plan available to all individuals in the plan being replaced. The replacement plan must include all of the services covered under the replaced plan, and must not significantly limit access to the kind of services covered under the replacement plan through unreasonable cost-sharing requirements or otherwise. The pool may also allow individuals who are covered by a plan that is being replaced an unrestricted right to transfer to a fully comparable plan. (b) The guarantee of continuity of coverage provided by this section requires that if the pool discontinues offering a plan: (i) The pool must provide notice to each individual of the discontinuation at least ninety days prior to the date of the discontinuation; (ii) the pool must offer to each individual provided coverage under the discontinued plan the option to enroll in any other plan currently offered by the pool for which the individual is otherwise eligible; and (iii) in exercising the option to discontinue a plan and in offering the option of coverage under (b)(ii) of this subsection, the pool must act uniformly without regard to any health status-related factor of enrolled individuals or individuals who may become eligible for this coverage. (c) The pool cannot replace or discontinue a plan under this subsection (4) until it has completed an evaluation of the impact of replacing the plan upon: (i) The cost and quality of care to pool enrollees; (ii) Pool financing and enrollment; (iii) The board's ability to offer comprehensive and other plans to its enrollees; (iv) Other items identified by the board. In its evaluation, the board must request input from the constituents represented by the board members. (d) The guarantee of continuity of coverage provided by this section does not apply if the pool has zero enrollment in a plan. (5) The pool may not change the rates for pool policies except on a class basis, with a clear disclosure in the policy of the pool's right to do so. (6) A pool policy offered under this chapter shall provide that, upon the death of the individual in whose name the policy is issued, every other individual then covered under the policy may elect, within a period specified in the policy, to continue coverage under the same or a different policy. (7) All pool policies issued on or after January 1, 2014, must reflect the new eligibility requirements of RCW 48.41.100 . (8) Pool policies issued prior to January 1, 2014, shall be modified effective January 1, 2018, consistent with subsection (3)(g) of this section.
RCW 48.19.350 — Washington Code / Title 48 / Chapter 19 / Section 350
RCW 48.19.350: Disqualification of data.
Status: in_force

No insurer which makes its own filing nor any rating organization shall support its filings by statistics or adopt rate making recommendations, furnished to it by an advisory organization which has not complied with this chapter or with any order of the commissioner involving such statistics or recommendations issued under RCW 48.19.340 . If the commissioner finds such insurer or rating organization to be in violation of this section he or she may issue an order requiring the discontinuance of the violation.
RCW 48.43.0126 — Washington Code / Title 48 / Chapter 43 / Section 0126
RCW 48.43.0126: Summary of benefits and explanation of coverage—Standards and requirements—Notice of modification—Fines—Standards for definitions of health insurance terms—Rules.
Status: in_force

(1) The commissioner shall develop standards for use by a health carrier offering individual or group coverage, in compiling and providing to applicants and enrollees a summary of benefits and coverage explanation that accurately describes the benefits and coverage under the applicable plan. In developing the standards, the commissioner must use the standards developed under 42 U.S.C. Sec. 300gg-15 in use on April 17, 2019. (2) The standards must provide for the following: (a) The standards must ensure that the summary of benefits and coverage is presented in a uniform format that does not exceed four pages in length and does not include print smaller than twelve-point font. (b) The standards must ensure that the summary is presented in a culturally and linguistically appropriate manner and utilizes terminology understandable by the average plan enrollee. (c) The standards must ensure that the summary of benefits and coverage includes: (i) Uniform definitions of standard insurance and medical terms, consistent with the standard definitions developed under this section, so that consumers may compare health insurance coverage and understand the terms of coverage, or exceptions to such coverage; (ii) A description of the coverage, including cost sharing for: (A) The essential health benefits; and (B) Other benefits identified by the commissioner; (iii) The exceptions, reductions, and limitations on coverage; (iv) The cost-sharing provisions, including deductible, coinsurance, and copayment obligations; (v) The renewability and continuation of coverage provisions; (vi) A coverage facts label that includes examples to illustrate common benefits scenarios, including pregnancy and serious or chronic medical conditions and related cost sharing. The scenarios must be based on recognized clinical practice guidelines; (vii) A statement of whether the plan: (A) Provides minimum essential coverage under 26 U.S.C. Sec. 5000A(f); and (B) Ensures that the plan share of the total allowed costs of benefits provided under the plan is no less than sixty percent of the costs; (viii) A statement that the outline is a summary of the policy or certificate and that the coverage document itself should be consulted to determine the governing contractual provisions; and (ix) A contact number for the consumer to call with additional questions and a website where a copy of the actual individual coverage policy or group certificate of coverage may be reviewed and obtained. (3) The commissioner shall periodically review and update the standards developed under this section. (4) A health carrier must provide a summary of benefits and coverage explanation to: (a) An applicant at the time of application; (b) An enrollee prior to the time of enrollment or reenrollment, as applicable; and (c) A policyholder or certificate holder at the time of issuance of the policy or delivery of the certificate. (5) A health carrier may provide the summary of benefits and coverage either in paper or electronically. (6) If a health carrier makes any material modification in any of the terms of the plan that is not reflected in the most recently provided summary of benefits and coverage, the carrier shall provide notice of the modification to enrollees no later than sixty days prior to the date on which the modification will become effective. (7) A health carrier that fails to provide the information required under this section is subject to a fine of no more than one thousand dollars for each failure. A failure with respect to each enrollee constitutes a separate offense for purposes of this subsection. (8) The commissioner shall, by rule, provide for the development of standards for the definitions of terms used in health insurance coverage, including the following: (a) Insurance-related terms, including premium; deductible; coinsurance; copayment; out-of-pocket limit; preferred provider; nonpreferred provider; out-of-network copayments; usual, customary, and reasonable fees; excluded services; grievance; appeals; and any other terms the commissioner determines are important to define so that consumers may compare health insurance coverage and understand the terms of their coverage; and (b) Medical terms, including hospitalization, hospital outpatient care, emergency room care, physician services, prescription drug coverage, durable medical equipment, home health care, skilled nursing care, rehabilitation services, hospice services, emergency medical transportation, and any other terms the commissioner determines are important to define so that consumers may compare the medical benefits offered by health insurance and understand the extent of those medical benefits or exceptions to those benefits. (9) Unless preempted by federal law, the commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.
RCW 48.83.120 — Washington Code / Title 48 / Chapter 83 / Section 120
RCW 48.83.120: Nonforfeiture benefit option—Offer required—Rules.
Status: in_force

(1) Except as provided by this section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that includes a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. If a policyholder or certificate holder declines the nonforfeiture benefit, the issuer must provide a contingent benefit upon lapse that is available for a specified period of time following a substantial increase in premium rates. (2) If a group long-term care insurance policy is issued, the offer required in subsection (1) of this section must be made to the group policyholder. However, if the policy is issued as group long-term care insurance as defined in RCW 48.83.020 (6)(d) other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificate holder. (3) The commissioner must adopt rules specifying the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies and certificates, the standards for nonforfeiture benefits, and the rules regarding contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse will be available and the substantial premium rate increase that triggers a contingent benefit upon lapse.
RCW 48.49.060 — Washington Code / Title 48 / Chapter 49 / Section 060
RCW 48.49.060: Notice of consumer rights—Development of standard template language by commissioner.
Status: in_force

(1) The commissioner, in consultation with health carriers, health care providers, health care facilities, behavioral health emergency services providers, ground ambulance services organizations, and consumers, must develop standard template language for a notice of consumer rights notifying consumers of their rights under this chapter, and sections 2799A-1 and 2799A-2 of the public health service act (42 U.S.C. Secs. 300gg-111 and 300gg-112) and implementing federal regulations in effect on March 31, 2022. (2) The standard template language must include contact information for the office of the insurance commissioner so that consumers may contact the office of the insurance commissioner if they believe they have received a balance bill in violation of this chapter. (3) The office of the insurance commissioner shall determine by rule when and in what format health carriers, health care providers, health care facilities, behavioral health emergency services providers, and ground ambulance services organizations must provide consumers with the notice developed under this section.
RCW 48.20.015 — Washington Code / Title 48 / Chapter 20 / Section 015
RCW 48.20.015: Endorsements.
Status: in_force

If a contract is issued on any basis other than as applied for, an endorsement setting forth such modification(s) must accompany and be attached to the policy; and no endorsement shall be effective unless signed by the policyowner, and a signed copy thereof returned to the insurer.
RCW 48.30.200 — Washington Code / Title 48 / Chapter 30 / Section 200
RCW 48.30.200: Hypothecation of premium notes.
Status: in_force

It shall be unlawful for any insurer or its representative, or any insurance producer, to hypothecate, sell, or dispose of any promissory note, received in payment for any premium or part thereof on any contract of life insurance or of disability insurance applied for, prior to delivery of the policy to the applicant.
RCW 48.09.140 — Washington Code / Title 48 / Chapter 09 / Section 140
RCW 48.09.140: Notice of annual meeting.
Status: in_force

(1) Notice of the time and place of the annual meeting of members of a domestic mutual insurer shall be given by imprinting such notice plainly on the policies issued by the insurer. (2) Any change of the date or place of the annual meeting shall be made only by an annual meeting of members. Notice of such change may be given: (a) By imprinting such new date or place on all policies which will be in effect as of the date of such changed meeting; or (b) Unless the commissioner otherwise orders, notice of the new date or place need be given only through policies issued after the date of the annual meeting at which such change was made and in premium notices and renewal certificates issued during the twenty-four months immediately following such meeting.
RCW 48.35.180 — Washington Code / Title 48 / Chapter 35 / Section 180
RCW 48.35.180: Domestication agreement—Necessary authorization.
Status: in_force

(1) The domestication agreement shall be authorized, adopted, approved, signed, and acknowledged by the alien insurer in accordance with the laws of the country under which it is organized. (2) In the case of a domestic insurer, the domestication agreement shall be approved, adopted, and authorized by its board of directors and executed by its president or a vice president and attested by its secretary or assistant secretary under its corporate seal.
RCW 48.20.410 — Washington Code / Title 48 / Chapter 20 / Section 410
RCW 48.20.410: Optometry.
Status: in_force

Notwithstanding any provision of any disability insurance contract, benefits shall not be denied thereunder for any eye care service rendered by a holder of a license issued pursuant to chapter 18.53 RCW, provided, that (1) the service rendered was within the lawful scope of such person's license, and (2) such contract would have provided the benefits for such service if rendered by a holder of a license issued pursuant to chapter 18.71 RCW.
RCW 48.31.080 — Washington Code / Title 48 / Chapter 31 / Section 080
RCW 48.31.080: Conservation of assets—Foreign insurers.
Status: in_force

The commissioner may apply for an order directing him or her to conserve the assets within this state of a foreign insurer upon any one or more of the following grounds: (1) Upon any of the grounds specified in items (1) to (9) inclusive of RCW 48.31.030 and in item (2) of RCW 48.31.050 . (2) That its property has been sequestrated in its domiciliary sovereignty or in any other sovereignty.
RCW 48.46.045 — Washington Code / Title 48 / Chapter 46 / Section 045
RCW 48.46.045: Catastrophic health plans permitted.
Status: in_force

Notwithstanding the provisions of this chapter, a health maintenance organization may offer catastrophic health plans as defined in RCW 48.43.005 .
RCW 48.135.060 — Washington Code / Title 48 / Chapter 135 / Section 060
RCW 48.135.060: Disclosure of documents, materials, or other information—Exemptions.
Status: in_force

(1) Documents, materials, or other information as described in subsection (3), (4), or both of this section are exempt from public inspection and copying under chapters *42.17 and 42.56 RCW. The commissioner is authorized to use such documents, materials, or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties. (2) The commissioner: (a) May share documents, materials, or other information, including the documents, materials, or information subject to subsection (1) of this section, with (i) the national association of insurance commissioners and its affiliates and subsidiaries, (ii) regulatory and law enforcement officials of other states and nations, the federal government, and international authorities, (iii) the national insurance crime bureau, and (iv) an insurer with respect to whom the suspected fraudulent claim may be perpetrated; (b) May receive documents, materials, or information from (i) the national association of insurance commissioners and its affiliates and subsidiaries, (ii) regulatory and law enforcement officials of other states and nations, the federal government, and international authorities, (iii) the national insurance crime bureau, and (iv) an insurer with respect to whom the suspected fraudulent claim may be perpetrated and any such documents, materials, or information as described in subsection (3), (4), or both of this section are exempt from public inspection and copying; and (c) May enter into agreements governing the sharing and use of information consistent with this subsection. (3) Specific intelligence information and specific investigative records compiled by investigative, law enforcement, and penology agencies, the fraud program of the office of the insurance commissioner, and state agencies vested with the responsibility to discipline members of any profession, the nondisclosure of which is essential to effective law enforcement or for the protection of any person's right to privacy, are exempt under subsection (1) of this section. (4) Information revealing the identity of persons who are witnesses to or victims of crime or who file complaints with investigative, law enforcement, and penology agencies, or the fraud program of the office of the insurance commissioner, if disclosure would endanger any person's life, physical safety, or property, is exempt under subsection (1) of this section. If at the time a complaint is filed the complainant, victim, or witness indicates a desire for disclosure or nondisclosure, such desire shall govern. (5) No waiver of an existing privilege or claim of confidentiality in the documents, materials, or information may occur as a result of disclosure to the commissioner under this section or as a result of sharing documents, materials, or information as authorized in subsection (2) of this section. (6) Documents, materials, or other information that is in the possession of persons other than the commissioner that would otherwise not be confidential by law or privileged do not become confidential by law or privileged by providing the documents, materials, or other information to the commissioner.
RCW 48.43.205 — Washington Code / Title 48 / Chapter 43 / Section 205
RCW 48.43.205: Material acquisitions or dispositions.
Status: in_force

No acquisitions or dispositions of assets need be reported pursuant to RCW 48.43.200 if the acquisitions or dispositions are not material. For purposes of RCW 48.43.200 through 48.43.225 , a material acquisition, or the aggregate of any series of related acquisitions during any thirty-day period; or disposition, or the aggregate of any series of related dispositions during any thirty-day period is an acquisition or disposition that is nonrecurring and not in the ordinary course of business and involves more than five percent of the reporting certified health plan's total assets as reported in its most recent statutory statement filed with the commissioner.
RCW 48.18.296 — Washington Code / Title 48 / Chapter 18 / Section 296
RCW 48.18.296: Contracts to which RCW 48.18.291 through 48.18.297 inapplicable.
Status: in_force

The provisions of RCW 48.18.291 through 48.18.297 shall not apply to: (1) Contracts of insurance issued under the assigned risk plan; (2) Any policy covering garage, automobile sales agency, repair shop, service station, or public parking place operation hazards; and (3) Contracts of insurance procured under the provisions of chapter 48.15 RCW.
RCW 48.201.060 — Washington Code / Title 48 / Chapter 201 / Section 060
RCW 48.201.060: Commissioner's rule-making authority.
Status: in_force

The commissioner may adopt rules as necessary to implement chapter 281, Laws of 2021.
RCW 17.21.060 — Washington Code / Title 48 / Chapter 21 / Section 060
RCW 17.21.060: Subpoenas—Witness fees.
Status: in_force

The director may issue subpoenas to compel the attendance of witnesses and/or production of books, documents, and records anywhere in the state in any hearing affecting the authority or privilege granted by a license, certification, or permit issued under the provisions of this chapter. Witnesses shall be entitled to fees for attendance and travel as provided for in chapter 2.40 RCW as enacted or hereafter amended.There shall be a provision that a copy of the application, if any, of the policyholder shall be attached to the policy when issued; that all statements made by the policyholder or by the individuals insured shall in the absence of fraud be deemed representations and not warranties, and that no statement made by any individual insured shall be used in any contest unless a copy of the instrument containing the statement is or has been furnished to such individual or to his or her beneficiary, if any.
RCW 48.21.047 — Washington Code / Title 48 / Chapter 21 / Section 047
RCW 48.21.047: Requirements for plans offered to small employers—Definitions.
Status: in_force

(1) An insurer may not offer any health benefit plan to any small employer without complying with RCW 48.21.045 (3). (2) Employers purchasing health plans provided through associations or through member-governed groups formed specifically for the purpose of purchasing health care are not small employers and the plans are not subject to RCW 48.21.045 (3). (3) For purposes of this section, "health benefit plan," "health plan," and "small employer" mean the same as defined in RCW 48.43.005 . (4) For purposes of this section, "census date" has the same meaning as defined in RCW 48.44.010 .
RCW 48.10.030 — Washington Code / Title 48 / Chapter 10 / Section 030
RCW 48.10.030: Scope of chapter.
Status: in_force

All authorized reciprocal insurers shall be governed by those sections of this chapter not expressly made applicable to domestic reciprocal insurers.
RCW 48.160.010 — Washington Code / Title 48 / Chapter 160 / Section 010
RCW 48.160.010: Definitions.
Status: in_force

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise. (1) "Administrator" means a person, other than an insurer or creditor that performs administrative or operational functions pursuant to guaranteed asset protection waiver programs. (2) "Borrower" means a debtor, retail buyer, or lessee, under a finance agreement, or a person who receives a loan or enters into a retail installment contract to purchase or lease a motor vehicle or vessel under chapter 63.14 RCW. (3) "Creditor" means: (a) The lender in a loan or credit transaction; (b) The lessor in a lease transaction; (c) Any retail seller of motor vehicles that provides credit to retail buyers of motor vehicles provided the seller complies with this chapter; (d) The seller in commercial retail installment transactions; or (e) The assignees of any creditor under this subsection to whom the credit obligation is payable. (4) "Finance agreement" means a loan, lease, or retail installment sales contract for the purchase or lease of a motor vehicle. (5) "Free look period" means the period of time from the effective date of the waiver until the date the borrower may cancel the waiver without penalty, fees, or costs to the borrower. This period of time must not be shorter than thirty days. (6) "Guaranteed asset protection waiver" or "waiver" means a contractual agreement wherein a creditor agrees for a separate charge to cancel or waive all or part of amounts due that creditor on a borrower's finance agreement with that creditor in the event of a total physical damage loss or unrecovered theft of the motor vehicle, which agreement must be part of, or a separate addendum to, the finance agreement. (7) "Insurer" means an insurance company licensed, registered, or otherwise authorized to do business under the insurance laws of this state. (8) "Motor vehicle" means self-propelled or towed vehicles designed for personal or commercial use, including but not limited to automobiles, trucks, motorcycles, recreational vehicles, all-terrain vehicles, snowmobiles, campers, boats, personal watercraft, and motorcycle, boat, camper, and personal watercraft trailers. (9) "Motor vehicle dealer" has the same meaning as "vehicle dealer" in RCW 46.70.011 . (10) "Person" includes an individual, company, association, organization, partnership, business trust, corporation, and every form of legal entity. (11) "Retail buyer" means a person who buys or agrees to buy a motor vehicle or obtain motor vehicle services or agrees to have motor vehicle services rendered or furnished from a retail seller. (12) "Retail seller" means a person engaged in the business of selling motor vehicles or motor vehicle services to retail buyers. (13) "Unregistered marketers" means persons who offer for sale and sell guaranteed asset protection waivers who are not registered under this chapter and who are not otherwise exempt under this chapter.
RCW 48.66.165 — Washington Code / Title 48 / Chapter 66 / Section 165
RCW 48.66.165: Conformity with federal law—Rules.
Status: in_force

The commissioner may adopt, from time-to-time, such rules as are necessary with respect to medicare supplemental insurance to conform Washington policies, contracts, certificates, standards, and practices to the requirements of federal law, specifically including 42 U.S.C. Sec. 1395ss, and federal regulations adopted thereunder.
RCW 48.44.260 — Washington Code / Title 48 / Chapter 44 / Section 260
RCW 48.44.260: Notice of reason for cancellation, denial, or refusal to renew contract.
Status: in_force

Every authorized health care service contractor, upon canceling, denying, or refusing to renew any individual health care service contract, shall, upon written request, directly notify in writing the applicant or subscriber, as the case may be, of the reasons for the action by the health care service contractor. Any benefits, terms, rates, or conditions of such a contract which are restricted, excluded, modified, increased, or reduced shall, upon written request, be set forth in writing and supplied to the subscriber. The written communications required by this section shall be phrased in simple language which is readily understandable to a person of average intelligence, education, and reading ability.
RCW 48.46.900 — Washington Code / Title 48 / Chapter 46 / Section 900
RCW 48.46.900: Liberal construction.
Status: in_force

It is intended that the provisions of this chapter shall be liberally construed to accomplish the purposes provided for and authorized herein.
RCW 48.20.050 — Washington Code / Title 48 / Chapter 20 / Section 050
RCW 48.20.050: Standard provision No. 2—Misstatement of age or sex.
Status: in_force

There shall be a provision as follows: "MISSTATEMENT OF AGE OR SEX: If the age or sex of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age or sex." The amount of any underpayments which may have been made on account of any such misstatement under a disability income policy shall be paid the insured along with the current payment and the amount of any overpayment may be charged against the current or succeeding payments to be made by the insurer. Interest may be applied to such underpayments or overpayments as specified in the insurance policy form but not exceeding six percent per annum.
RCW 48.10.190 — Washington Code / Title 48 / Chapter 10 / Section 190
RCW 48.10.190: Attorney's contribution—Repayment.
Status: in_force

No contribution to a domestic reciprocal insurer's surplus by the attorney shall be retrievable by the attorney except under such terms and in such circumstances as the commissioner approves.
RCW 48.43.041 — Washington Code / Title 48 / Chapter 43 / Section 041
RCW 48.43.041: Individual health benefit plans—Mandatory benefits.
Status: in_force

(1) All individual health benefit plans, other than catastrophic health plans, offered or renewed on or after October 1, 2000, shall include benefits described in this section. Nothing in this section shall be construed to require a carrier to offer an individual health benefit plan. (a) Maternity services that include, with no enrollee cost-sharing requirements beyond those generally applicable cost-sharing requirements: Diagnosis of pregnancy; prenatal care; delivery; care for complications of pregnancy; physician services; hospital services; operating or other special procedure rooms; radiology and laboratory services; appropriate medications; anesthesia; and services required under RCW 48.43.115 ; and (b) Prescription drug benefits with at least a two thousand dollar benefit payable by the carrier annually. (2) If a carrier offers a health benefit plan that is not a catastrophic health plan to groups, and it chooses to offer a health benefit plan to individuals, it must offer at least one health benefit plan to individuals that is not a catastrophic health plan.
RCW 48.180.065 — Washington Code / Title 48 / Chapter 180 / Section 065
RCW 48.180.065: Immunity from liability—Person who files, reports, or furnishes information—State risk manager and agents or employees.
Status: in_force

(1) Any person who files, reports, or furnishes other information required under this title, required by the state risk manager under the authority granted under this title, or which is useful to the state risk manager in the administration of this title is immune from liability in any civil action or suit arising from the filing of any such report or furnishing such information to the state risk manager, unless actual malice, fraud, or bad faith is shown. (2) The state risk manager and his or her agents and employees are immune from liability in any civil action or suit arising from the publication of any report or bulletin or from dissemination of information related to the official activities of the state risk manager unless actual malice, fraud, or bad faith is shown. (3) The immunity granted under this section is in addition to any common law or statutory privilege or immunity enjoyed by such person. This section is not intended to abrogate or modify in any way such common law or statutory privilege or immunity.
RCW 48.41.130 — Washington Code / Title 48 / Chapter 41 / Section 130
RCW 48.41.130: Policy forms—Approval required.
Status: in_force

All policy forms issued by the pool shall conform in substance to prototype forms developed by the pool, and shall in all other respects conform to the requirements of this chapter, and shall be filed with and approved by the commissioner before they are issued.
RCW 48.43.091 — Washington Code / Title 48 / Chapter 43 / Section 091
RCW 48.43.091: Health carrier coverage of outpatient mental health services—Requirements.
Status: in_force

Every health carrier that provides coverage for any outpatient mental health service shall comply with the following requirements: (1) In performing a utilization review of mental health services for a specific enrollee, the utilization review is limited to accessing only the specific health care information contained in the enrollee's record. (2) In performing an audit of a provider that has furnished mental health services to a carrier's enrollees, the audit is limited to accessing only the records of enrollees covered by the specific health carrier for which the audit is being performed, except as otherwise permitted by RCW 70.02.050 and * 71.05.630 .
RCW 48.74.010 — Washington Code / Title 48 / Chapter 74 / Section 010
RCW 48.74.010: Short title.
Status: in_force

This chapter may be known and cited as the standard valuation law.
RCW 48.36A.276 — Washington Code / Title 48 / Chapter 36A / Section 276
RCW 48.36A.276: Reauthorization of license.
Status: in_force

A society whose license has been suspended, revoked, or refused may not subsequently be authorized unless the grounds for the suspension, revocation, or refusal no longer exist and the society is otherwise fully qualified.
RCW 48.46.277 — Washington Code / Title 48 / Chapter 46 / Section 277
RCW 48.46.277: Prostate cancer screening.
Status: in_force

(1) Each health maintenance agreement issued or renewed after December 31, 2006, that provides coverage for hospital or medical expenses shall provide coverage for prostate cancer screening, provided that the screening is delivered upon the recommendation of the patient's physician, *advanced registered nurse practitioner, or physician assistant. (2) All services must be provided by the health maintenance organization or rendered upon a referral by the health maintenance organization. (3) This section shall not be construed to prevent the application of standard policy provisions applicable to other benefits, such as deductible or copayment provisions. This section does not limit the authority of a health maintenance organization to negotiate rates and contract with specific providers for the delivery of prostate cancer screening services. This section shall not apply to medicare supplemental policies or supplemental contracts covering a specified disease or other limited benefits.
RCW 48.18.410 — Washington Code / Title 48 / Chapter 18 / Section 410
RCW 48.18.410: Exemption of proceeds—Life.
Status: reserved

(1) The lawful beneficiary, assignee, or payee of a life insurance policy, other than an annuity, heretofore or hereafter effected by any person on his or her own life, or on the life of another, in favor of a person other than himself or herself, shall be entitled to the proceeds and avails of the policy against the creditors and representatives of the insured and of the person effecting the insurance, and such proceeds and avails shall also be exempt from all liability for any debt of such beneficiary, existing at the time the proceeds or avails are made available for his or her own use. (2) The provisions of subsection (1) of this section shall apply (a) whether or not the right to change the beneficiary is reserved or permitted in the policy; or (b) whether or not the policy is made payable to the person whose life is insured or to his or her estate if the beneficiary, assignee or payee shall predecease such person; except, that this subsection shall not be construed so as to defeat any policy provision which provides for disposition of proceeds in the event the beneficiary shall predecease the insured. (3) The exemptions provided by subsection (1) of this section, subject to the statute of limitations, shall not apply (a) to any claim to or interest in such proceeds or avails by or on behalf of the insured, or the person so effecting the insurance, or their administrators or executors, in whatever capacity such claim is made or such interest is asserted; or (b) to any claim to or interest in such proceeds or avails by or on behalf of any person to whom rights thereto have been transferred with intent to defraud creditors; but an insurer shall be liable to all such creditors only as to amounts aggregating not to exceed the amount of such proceeds or avails remaining in the insurer's possession at the time the insurer receives at its home office written notice by or on behalf of such creditors, of claims to recover for such transfer, with specification of the amounts claimed; or (c) to so much of such proceeds or avails as equals the amount of any premiums or portion thereof paid for the insurance with intent to defraud creditors, with interest thereon, and if prior to the payment of such proceeds or avails the insurer has received at its home office written notice by or on behalf of the creditor, of a claim to recover for premiums paid with intent to defraud creditors, with specification of the amount claimed. (4) For the purposes of subsection (1) of this section a policy shall also be deemed to be payable to a person other than the insured if and to the extent that a facility-of-payment clause or similar clause in the policy permits the insurer to discharge its obligation after the death of the individual insured by paying the death benefits to a person as permitted by such clause. (5) No person shall be compelled to exercise any rights, powers, options or privileges under any such policy.
RCW 48.62.081 — Washington Code / Title 48 / Chapter 62 / Section 081
RCW 48.62.081: Multistate program participants—Requirements.
Status: in_force

A local government entity may participate in a joint self-insurance program covering property or liability risks with similar local government entities from other states if the program satisfies the following requirements: (1) Only those local government entities of this state and similar entities of other states that are provided insurance by the program may have ownership interest in the program; (2) The participating local government entities of this state and other states shall elect a board of directors to manage the program, a majority of whom shall be affiliated with one or more of the participating entities; (3) The program must provide coverage through the delivery to each participating entity of one or more written policies effecting insurance of covered risks; (4) The program shall be financed, including the payment of premiums and the contribution of initial capital, in accordance with the plan of management and operation submitted to the state risk manager in accordance with this chapter; (5) The financial statements of the program shall be audited annually by the certified public accountants for the program, and such audited financial statements shall be delivered to the Washington state auditor and the state risk manager not more than one hundred twenty days after the end of each fiscal year of the program; (6) The investments of the program shall be initiated only with financial institutions and/or broker-dealers doing business in those states in which participating entities are located, and such investments shall be audited annually by the certified public accountants for the program, and a list of such investments shall be delivered to the Washington state auditor not more than one hundred twenty days after the end of each fiscal year of the program; (7) The treasurer of a multistate joint self-insurance program shall be designated by resolution of the program and such treasurer shall be located in the state of one of the participating entities; (8) The participating entities may have no contingent liabilities for covered claims, other than liabilities for unpaid premiums, retrospective premiums, or assessments, if assets of the program are insufficient to cover the program's liabilities; and (9) The program shall obtain approval from the state risk manager in accordance with this chapter and shall remain in compliance with the provisions of this chapter, except to the extent that such provisions are modified by or inconsistent with this section.
RCW 48.24.027 — Washington Code / Title 48 / Chapter 24 / Section 027
RCW 48.24.027: Offering group life insurance to state residents—Commissioner's findings.
Status: in_force

(1) Group life insurance offered to a resident of this state under a group life insurance policy may be issued to a group other than one described in RCW 48.24.020 , 48.24.035 , 48.24.040 , 48.24.045 , 48.24.050 , 48.24.060 , 48.24.070 , 48.24.080 , 48.24.090 , or 48.24.095 subject to the requirements in this subsection. No such group life insurance policy may be delivered in this state unless the commissioner finds that: (a) The issuance of the group policy is not contrary to the best interest of the public; (b) The issuance of the group policy would result in economies of acquisition or administration; and (c) The benefits are reasonable in relation to the premiums charged. (2) No such group life insurance coverage may be offered under this section in this state by an insurer under a policy issued in another state unless the commissioner or the insurance commissioner of another state having requirements substantially similar to those contained in subsection (1)(a) through (c) of this section has made a determination that the requirements have been met. (3) The premium for the policy shall be paid either from the policyholder's funds or from funds contributed by the covered persons, or from both.
RCW 48.21.157 — Washington Code / Title 48 / Chapter 21 / Section 157
RCW 48.21.157: Option to cover dependents under age twenty-six.
Status: in_force

Any group disability insurance contract or blanket disability insurance contract that provides coverage for a participating member's dependent must offer each participating member the option of covering any dependent under the age of twenty-six.
RCW 48.125.003 — Washington Code / Title 48 / Chapter 125 / Section 003
RCW 48.125.003: Short title.
Status: in_force

This chapter may be cited as the "self-funded multiple employer welfare arrangement regulation act."
RCW 48.10.100 — Washington Code / Title 48 / Chapter 10 / Section 100
RCW 48.10.100: Policies of original subscribers, effective when.
Status: in_force

Any policy applied for by an original subscriber shall become effective coincidentally with the issuance of a certificate of authority to the reciprocal insurer.
RCW 48.24.280 — Washington Code / Title 48 / Chapter 24 / Section 280
RCW 48.24.280: Group life insurance—Noninsurance benefits.
Status: in_force

(1) A life insurer may include the following noninsurance benefits as part of a policy or certificate of group life insurance, with the prior approval of the commissioner: (a) Will preparation services; (b) Financial planning and estate planning services; (c) Probate and estate settlement services; (d) Grief counseling; (e) Funeral planning and funeral services, but it must be disclosed that this noninsurance benefit does not constitute an insurance funded prearrangement contract, pursuant to RCW 18.39.255 ; and (f) Such other services as the commissioner may identify by rule. (2) The commissioner may adopt rules to regulate the disclosure of noninsurance benefits permitted under this section, including but not limited to guidelines regarding the coverage provided under the policy or certificate of insurance. (3) Those providing the services listed in subsection (1) of this section must be appropriately licensed. (4) This section does not require the commissioner to approve any particular proposed noninsurance benefit. The commissioner may disapprove any proposed noninsurance benefit that the commissioner determines may tend to promote or facilitate the violation of any other section of this title. (5) This section does not expand, limit, or otherwise affect the authority and ethical obligations of those who are authorized by the state supreme court to practice law in this state. This section does not limit the prohibition against the unauthorized practice of law under chapter 2.48 RCW. (6) This section does not affect the application of chapter 21.20 RCW.
RCW 48.46.100 — Washington Code / Title 48 / Chapter 46 / Section 100
RCW 48.46.100: Grievance procedure.
Status: in_force

A health maintenance organization shall establish and maintain a grievance procedure, approved by the commissioner, to provide reasonable and effective resolution of complaints initiated by enrolled participants concerning any matter relating to the interpretation of any provision of such enrolled participants' health maintenance contracts, including, but not limited to, claims regarding the scope of coverage for health care services; denials, cancellations, or nonrenewals of enrolled participants' coverage; and the quality of the health care services rendered, and which may include procedures for arbitration.
RCW 48.62.031 — Washington Code / Title 48 / Chapter 62 / Section 031
RCW 48.62.031: Authority to self-insure—Options—Risk manager.
Status: in_force

(1) The governing body of a local government entity may individually self-insure, may join or form a self-insurance program together with other entities, including the board of pilotage commissioners, and may jointly purchase insurance or reinsurance with those other entities for property and liability risks, and health and welfare benefits only as permitted under this chapter. In addition, the entity or entities may contract for or hire personnel to provide risk management, claims, and administrative services in accordance with this chapter. (2) The agreement to form a joint self-insurance program shall be made under chapter 39.34 RCW and may create a separate legal or administrative entity with powers delegated thereto. (3) Every individual and joint self-insurance program is subject to audit by the state auditor. (4) If provided for in the agreement or contract established under chapter 39.34 RCW, a joint self-insurance program may, in conformance with this chapter: (a) Contract or otherwise provide for risk management and loss control services; (b) Contract or otherwise provide legal counsel for the defense of claims and other legal services; (c) Consult with the state insurance commissioner and the state risk manager; (d) Jointly purchase insurance and reinsurance coverage in such form and amount as the program's participants agree by contract; (e) Obligate the program's participants to pledge revenues or contribute money to secure the obligations or pay the expenses of the program, including the establishment of a reserve or fund for coverage; and (f) Possess any other powers and perform all other functions reasonably necessary to carry out the purposes of this chapter. (5) A self-insurance program formed and governed under this chapter that has decided to assume a risk of loss must have available for inspection by the state auditor a written report indicating the class of risk or risks the governing body of the entity has decided to assume. (6) Every joint self-insurance program governed by this chapter shall appoint the risk manager as its attorney to receive service of, and upon whom shall be served, all legal process issued against it in this state upon causes of action arising in this state. (a) Service upon the risk manager as attorney shall constitute service upon the program. Service upon joint insurance programs subject to chapter 30, Laws of 1991 sp. sess. can be had only by service upon the risk manager. At the time of service, the plaintiff shall pay to the risk manager a fee to be set by the risk manager, taxable as costs in the action. (b) With the initial filing for approval with the risk manager, each joint self-insurance program shall designate by name and address the person to whom the risk manager shall forward legal process so served upon him or her. The joint self-insurance program may change such person by filing a new designation. (c) The appointment of the risk manager as attorney shall be irrevocable, shall bind any successor in interest or to the assets or liabilities of the joint self-insurance program, and shall remain in effect as long as there is in force in this state any contract made by the joint self-insurance program or liabilities or duties arising therefrom. (d) The risk manager shall keep a record of the day and hour of service upon him or her of all legal process. A copy of the process, by registered mail with return receipt requested, shall be sent by the risk manager, to the person designated for the purpose by the joint self-insurance program in its most recent such designation filed with the risk manager. No proceedings shall be had against the joint self-insurance program, and the program shall not be required to appear, plead, or answer, until the expiration of forty days after the date of service upon the risk manager. (7) Public utility districts established under Title 54 RCW may form, own, or use captive insurers in accordance with chapter 48.201 RCW.
RCW 48.31.155 — Washington Code / Title 48 / Chapter 31 / Section 155
RCW 48.31.155: Unclaimed funds—Liquidator's application for discharge—Deposits with the department of revenue.
Status: in_force

Unclaimed funds subject to distribution remaining in the liquidator's hands when he or she is ready to apply to the court for discharge, including the amount distributable to a person who is unknown or cannot be found, shall be deposited with the state department of revenue as unclaimed funds, and shall be paid without interest to the person entitled to them or his or her legal representative upon proof satisfactory to the state department of revenue of his or her right to them. An amount on deposit not claimed within six years from the discharge of the liquidator is deemed to have been abandoned and shall be escheated without formal escheat proceedings and be deposited with the state treasurer.
RCW 48.150.040 — Washington Code / Title 48 / Chapter 150 / Section 040
RCW 48.150.040: Prohibited and authorized practices.
Status: in_force

(1) Direct practices may not: (a) Enter into a participating provider contract as defined in RCW 48.44.010 or 48.46.020 with any carrier or with any carrier's contractor or subcontractor, or plans administered under chapter 41.05 , 70.47, or * 70.47A RCW, to provide health care services through a direct agreement except as set forth in subsection (2) of this section; (b) Submit a claim for payment to any carrier or any carrier's contractor or subcontractor, or plans administered under chapter 41.05 , 70.47, or * 70.47A RCW, for health care services provided to direct patients as covered by their agreement; (c) With respect to services provided through a direct agreement, be identified by a carrier or any carrier's contractor or subcontractor, or plans administered under chapter 41.05 , 70.47, or * 70.47A RCW, as a participant in the carrier's or any carrier's contractor or subcontractor network for purposes of determining network adequacy or being available for selection by an enrollee under a carrier's benefit plan; or (d) Pay for health care services covered by a direct agreement rendered to direct patients by providers other than the providers in the direct practice or their employees, except as described in subsection (2)(b) of this section. (2) Direct practices and providers may: (a) Enter into a participating provider contract as defined by RCW 48.44.010 and 48.46.020 or plans administered under chapter 41.05 , 70.47, or * 70.47A RCW for purposes other than payment of claims for services provided to direct patients through a direct agreement. Such providers shall be subject to all other provisions of the participating provider contract applicable to participating providers including but not limited to the right to: (i) Make referrals to other participating providers; (ii) Admit the carrier's members to participating hospitals and other health care facilities; (iii) Prescribe prescription drugs; and (iv) Implement other customary provisions of the contract not dealing with reimbursement of services; (b)(i) Pay for charges associated with: (A) The provision of routine lab and imaging services; and (B) The dispensing, at no additional cost to the direct patient, of an initial supply, not to exceed thirty days, of generic prescription drugs prescribed by the direct provider. (ii) In aggregate payments made under (b)(i)(A) and (B) of this subsection per year per direct patient are not to exceed fifteen percent of the total annual direct fee charged that direct patient. Exceptions to this limitation may occur with respect to routine lab and imaging services in the event of short-term equipment failure if such failure prevents the provision of care that should not be delayed; and (c) Charge an additional fee to direct patients for supplies, medications, and specific vaccines provided to direct patients that are specifically excluded under the agreement, provided the direct practice notifies the direct patient of the additional charge, prior to their administration or delivery.
RCW 48.18.050 — Washington Code / Title 48 / Chapter 18 / Section 050
RCW 48.18.050: Named insured—Interest insured.
Status: in_force

When the name of a person intended to be insured is specified in the policy, such insurance can be applied only to his or her own proper interest. This section shall not apply to life and disability insurances.
RCW 48.17.530 — Washington Code / Title 48 / Chapter 17 / Section 530
RCW 48.17.530: Commissioner may place on probation, suspend, revoke, or refuse to issue or renew a license.
Status: in_force

(1) The commissioner may place on probation, suspend, revoke, or refuse to issue or renew an adjuster's license, an insurance producer's license, a title insurance agent's license, or any surplus line broker's license, or may levy a civil penalty in accordance with RCW 48.17.560 or any combination of actions, for any one or more of the following causes: (a) Providing incorrect, misleading, incomplete, or materially untrue information in the license application; (b) Violating any insurance laws, or violating any rule, subpoena, or order of the commissioner or of another state's insurance commissioner; (c) Obtaining or attempting to obtain a license through misrepresentation or fraud; (d) Improperly withholding, misappropriating, or converting any moneys or properties received in the course of doing insurance business; (e) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance; (f) Having been convicted of a felony; (g) Having admitted or been found to have committed any insurance unfair trade practice or fraud; (h) Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial irresponsibility in this state or elsewhere; (i) Having an insurance producer license, or its equivalent, denied, suspended, or revoked in any other state, province, district, or territory; (j) Forging another's name to an application for insurance or to any document related to an insurance transaction; (k) Improperly using notes or any other reference material to complete an examination for an insurance license; (l) Knowingly accepting insurance business from a person who is required to be licensed under this title and is not so licensed, other than orders for issuance of title insurance on property located in this state placed by a nonresident title insurance agent authorized to act as a title insurance agent in the title insurance agent's home state; or (m) Obtaining a loan from an insurance client that is not a financial institution and who is not related to the insurance producer by birth, marriage, or adoption, except the commissioner may, by rule, define and permit reasonable arrangements. (2) The license of a business entity may be suspended, revoked, or refused if the commissioner finds that an individual licensee's violation was known or should have been known by one or more of the partners, officers, or managers acting on behalf of the partnership or corporation, and the violation was neither reported to the commissioner nor corrective action taken. (3) The commissioner shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and this title against any person who is under investigation for or charged with a violation of this chapter or this title, even if the person's license or registration has been surrendered or has lapsed by operation of law. (4) The holder of any license which has been revoked or suspended shall surrender the license certificate to the commissioner at the commissioner's request. (5) The commissioner may probate a suspension or revocation of a license under reasonable terms determined by the commissioner. In addition, the commissioner may require a licensee who is placed on probation to: (a) Report regularly to the commissioner on matters that are the basis of the probation; (b) Limit practice to an area prescribed by the commissioner; or (c) Continue or renew continuing education until the licensee attains a degree of skill satisfactory to the commissioner in the area that is the basis of the probation. (6) At any time during a probation term where the licensee has violated the probation order, the commissioner may: (a) Rescind the probation and enforce the commissioner's original order; and (b) Impose any disciplinary action permitted under this section in addition to or in lieu of enforcing the original order.
RCW 48.92.110 — Washington Code / Title 48 / Chapter 92 / Section 110
RCW 48.92.110: Penalties.
Status: in_force

A risk retention group which violates any provision of this chapter shall be subject to fines and penalties applicable to licensed insurers generally, including revocation of its license and/or the right to do business in this state.
RCW 48.125.080 — Washington Code / Title 48 / Chapter 125 / Section 080
RCW 48.125.080: Certificate of authority—Granting or denying application.
Status: in_force

(1) The commissioner shall grant or deny an application for a certificate of authority within one hundred eighty days of the date that a completed application, together with the items designated in RCW 48.125.050 , is submitted to the commissioner. (2) The commissioner shall grant the application of an arrangement that satisfies the applicable requirements of RCW 48.125.030 through 48.125.070 . (3) The commissioner shall deny the application of an arrangement that does not satisfy the applicable requirements of RCW 48.125.030 through 48.125.070 . Denial of an application for a certificate of authority is subject to appeal under chapter 34.05 RCW. (4) A certificate of authority granted to an arrangement is effective unless revoked by the commissioner under RCW 48.125.100 .
RCW 48.02.140 — Washington Code / Title 48 / Chapter 02 / Section 140
RCW 48.02.140: Interstate cooperation.
Status: in_force

(1) The commissioner shall to the extent he or she deems useful for the proper discharge of his or her responsibilities under the provisions of this code: (a) Consult and cooperate with the public officials having supervision over insurance in other states. (b) Share jointly with other states in the employment of actuaries, statisticians, and other insurance technicians whose services or the products thereof are made available and are useful to the participating states and to the commissioner. (c) Share jointly with other states in establishing and maintaining offices and clerical facilities for purposes useful to the participating states and to the commissioner. (2) All arrangements made jointly with other states under items (b) and (c) of subsection (1) of this section shall be in writing executed on behalf of this state by the commissioner. Any such arrangement, as to participation of this state therein, shall be subject to termination by the commissioner at any time upon reasonable notice. (3) For the purposes of this code "National Association of Insurance Commissioners" means that voluntary organization of the public officials having supervision of insurance in the respective states, districts, and territories of the United States, whatever other name such organization may hereafter adopt, and in the affairs of which each of such public officials is entitled to participate subject to the constitution and bylaws of such organization.
RCW 48.37.070 — Washington Code / Title 48 / Chapter 37 / Section 070
RCW 48.37.070: Access to records and information—Commissioner's authority—Depositions, subpoena, and oaths.
Status: in_force

(1) Except as otherwise provided by law, market conduct oversight personnel shall have free, convenient, and full access to all books, records, employees, officers, and directors, as practicable, of the insurer during regular business hours. (2) An insurer using a third-party model or product for any of the activities under examination shall cause, upon the request of market conduct oversight personnel, the details of such models or products to be made available to such personnel. (3) Each officer, director, employee, and agent of an insurer shall facilitate and aid in a market conduct action or examination. (4) No waiver of any applicable privilege or claim of confidentiality in the documents, materials, or information shall occur as a result of disclosure to the commissioner, any employee of the office of the insurance commissioner, or any agent retained by the office of the insurance commissioner to assist in the market conduct examination under this chapter. (5)(a) The commissioner may take depositions, subpoena witnesses or documentary evidence, administer oaths, and examine under oath any individual relative to the affairs of any person being examined, or relative to the subject of any hearing or investigation: PROVIDED, That the provisions of RCW 34.05.446 shall apply in lieu of the provisions of this section as to subpoenas relative to hearings in rule-making and adjudicative proceedings. (b) The subpoena shall be effective if served within the state of Washington and shall be served in the same manner as if issued from a court of record. (c) Witness fees and mileage, if claimed, shall be allowed the same as for testimony in a court of record. Witness fees, mileage, and the actual expenses necessarily incurred in securing attendance of witnesses and their testimony shall be itemized, and shall be paid by the person as to whom the examination is being made, or by the person if other than the commissioner, at whose request the hearing is held. (d) Enforcement of subpoenas shall be in accordance with RCW 34.05.588 . (6) In order to assist in the performance of the commissioner's duties, the commissioner may: (a) Share documents, materials, market conduct examination reports, preliminary market conduct examination reports, and other matters related to such reports, or other information, including the confidential and privileged documents, materials, or information subject to subsection (1) of this section, with other state, federal, and international regulatory agencies and law enforcement authorities, and the NAIC and its affiliates and subsidiaries, provided that the recipient agrees to and asserts that it has the legal authority to maintain the confidentiality and privileged status of the document, material, communication, or other information; (b) Receive documents, materials, communications, or information, including otherwise confidential and privileged documents, materials, or information, from the NAIC and its affiliates or subsidiaries, and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information; and (c) Enter into agreements governing the sharing and use of information consistent with this subsection.
RCW 48.25.200 — Washington Code / Title 48 / Chapter 25 / Section 200
RCW 48.25.200: Title on policy.
Status: in_force

There shall be a title on the face of each such policy briefly describing its form.
RCW 48.24.035 — Washington Code / Title 48 / Chapter 24 / Section 035
RCW 48.24.035: Credit union groups.
Status: in_force

The lives of a group of individuals may be insured under a policy issued to a credit union, which shall be deemed the policyholder, to insure eligible members of such credit union for the benefit of persons other than the credit union or its officials, subject to the following requirements: (1) The members eligible for insurance under the policy shall be all of the members of a credit union, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer, or all of any class or classes thereof determined by conditions pertaining to their age or membership in the credit union or both. (2) The premium for the policy shall be paid by the policyholder, either wholly from the credit union's funds, or partly from such funds and partly from funds contributed by the insured members specifically for their insurance. No policy may be issued for which the entire premium is to be derived from funds contributed by the insured members specifically for their insurance. (3) The policy must cover at least twenty-five members at the date of issue. (4) The amount of insurance under the policy shall not exceed the amount of the total shares and deposits of the member. (5) As used herein, "credit union" means a credit union organized and operating under the federal credit union act of 1934 or chapter 31.12 RCW.
RCW 48.32A.145 — Washington Code / Title 48 / Chapter 32A / Section 145
RCW 48.32A.145: Examination of the association—Annual report.
Status: in_force

The association is subject to examination and regulation by the commissioner. The board of directors shall submit to the commissioner each year, not later than one hundred eighty days after the association's fiscal year, a financial report in a form approved by the commissioner and a report of its activities during the preceding fiscal year. Upon the request of a member insurer, the association shall provide the member insurer with a copy of the report.
RCW 48.23A.070 — Washington Code / Title 48 / Chapter 23A / Section 070
RCW 48.23A.070: Policy designated for use of illustrations—Annual report—Required information—In-force illustrations—Notice of adverse changes.
Status: in_force

(1) In the case of a policy designated as one for which illustrations will be used, the insurer shall provide each policy owner with an annual report on the status of the policy that shall contain at least the following information: (a) For universal life policies, the report shall include the following: (i) The beginning and end date of the current report period; (ii) The policy value at the end of the previous report period and at the end of the current report period; (iii) The total amounts that have been credited or debited to the policy value during the current report period, identifying each type, such as interest, mortality, expense, and riders; (iv) The current death benefit at the end of the current report period on each life covered by the policy; (v) The net cash surrender value of the policy as of the end of the current report period; (vi) The amount of outstanding loans, if any, as of the end of the current report period; and (vii) For fixed premium policies: If, assuming guaranteed interest, mortality, and expense loads and continued scheduled premium payments, the policy's net cash surrender value is such that it would not maintain insurance in force until the end of the next reporting period, a notice to this effect shall be included in the report; or (viii) For flexible premium policies: If, assuming guaranteed interest, mortality, and expense loads, the policy's net cash surrender value will not maintain insurance in force until the end of the next reporting period unless further premium payments are made, a notice to this effect shall be included in the report. (b) For all other policies, where applicable: (i) Current death benefit; (ii) Annual contract premium; (iii) Current cash surrender value; (iv) Current dividend; (v) Application of current dividend; and (vi) Amount of outstanding loan. (c) Insurers writing life insurance policies that do not build nonforfeiture values shall only be required to provide an annual report with respect to these policies for those years when a change has been made to nonguaranteed policy elements by the insurer. (2) If the annual report does not include an in-force illustration, it shall contain the following notice displayed prominently: "IMPORTANT POLICY OWNER NOTICE: You should consider requesting more detailed information about your policy to understand how it may perform in the future. You should not consider replacement of your policy or make changes in your coverage without requesting a current illustration. You may annually request, without charge, such an illustration by calling (insurer's phone number), writing to (insurer's name) at (insurer's address) or contacting your insurance producer. If you do not receive a current illustration of your policy within 30 days from your request, you should contact your state insurance department." The insurer may vary the sequential order of the methods for obtaining an in-force illustration. (3) Upon the request of the policy owner, the insurer shall furnish an in-force illustration of current and future benefits and values based on the insurer's present illustrated scale. This illustration shall comply with the requirements of RCW 48.23A.030 (1) and (2) and 48.23A.040 (1) and (5). No signature or other acknowledgment of receipt of this illustration shall be required. (4) If an adverse change in nonguaranteed elements that could affect the policy has been made by the insurer since the last annual report, the annual report shall contain a notice of that fact and the nature of the change prominently displayed.
RCW 48.14.040 — Washington Code / Title 48 / Chapter 14 / Section 040
RCW 48.14.040: Retaliatory provision.
Status: in_force

(1) If pursuant to the laws of any other state or country, any taxes, licenses, fees, deposits, or other obligations or prohibitions, in the aggregate, or additional to or at a net rate in excess of any such taxes, licenses, fees, deposits or other obligations or prohibitions imposed by the laws of this state upon like foreign or alien insurers and their appointed insurance producers or title insurance agents, are imposed on insurers of this state and their appointed insurance producers or title insurance agents doing business in such other state or country, a like rate, obligation or prohibition may be imposed by the commissioner, as to any item or combination of items involved, upon all insurers of such other state or country and their appointed insurance producers or title insurance agents doing business in this state, so long as such laws remain in force or are so applied. (2) For the purposes of this section, an alien insurer may be deemed to be domiciled in the state wherein it has established its principal office or agency in the United States. If no such office or agency has been established, the domicile of the alien insurer shall be deemed to be the country under the laws of which it is formed. (3) For the purposes of this section, the regulatory and insurance fraud surcharges imposed by RCW 48.02.190 shall not be included in the calculation of any retaliatory taxes, licenses, fees, deposits, or other obligations or prohibitions imposed under this section.
RCW 48.43.021 — Washington Code / Title 48 / Chapter 43 / Section 021
RCW 48.43.021: Personally identifiable health information—Restrictions on release.
Status: in_force

Except as otherwise required by statute or rule, a carrier and the Washington state health insurance pool, and persons acting at the direction of or on behalf of a carrier or the pool, who are in receipt of an enrollee's or applicant's personally identifiable health information included in the standard health questionnaire shall not disclose the identifiable health information unless such disclosure is explicitly authorized in writing by the person who is the subject of the information.
RCW 48.66.050 — Washington Code / Title 48 / Chapter 66 / Section 050
RCW 48.66.050: Policy or certificate provisions prohibited by rule—Waivers restricted.
Status: in_force

(1) The insurance commissioner may issue reasonable rules that specify prohibited policy provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unfair, unjust, or unfairly discriminatory to any person insured or proposed to be insured under a medicare supplement insurance policy or certificate. (2) No medicare supplement insurance policy may use waivers to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.
RCW 48.09.250 — Washington Code / Title 48 / Chapter 09 / Section 250
RCW 48.09.250: Contingent liability as asset.
Status: in_force

Any contingent liability of members of a domestic mutual insurer to assessment does not constitute an asset of the insurer in any determination of its financial condition.
RCW 48.30.010 — Washington Code / Title 48 / Chapter 30 / Section 010
RCW 48.30.010: Unfair practices in general—Remedies and penalties.
Status: in_force

(1) No person engaged in the business of insurance shall engage in unfair methods of competition or in unfair or deceptive acts or practices in the conduct of such business as such methods, acts, or practices are defined pursuant to subsection (2) of this section. (2) In addition to such unfair methods and unfair or deceptive acts or practices as are expressly defined and prohibited by this code, the commissioner may from time to time by regulation promulgated pursuant to chapter 34.05 RCW, define other methods of competition and other acts and practices in the conduct of such business reasonably found by the commissioner to be unfair or deceptive after a review of all comments received during the notice and comment rule-making period. (3)(a) In defining other methods of competition and other acts and practices in the conduct of such business to be unfair or deceptive, and after reviewing all comments and documents received during the notice and comment rule-making period, the commissioner shall identify his or her reasons for defining the method of competition or other act or practice in the conduct of insurance to be unfair or deceptive and shall include a statement outlining these reasons as part of the adopted rule. (b) The commissioner shall include a detailed description of facts upon which he or she relied and of facts upon which he or she failed to rely, in defining the method of competition or other act or practice in the conduct of insurance to be unfair or deceptive, in the concise explanatory statement prepared under RCW 34.05.325 (6). (c) Upon appeal the superior court shall review the findings of fact upon which the regulation is based de novo on the record. (4) No such regulation shall be made effective prior to the expiration of thirty days after the date of the order by which it is promulgated. (5) If the commissioner has cause to believe that any person is violating any such regulation, the commissioner may order such person to cease and desist therefrom. The commissioner shall deliver such order to such person direct or mail it to the person by registered mail with return receipt requested. If the person violates the order after expiration of ten days after the cease and desist order has been received by him or her, he or she may be fined by the commissioner a sum not to exceed two hundred and fifty dollars for each violation committed thereafter. (6) If any such regulation is violated, the commissioner may take such other or additional action as is permitted under the insurance code for violation of a regulation. (7) An insurer engaged in the business of insurance may not unreasonably deny a claim for coverage or payment of benefits to any first party claimant. "First party claimant" has the same meaning as in RCW 48.30.015 .
RCW 48.03.005 — Washington Code / Title 48 / Chapter 03 / Section 005
RCW 48.03.005: Application.
Status: in_force

This chapter applies to the financial analysis and examination of insurers and other regulated entities.
RCW 48.46.180 — Washington Code / Title 48 / Chapter 46 / Section 180
RCW 48.46.180: Duty of employer to inform and make available to employees option of enrolling in health maintenance organization.
Status: in_force

(1) The state government, or any political subdivision thereof, which offers its employees a health benefits plan shall make available to and inform its employees or members of the option to enroll in at least one health maintenance organization holding a valid certificate of authority which provides health care services in the geographic areas in which such employees or members reside. (2) Each employer, public or private, having more than fifty employees in this state which offers its employees a health benefits plan, and each employee benefits fund in this state having more than fifty members which offers its members any form of health benefits shall make available to and inform its employees or members of the option to enroll in at least one health maintenance organization holding a valid certificate of authority which provides health care services in the geographic areas in which a substantial number of such employees or members reside: PROVIDED, That unless at least twenty-five employees agree to participate in a health maintenance organization the employer need not provide such an option: PROVIDED FURTHER, That where such employees are members of a bona fide bargaining unit covered by a labor-management collective bargaining agreement, the selection of the options required by this section may be specified in such agreement: AND PROVIDED FURTHER, That the provisions of this section shall not be mandatory where such members are covered by a Taft-Hartley health care trust, except that the labor-management trustees may contract with a health maintenance organization if a feasibility study determines it is to the advantage of the members to so contract. (3) Subsections (1) and (2) of this section shall impose no responsibilities or duties upon state government or any political subdivision thereof or any other employer, either public or private, to provide health maintenance organization coverage when no health maintenance organization exists for the purpose of providing health care services in the geographic areas in which the employees or members reside. (4) No employer in this state shall in any way be required to pay more for health benefits as a result of the application of this section than would otherwise be required by any prevailing collective bargaining agreement or other legally enforceable contract of obligation for the provision of health benefits between such employer and its employees.
RCW 48.37.050 — Washington Code / Title 48 / Chapter 37 / Section 050
RCW 48.37.050: Protocols for market conduct actions—Rules.
Status: in_force

(1) Market conduct actions shall be taken as a result of market analysis and shall focus on the general business practices and compliance activities of insurers, rather than identifying obviously infrequent or unintentional random errors that do not cause significant consumer harm. (2)(a) The commissioner is authorized to determine the frequency and timing of such market conduct actions. The timing shall depend upon the specific market conduct action to be initiated, unless extraordinary circumstances indicating a risk to consumers require immediate action. (b) If the commissioner has information that more than one insurer is engaged in common practices that may violate statutes or rules, the commissioner may schedule and coordinate multiple examinations simultaneously. (3) The insurer shall be given reasonable opportunity to resolve matters that arise as a result of a market analysis to the satisfaction of the commissioner before any additional market conduct actions are taken against the insurer. (4) The commissioner shall adopt by rule, under chapter 34.05 RCW, procedures and documents that are substantially similar to the NAIC work products defined or referenced in this chapter. Market analysis, market conduct actions, and market conduct examinations shall be performed in accordance with the rule.
RCW 48.32A.035 — Washington Code / Title 48 / Chapter 32A / Section 035
RCW 48.32A.035: Construction.
Status: in_force

This chapter shall be construed to effect the purpose under RCW 48.32A.015 .
RCW 48.111.070 — Washington Code / Title 48 / Chapter 111 / Section 070
RCW 48.111.070: Name of contract provider—Use of legal name—False or misleading statements—Restrictions on requirement to purchase service contracts.
Status: in_force

(1) A home heating fuel service contract provider shall not use in its name the words insurance, casualty, guaranty, surety, mutual, or any other words descriptive of the insurance, casualty, guaranty, or surety business; or a name deceptively similar to the name or description of any insurance or surety corporation, or to the name of any other home heating fuel service contract provider. This subsection does not apply to a company that was using any of the prohibited language in its name prior to June 7, 2006. However, a company using the prohibited language in its name shall conspicuously disclose in its home heating fuel service contracts the following statement: "This agreement is not an insurance contract." (2) Every home heating fuel service contract provider shall conduct its business in its own legal name, unless the commissioner has approved the use of another name. (3) A home heating fuel service contract provider or its representative shall not in its contracts or literature make, permit, or cause to be made any false or misleading statement, or deliberately omit any material statement that would be considered misleading if omitted. (4) A person, such as a bank, savings and loan association, lending institution, manufacturer, or seller shall not require the purchase of a home heating fuel service contract as a condition of a loan or a condition for the sale of any property.
RCW 48.21.223 — Washington Code / Title 48 / Chapter 21 / Section 223
RCW 48.21.223: Prescribed, self-administered anticancer medication.
Status: in_force

(1) Each health plan issued or renewed on or after January 1, 2012, that provides coverage for cancer chemotherapy treatment must provide coverage for prescribed, self-administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis at least comparable to cancer chemotherapy medications administered by a health care provider or facility as defined in *RCW 48.43.005 (25) and (26). (2) Nothing in this section may be interpreted to prohibit a health plan from administering a formulary or preferred drug list, requiring prior authorization, or imposing other appropriate utilization controls in approving coverage for any chemotherapy.
RCW 48.19.360 — Washington Code / Title 48 / Chapter 19 / Section 360
RCW 48.19.360: Joint underwriting or joint reinsurance.
Status: in_force

(1) Every group, association or other organization of insurers which engages in joint underwriting or joint reinsurance, shall be subject to regulation with respect thereto as is provided in this section, subject, however, with respect to joint underwriting, to all other provisions of this chapter, and, with respect to joint reinsurance, to RCW 48.19.270 , 48.01.080 and 48.19.430 ; and to chapter 48.03 RCW of this code. (2) If, after a hearing, the commissioner finds that any activity or practice of any such group, association or other organization is unfair or unreasonable or otherwise inconsistent with the provisions of this chapter, he or she may issue a written order specifying in what respects such activity or practice is unfair, or unreasonable or so inconsistent, and requiring the discontinuance of the activity or practice.
RCW 48.208.010 — Washington Code / Title 48 / Chapter 208 / Section 010
RCW 48.208.010: Covered lives assessment—Notification.
Status: in_force

(1) All health carriers and medicaid managed care organizations shall pay an annual covered lives assessment under RCW 74.76.030 . (2) The commissioner shall assess a per member per month assessment for health carriers pursuant to RCW 74.76.030 . (3) The commissioner shall annually notify, in writing, each health carrier of the estimated total assessment and its payment obligation for the upcoming year. The commissioner shall determine a payment schedule for receipt of assessments under this section in accordance with the medicaid access program rules established by the authority. Payment collections may be made no more frequently than quarterly. (4) Payments from health carriers are due to the commissioner within 45 days of the payment schedule determined under subsection (3) of this section. The commissioner shall charge interest as defined by RCW 43.17.240 , which begins to accrue on the 46th day, on amounts received after the 45-day period. The commissioner may allow each health carrier in arrears to submit a payment plan, subject to approval by the commissioner and initial payment under an approved payment plan. (5) The commissioner shall deposit annual assessments and interest collected under this section with the state treasurer to the credit of the medicaid access program account created in RCW 74.76.040 . (6) Health carriers shall submit any annual statements or other reports deemed necessary by the commissioner for the health care authority to calculate the assessment in a manner consistent with the schedule and procedures in accordance with RCW 74.76.030 .
RCW 48.17.597 — Washington Code / Title 48 / Chapter 17 / Section 597
RCW 48.17.597: Administrative action taken against a licensee in another jurisdiction or governmental agency—Report to commissioner.
Status: in_force

(1) An insurance producer, title insurance agent, or adjuster shall report to the commissioner any administrative action taken against the insurance producer, title insurance agent, or adjuster in another jurisdiction or by another governmental agency in this state within thirty days of the final disposition of the matter. This report shall include a copy of the order, consent to order, or other relevant legal documents. (2) Within thirty days of the initial pretrial hearing date, an insurance producer, title insurance agent, or adjuster shall report to the commissioner any criminal prosecution of the insurance producer, title insurance agent, or adjuster taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing, and any other relevant legal documents.
RCW 48.64.100 — Washington Code / Title 48 / Chapter 64 / Section 100
RCW 48.64.100: Employees or officials of a participating affordable housing entity—Restrictions on receiving anything of value.
Status: in_force

(1) An employee or official of a participating affordable housing entity in a joint self-insurance program may not directly or indirectly receive anything of value for services rendered in connection with the operation and management of a self-insurance program other than the salary and benefits provided by his or her employer or the reimbursement of expenses reasonably incurred in furtherance of the operation or management of the program. An employee or official of a participating affordable housing entity in a joint self-insurance program may not accept or solicit anything of value for personal benefit or for the benefit of others under circumstances in which it can be reasonably inferred that the employee's or official's independence of judgment is impaired with respect to the management and operation of the program. (2) RCW 48.30.140 , 48.30.150 , and 48.30.157 apply to the use of insurance producers by a joint self-insurance program.
RCW 48.13.141 — Washington Code / Title 48 / Chapter 13 / Section 141
RCW 48.13.141: Aggrieved insurer—Request for hearing.
Status: in_force

An insurer aggrieved by an order or any other act or failure to act of the commissioner regarding compliance with this chapter or rules adopted under this chapter may request a hearing by following the procedures of chapters 48.04 and 34.05 RCW.
RCW 48.42.030 — Washington Code / Title 48 / Chapter 42 / Section 030
RCW 48.42.030: Examination by commissioner—When required, scope of.
Status: in_force

Any person or entity which is unable to show under RCW 48.42.020 that it is subject to the jurisdiction and regulation of another agency of this state, any subdivision thereof, or the federal government, shall submit to an examination by the insurance commissioner to determine the organization and solvency of the person or the entity, and to determine whether or not such person or entity complies with the applicable provisions of this title.
RCW 48.43.335 — Washington Code / Title 48 / Chapter 43 / Section 335
RCW 48.43.335: Confidentiality of RBC reports and plans—Use of certain comparisons prohibited—Certain information intended solely for use by commissioner.
Status: in_force

(1) All RBC reports, to the extent the information therein is not required to be set forth in a publicly available annual statement schedule, and RBC plans, including the results or report of any examination or analysis of a carrier and any corrective order issued by the commissioner, with respect to any domestic carrier or foreign carrier that are filed with the commissioner constitute information that might be damaging to the carrier if made available to its competitors, and therefore shall be kept confidential by the commissioner. This information shall not be made public or be subject to subpoena, other than by the commissioner and then only for the purpose of enforcement actions taken by the commissioner. (2) The comparison of a carrier's total adjusted capital to any of its RBC levels is a regulatory tool that may indicate the need for possible corrective action with respect to the carrier, and is not a means to rank carriers generally. Therefore, except as otherwise required under the provisions of RCW 48.43.300 through 48.43.370 , the making, publishing, disseminating, circulating, or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in a newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio or television station, or in any other way, an advertisement, announcement, or statement containing an assertion, representation, or statement with regard to the RBC levels of any carrier, or of any component derived in the calculation, by any carrier, insurance producer, or other person engaged in any manner in the insurance business would be misleading and is therefore prohibited. However, if any materially false statement with respect to the comparison regarding a carrier's total adjusted capital to its RBC levels (or any of them) or an inappropriate comparison of any other amount to the carrier's RBC levels is published in any written publication and the carrier is able to demonstrate to the commissioner with substantial proof the falsity of such statement, or the inappropriateness, as the case may be, then the carrier may publish an announcement in a written publication if the sole purpose of the announcement is to rebut the materially false statement. (3) The RBC instructions, RBC reports, adjusted RBC reports, RBC plans, and revised RBC plans are intended solely for use by the commissioner in monitoring the solvency of carriers and the need for possible corrective action with respect to carriers and shall not be used by the commissioner for ratemaking nor considered or introduced as evidence in any rate proceeding nor used by the commissioner to calculate or derive any elements of an appropriate premium level or rate of return for any line of insurance that a carrier or any affiliate is authorized to write.
RCW 48.15.130 — Washington Code / Title 48 / Chapter 15 / Section 130
RCW 48.15.130: Penalty for default.
Status: in_force

If any surplus line broker fails to file his or her annual statement, or fails to remit the tax provided by RCW 48.15.120 , by the last day of the month in which the tax becomes due, the surplus line broker must pay the penalties provided in RCW 48.14.060 (1). The tax may be collected by distraint, or the tax and fine may be recovered by an action instituted by the commissioner in any court of competent jurisdiction. Any fine collected by the commissioner must be paid to the state treasurer and credited to the general fund.
RCW 48.155.030 — Washington Code / Title 48 / Chapter 155 / Section 030
RCW 48.155.030: Minimum net worth.
Status: in_force

(1) Except under subsection (3) of this section, before the commissioner issues a license to any person required to obtain a license under RCW 48.155.020 , the person seeking to operate a discount plan organization must have a net worth of at least one hundred fifty thousand dollars. (2) At all times, except under subsection (3) of this section, each discount plan organization must maintain a net worth of at least one hundred fifty thousand dollars. (3) By rule of the commissioner, the amounts in subsections (1) and (2) of this section may be adjusted annually for inflation.
RCW 48.20.480 — Washington Code / Title 48 / Chapter 20 / Section 480
RCW 48.20.480: Standardization and simplification—Simplified application form—Coverage of loss from preexisting health condition.
Status: in_force

Notwithstanding the provisions of RCW 48.20.052 , if an insurer elects to use a simplified application form, with or without a question as to the applicant's health at the time of application, but without any questions concerning the insured's health history or medical treatment history, the policy must cover any loss occurring after twelve months from any preexisting condition not specifically excluded from coverage by terms of the policy, and, except as so provided, the policy shall not include wording that would permit a defense based upon preexisting conditions.
RCW 48.15.039 — Washington Code / Title 48 / Chapter 15 / Section 039
RCW 48.15.039: National database—Surplus line brokers.
Status: in_force

When a national insurance producer database of the national association of insurance commissioners, or other equivalent uniform national database, for the licensure of surplus line brokers is created, the commissioner may participate in the database.
RCW 48.44.245 — Washington Code / Title 48 / Chapter 44 / Section 245
RCW 48.44.245: "Chemical dependency" defined.
Status: in_force

For the purposes of RCW 48.44.240 , "chemical dependency" means an illness characterized by a physiological or psychological dependency, or both, on a controlled substance regulated under chapter 69.50 RCW and/or alcoholic beverages. It is further characterized by a frequent or intense pattern of pathological use to the extent the user exhibits a loss of self-control over the amount and circumstances of use; develops symptoms of tolerance or physiological and/or psychological withdrawal if use of the controlled substance or alcoholic beverage is reduced or discontinued; and the user's health is substantially impaired or endangered or his or her social or economic function is substantially disrupted.
RCW 48.135.005 — Washington Code / Title 48 / Chapter 135 / Section 005
RCW 48.135.005: Purpose.
Status: in_force

The purpose of this chapter and sections 14 through 17, chapter 284, Laws of 2006 is to confront the problem of insurance fraud in this state by making a concerted effort to detect insurance fraud, reduce the occurrence of fraud through criminal enforcement and deterrence, require restitution of fraudulently obtained insurance benefits and expenses incurred by an insurer in investigating fraudulent claims, and reduce the amount of premium dollars used to pay fraudulent claims. The primary focus of the insurance fraud program is on organized fraudulent activities committed against insurance companies.
RCW 48.83.170 — Washington Code / Title 48 / Chapter 83 / Section 170
RCW 48.83.170: Rules, generally.
Status: in_force

(1) The commissioner must adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. The commissioner must adopt rules establishing loss ratio standards for long-term care insurance policies. The commissioner must adopt rules to promote premium adequacy and to protect policyholders in the event of proposed substantial rate increases, and to establish minimum standards for producer education, marketing practices, producer compensation, producer testing, penalties, and reporting practices for long-term care insurance. (2) The commissioner must adopt rules establishing standards protecting patient privacy rights, rights to receive confidential health care services, and standards for an issuer's timely review of a claim denial upon request of a covered person. (3) The commissioner must adopt by rule prompt payment requirements for long-term care insurance. The rules must include a definition of a "claim" and a definition of "clean claim." In adopting the rules the commissioner must consider the prompt payment requirements in long-term care insurance model acts developed by the national association of insurance commissioners. (4) The commissioner may adopt reasonable rules to effectuate any provision of this chapter in accordance with the requirements of chapter 34.05 RCW.
RCW 48.17.510 — Washington Code / Title 48 / Chapter 17 / Section 510
RCW 48.17.510: Temporary licenses—Restrictions—Commissioner's discretion.
Status: in_force

(1) The commissioner may issue a temporary insurance producer license for a period not to exceed one hundred eighty days without requiring an examination if the commissioner deems that the temporary license is necessary for the servicing of an insurance business in the following cases: (a) To the surviving spouse or court-appointed personal representative of a licensed insurance producer who dies or becomes mentally or physically disabled to allow adequate time for the sale of the insurance business owned by the insurance producer or for the recovery or return of the insurance producer to the business, or to provide for the training and licensing of new personnel to operate the insurance producer's business; (b) To a member or employee of a business entity licensed as an insurance producer, upon the death or disability of an individual designated in the business entity application or the license; (c) To the designee of a licensed insurance producer entering active service in the armed forces of the United States; or (d) In any other circumstance where the commissioner deems that the public interest will best be served by the issuance of this license. (2) The commissioner may, by order, limit the authority of any temporary licensee in any way deemed necessary to protect insureds and the public. The commissioner may require the temporary licensee to have a suitable sponsor who is a licensed insurance producer or insurer and who assumes responsibility for all acts of the temporary licensee, and may impose other similar requirements designed to protect insureds and the public. The commissioner may, by order, revoke a temporary license if the interest of insureds or the public are endangered. A temporary license may not continue after the owner or the personal representatives dispose of the business.
RCW 48.20.282 — Washington Code / Title 48 / Chapter 20 / Section 282
RCW 48.20.282: Order of certain policy provisions.
Status: in_force

The provisions which are the subject of RCW 48.20.042 to *48.20.272, inclusive, or any corresponding provisions which are used in lieu thereof in accordance with such sections, shall be printed in the consecutive order of the provisions in such sections or, at the insurer's option, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related, provided the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered or issued.
RCW 48.11.140 — Washington Code / Title 48 / Chapter 11 / Section 140
RCW 48.11.140: Limitation of single risk.
Status: in_force

(1) An insurer may not retain any risk on any one subject of insurance, whether located or to be performed in this state or elsewhere, in an amount exceeding ten percent of its surplus to policyholders. (2) For the purposes of this section, a "subject of insurance" as to insurance against fire includes all properties insured by the same insurer that are reasonably subject to loss or damage from the same fire. (3) Reinsurance in an alien reinsurer not qualified under *RCW 48.12.166 may not be deducted in determining risk retained for the purposes of this section. (4) In the case of surety insurance, the net retention shall be computed after deduction of reinsurances, the amount assumed by any co-surety, the value of any security deposited, pledged, or held subject to the consent of the surety and for the protection of the surety. (5) This section does not apply to life insurance, disability insurance, title insurance, or insurance of marine risks or marine protection and indemnity risks.
RCW 48.36A.278 — Washington Code / Title 48 / Chapter 36A / Section 278
RCW 48.36A.278: Notice to agents of loss of authority.
Status: in_force

Upon the suspension, revocation, or refusal of a society's license, the commissioner shall give notice to the society and shall suspend, revoke, or refuse the authority of its agents to represent it in this state and give notice to the agents.
RCW 48.10.055 — Washington Code / Title 48 / Chapter 10 / Section 055
RCW 48.10.055: Real property—Attorney's duty.
Status: in_force

A reciprocal insurer may purchase, sell, mortgage, encumber, lease, or otherwise affect the title to real property for the purposes and objects of the reciprocal insurer. All deeds, notes, mortgages, or other documents relating to the real property may be executed in the name of the reciprocal insurer by its attorney.
RCW 48.30.120 — Washington Code / Title 48 / Chapter 30 / Section 120
RCW 48.30.120: Misconduct of officers, employees.
Status: in_force

No director, officer, agent, attorney-in-fact, or employee of an insurer shall: (1) Knowingly receive or possess himself or herself of any of its property, otherwise than in payment for a just demand, and with intent to defraud, omit to make or to cause or direct to be made, a full and true entry thereof in its books and accounts; nor (2) Make or concur in making any false entry, or concur in omitting to make any material entry, in its books or accounts; nor (3) Knowingly concur in making or publishing any written report, exhibit or statement of its affairs or pecuniary condition containing any material statement which is false, or omit or concur in omitting any statement required by law to be contained therein; nor (4) Having the custody or control of its books, willfully fail to make any proper entry in the books of the insurer as required by law, or to exhibit or allow the same to be inspected and extracts to be taken therefrom by any person entitled by law to inspect the same, or take extracts therefrom; nor (5) If a notice of an application for an injunction or other legal process affecting or involving the property or business of the insurer is served upon him or her, fail to disclose the fact of such service and the time and place of such application to the other directors, officers, and managers thereof; nor (6) Fail to make any report or statement lawfully required by a public officer.
RCW 48.90.030 — Washington Code / Title 48 / Chapter 90 / Section 030
RCW 48.90.030: Authority to self-insure.
Status: in_force

Associations meeting the criteria of RCW 48.90.020 are empowered to create and operate self-insurance plans to provide general liability coverage to member child day care centers who choose to subscribe to the plans.
RCW 48.99.060 — Washington Code / Title 48 / Chapter 99 / Section 060
RCW 48.99.060: Priority of certain claims.
Status: in_force

(1) In a delinquency proceeding against an insurer domiciled in this state, claims owing to residents of ancillary states shall be preferred claims if like claims are preferred under the laws of this state. All such claims whether owing to residents or nonresidents shall be given equal priority of payment from general assets regardless of where such assets are located. (2) In a delinquency proceeding against an insurer domiciled in a reciprocal state, claims owing to residents of this state shall be preferred if like claims are preferred by the laws of that state. (3) The owners of special deposit claims against an insurer for which a receiver is appointed in this or any other state shall be given priority against their several special deposits in accordance with the provisions of the statutes governing the creation and maintenance of such deposits. If there is a deficiency in any such deposit so that the claims secured thereby are not fully discharged therefrom, the claimants may share in the general assets, but such sharing shall be deferred until general creditors, and also claimants against other special deposits who have received smaller percentages from their respective special deposits, have been paid percentages of their claims equal to the percentage paid from the special deposit. (4) The owner of a secured claim against an insurer for which a receiver has been appointed in this or any other state may surrender his or her security and file his or her claim as a general creditor, or the claim may be discharged by resort to the security, in which case the deficiency, if any, shall be treated as a claim against the general assets of the insurer on the same basis as claims of unsecured creditors. If the amount of the deficiency has been adjudicated in ancillary proceedings as provided in this chapter, or if it has been adjudicated by a court of competent jurisdiction in proceedings in which the domiciliary receiver has had notice and opportunity to be heard, such amount shall be conclusive; otherwise the amount shall be determined in the delinquency proceeding in the domiciliary state.
RCW 48.20.292 — Washington Code / Title 48 / Chapter 20 / Section 292
RCW 48.20.292: Third party ownership.
Status: in_force

The word "insured," as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein.
RCW 48.46.615 — Washington Code / Title 48 / Chapter 46 / Section 615
RCW 48.46.615: Report of a material acquisition or disposition of assets—Information required.
Status: in_force

The following information is required to be disclosed in any report of a material acquisition or disposition of assets: (1) Date of the transaction; (2) Manner of acquisition or disposition; (3) Description of the assets involved; (4) Nature and amount of the consideration given or received; (5) Purpose of or reason for the transaction; (6) Manner by which the amount of consideration was determined; (7) Gain or loss recognized or realized as a result of the transaction; and (8) Names of the persons from whom the assets were acquired or to whom they were disposed.
RCW 48.42.100 — Washington Code / Title 48 / Chapter 42 / Section 100
RCW 48.42.100: Women's health care services—Duties of health care carriers.
Status: in_force

(1) For purposes of this section, health care carriers includes disability insurers regulated under chapter 48.20 or 48.21 RCW, health care services contractors regulated under chapter 48.44 RCW, health maintenance organizations regulated under chapter 48.46 RCW, plans operating under the health care authority under chapter 41.05 RCW, the state health insurance pool operating under chapter 48.41 RCW, and insuring entities regulated under chapter 48.43 RCW. (2) For purposes of this section and consistent with their lawful scopes of practice, types of health care practitioners that provide women's health care services shall include, but need not be limited by a health care carrier to, the following: Any generally recognized medical specialty of practitioners licensed under chapter 18.57 or 18.71 RCW who provides women's health care services; practitioners licensed under chapter 18.71A RCW when providing women's health care services; midwives licensed under chapter 18.50 RCW; and *advanced registered nurse practitioner specialists in women's health and midwifery under chapter 18.79 RCW. (3) For purposes of this section, women's health care services shall include, but need not be limited by a health care carrier to, the following: Maternity care; reproductive health services; gynecological care; general examination; and preventive care as medically appropriate and medically appropriate follow-up visits for the services listed in this subsection. (4) Health care carriers shall ensure that enrolled female patients have direct access to timely and appropriate covered women's health care services from the type of health care practitioner of their choice in accordance with subsection (5) of this section. (5)(a) Health care carrier policies, plans, and programs written, amended, or renewed after July 23, 1995, shall provide women patients with direct access to the type of health care practitioner of their choice for appropriate covered women's health care services without the necessity of prior referral from another type of health care practitioner. (b) Health care carriers may comply with this section by including all the types of health care practitioners listed in this section for women's health care services for women patients. (c) Nothing in this section shall prevent health care carriers from restricting women patients to seeing only health care practitioners who have signed participating provider agreements with the health care carrier.
RCW 48.43.074 — Washington Code / Title 48 / Chapter 43 / Section 074
RCW 48.43.074: Qualified health plans—Single invoice billing—Certification of compliance required in the segregation plan for premium amounts attributable to coverage of abortion services.
Status: in_force

(1) The legislature intends to codify the state's current practice of requiring health carriers to bill enrollees with a single invoice and to segregate into a separate account the premium attributable to abortion services for which federal funding is prohibited. Washington has achieved full compliance with section 1303 of the federal patient protection and affordable care act by requiring health carriers to submit a single invoice to enrollees and to segregate into a separate account the premium amounts attributable to coverage of abortion services for which federal funding is prohibited. Further, section 1303 states that the act does not preempt or otherwise have any effect on state laws regarding the prohibition of, or requirement of, coverage, funding, or procedural requirements on abortions. (2) In accordance with RCW 48.43.073 related to requirements for coverage and funding of abortion services, an issuer offering a qualified health plan must: (a) Bill enrollees and collect payment through a single invoice that includes all benefits and services covered by the qualified health plan; and (b) Include in the segregation plan required under applicable federal and state law a certification that the issuer's billing and payment processes meet the requirements of this section.
RCW 48.125.060 — Washington Code / Title 48 / Chapter 125 / Section 060
RCW 48.125.060: Surplus required—Amount—Enforcement.
Status: in_force

Self-funded multiple employer welfare arrangements must maintain continuously a surplus equal to at least ten percent of the next twelve months projected incurred claims or two million dollars, whichever is greater. The commissioner may proceed against self-funded multiple employer welfare arrangements that fail to maintain the level of surplus required by this section in any manner that the commissioner is authorized to proceed against a health care service contractor that failed to maintain minimum net worth.
RCW 48.30.135 — Washington Code / Title 48 / Chapter 30 / Section 135
RCW 48.30.135: Sponsoring events or making contributions—Definitions.
Status: in_force

(1) An insurance producer may sponsor events for, or make contributions to a bona fide charitable or nonprofit organization, if the sponsorship or contribution is not conditioned upon the organization applying for or obtaining insurance through the insurance producer. (2) For purposes of this section, a bona fide charitable or nonprofit organization is: (a) Any nonprofit corporation duly existing under the provisions of chapter 24.03A RCW for charitable, benevolent, eleemosynary, educational, civic, patriotic, political, social, fraternal, cultural, athletic, scientific, agricultural, or horticultural purposes; (b) Any professional, commercial, industrial, or trade association; (c) Any organization duly existing under the provisions of chapter 24.12 , 24.20, or 24.28 RCW; (d) Any agricultural fair authorized under the provisions of chapter 15.76 or 36.37 RCW; or (e) Any nonprofit organization, whether incorporated or otherwise, when determined by the commissioner to be organized and operated for one or more of the purposes described in (a) through (d) of this subsection. (3) RCW 48.30.140 and 48.30.150 do not apply to sponsorships or charitable contributions that are provided or given in compliance with subsection (1) of this section.
RCW 48.30.220 — Washington Code / Title 48 / Chapter 30 / Section 220
RCW 48.30.220: Destruction, injury, secretion, etc., of property.
Status: in_force

Any person, who, with intent to defraud or prejudice the insurer thereof, burns or in any manner injures, destroys, secretes, abandons, or disposes of any property which is insured at the time against loss or damage by fire, theft, embezzlement, or any other casualty, whether the same be the property of or in the possession of such person or any other person, under circumstances not making the offense arson in the first degree, is guilty of a class C felony.
RCW 48.46.490 — Washington Code / Title 48 / Chapter 46 / Section 490
RCW 48.46.490: Coverage for adopted children.
Status: in_force

(1) Any health maintenance agreement under this chapter which provides coverage for dependent children, as defined in the agreement of the enrolled participant, shall cover adoptive children placed with the enrolled participant on the same basis as other dependents, as provided in RCW 48.01.180 . (2) If payment of an additional premium is required to provide coverage for a child, the agreement may require that notification of placement of a child for adoption and payment of the required premium must be furnished to the health maintenance organization. The notification period shall be no less than sixty days from the date of placement.
RCW 48.30.060 — Washington Code / Title 48 / Chapter 30 / Section 060
RCW 48.30.060: Insurer name—Deceptive use prohibited.
Status: in_force

No person who is not an insurer shall assume or use any name which deceptively infers or suggests that it is an insurer.
RCW 48.22.900 — Washington Code / Title 48 / Chapter 22 / Section 900
RCW 48.22.900: Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.
Status: in_force

For the purposes of this chapter, the terms spouse, marriage, marital, husband, wife, widow, widower, next of kin, and family shall be interpreted as applying equally to state registered domestic partnerships or individuals in state registered domestic partnerships as well as to marital relationships and married persons, and references to dissolution of marriage shall apply equally to state registered domestic partnerships that have been terminated, dissolved, or invalidated, to the extent that such interpretation does not conflict with federal law. Where necessary to implement chapter 521, Laws of 2009, gender-specific terms such as husband and wife used in any statute, rule, or other law shall be construed to be gender neutral, and applicable to individuals in state registered domestic partnerships.
RCW 48.43.780 — Washington Code / Title 48 / Chapter 43 / Section 780
RCW 48.43.780: Cap on enrollee's required payment amount for specific drugs and equipment—Cost-sharing requirements.
Status: in_force

(1)(a) Except as required in (b) of this subsection, a health plan issued or renewed on or after January 1, 2023, that provides coverage for prescription insulin drugs for the treatment of diabetes must cap the total amount that an enrollee is required to pay for a covered insulin drug at an amount not to exceed $35 per 30-day supply of the drug. Prescription insulin drugs must be covered without being subject to a deductible, and any cost sharing paid by an enrollee must be applied toward the enrollee's deductible obligation. (b) If the federal internal revenue service removes insulin from the list of preventive care services which can be covered by a qualifying health plan for a health savings account before the deductible is satisfied, for a health plan that provides coverage for prescription insulin drugs for the treatment of diabetes and is offered as a qualifying health plan for a health savings account, the carrier must establish the plan's cost sharing for the coverage of prescription insulin for diabetes at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions from his or her health savings account under internal revenue service laws and regulations. (2)(a) Except as provided in (b) of this subsection, a health plan issued or renewed on or after January 1, 2025, that provides coverage for prescription asthma inhalers for the treatment of asthma shall cap the total amount that an enrollee is required to pay for at least one covered inhaled corticosteroid and at least one covered inhaled corticosteroid combination that is federal food and drug administration approved for the treatment of asthma at an amount not to exceed $35 per 30-day supply of the drug. A health plan must ensure that a covered inhaled corticosteroid and a covered inhaled corticosteroid combination is always available to a patient at the amount required by this subsection. Except as provided in (b) of this subsection, prescription asthma inhalers must be covered without being subject to a deductible, and any cost sharing paid by an enrollee must be applied toward the enrollee's deductible obligation. (b) For a health plan that is offered as a qualifying health plan for a health savings account, the health carrier shall establish the plan's cost sharing for asthma inhalers that are not on the federal internal revenue service's list of preventive care services at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions and withdrawals from the enrollee's health savings account under internal revenue service laws and regulations. If the federal internal revenue service removes asthma inhalers from the list of preventive care services which can be covered by a qualifying health plan for a health savings account before the deductible is satisfied, for a health plan that provides coverage for prescription asthma inhalers for the treatment of asthma and is offered as a qualifying health plan for a health savings account, the carrier shall establish the plan's cost sharing for the coverage of prescription asthma inhalers at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions from the enrollee's health savings account under internal revenue service laws and regulations. (3)(a) Except as provided in (b) of this subsection, a health plan issued or renewed on or after January 1, 2025, that provides coverage for prescription epinephrine autoinjectors for the treatment of allergic reaction shall cap the total amount that an enrollee is required to pay for at least one covered epinephrine autoinjector product containing at least two autoinjectors at an amount not to exceed $35. A health plan must ensure that a covered epinephrine autoinjector is always available to a patient at the amount required by this subsection. Except as provided in (b) of this subsection, prescription epinephrine autoinjectors must be covered without being subject to a deductible, and any cost sharing paid by an enrollee must be applied toward the enrollee's deductible obligation. (b) For a health plan that is offered as a qualifying health plan for a health savings account, the health carrier shall establish the plan's cost sharing for epinephrine autoinjectors at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions and withdrawals from the enrollee's health savings account under internal revenue service laws and regulations. If the federal internal revenue service adds epinephrine autoinjectors to the list of preventive care services which can be covered by a qualifying health plan for a health savings account before the deductible is satisfied, coverage must be provided as described in (a) of this subsection without being subject to the deductible. (4) The office of the insurance commissioner must provide written notice of any changes in internal revenue service guidance regarding any prescription drug covered in this section to affected parties, the chief clerk of the house of representatives, the secretary of the senate, the office of the code reviser, and others as deemed appropriate by the office. (5) To the extent not prohibited under this section, health plans may apply drug utilization management strategies to prescription drugs covered under subsections (2) and (3) of this section.
RCW 48.98.900 — Washington Code / Title 48 / Chapter 98 / Section 900
RCW 48.98.900: Short title.
Status: in_force

This chapter may be known and cited as the managing general agents act.
RCW 48.32A.901 — Washington Code / Title 48 / Chapter 32A / Section 901
RCW 48.32A.901: Prospective application—Savings—2001 c 50.
Status: repealed

(1) This chapter does not apply to any impaired insurer that was under an order of rehabilitation or conservation, or to any insolvent insurer that was placed under an order of liquidation, prior to July 22, 2001. (2) Any section repealed in this act pertaining to the powers and obligations of the association, reinsurance and guaranty of policies, assessments, and premium tax offsets shall apply to impaired insurers placed under an order of rehabilitation or conservation, and to insolvent insurers placed under an order of liquidation, prior to July 22, 2001.
RCW 48.18.250 — Washington Code / Title 48 / Chapter 18 / Section 250
RCW 48.18.250: Underwriters' and combination policies.
Status: in_force

(1) Two or more authorized insurers may jointly issue, and shall be jointly and severally liable on, an underwriters' policy bearing their names. Any one insurer may issue policies in the name of an underwriter's department and such policies shall plainly show the true name of the insurer. (2) Two or more authorized insurers may, with the commissioner's approval, issue a combination policy which shall contain provisions substantially as follows: (a) That the insurers executing the policy shall be severally liable for the full amount of any loss or damage, according to the terms of the policy, or for specified percentages or amounts thereof, aggregating the full amount of insurance under the policy. (b) That service of process, or of any notice or proof of loss required by such policy, upon any of the insurers executing the policy, shall constitute service upon all such insurers. (3) This section shall not apply to co-surety obligations.
RCW 48.30.240 — Washington Code / Title 48 / Chapter 30 / Section 240
RCW 48.30.240: Rate wars prohibited.
Status: in_force

(1) Any insurer which precipitates, or aids in precipitating or conducting a rate war and by so doing writes or issues a policy of insurance at a less rate than permitted under its schedules filed with the commissioner, or below the rate deemed by him or her to be proper and adequate to cover the class of risk insured, shall have its certificate of authority to do business in this state suspended until such time as the commissioner is satisfied that it is charging a proper rate of premium. (2) Any insurer which has precipitated, or aided in precipitating or conducting a rate war for the purpose of punishing or eliminating competitors or stifling competition, or demoralizing the business, or for any other purpose, and has ordered the cancellation or rewriting of policies at a rate lower than that provided by its rating schedules where such rate war is not in operation, and has paid or attempted to pay to the insured any return premiums, on any risk so to be rewritten, on which its appointed insurance producer has received or is entitled to receive a regular commission, such insurer shall not be allowed to charge back to such appointed insurance producer any portion of a commission on the ground that the same has not been earned.
RCW 48.12.405 — Washington Code / Title 48 / Chapter 12 / Section 405
RCW 48.12.405: Domestic ceding insurer—Asset or reduction from liability—Requirements.
Status: in_force

Credit for reinsurance is allowed a domestic ceding insurer as either an asset or a reduction from liability on account of reinsurance ceded only when the reinsurer meets the requirements of RCW 48.12.410 , 48.12.415 , 48.12.420 , 48.12.425 , 48.12.430 , 48.12.462 , or 48.12.435 . Credit is allowed under RCW 48.12.410 , 48.12.415 , or 48.12.420 only as respects cessions of those kinds or classes of business which the assuming insurer is licensed or otherwise permitted to write or assume in its state of domicile or, in the case of a United States branch of the alien assuming insurer, in the state through which it is entered and licensed to transact insurance or reinsurance. Credit is allowed under RCW 48.12.420 or 48.12.425 only if the applicable requirements of RCW 48.12.440 have been satisfied.
RCW 48.46.450 — Washington Code / Title 48 / Chapter 46 / Section 450
RCW 48.46.450: Conversion agreement to be offered—Exceptions, conditions.
Status: in_force

(1) Except as otherwise provided by this section, any group health maintenance agreement that provides benefits for hospital or medical care must contain a provision granting a person covered by the group agreement the right to obtain a conversion agreement from the health maintenance organization upon termination of the person's eligibility for coverage under the group agreement. (2) A health maintenance organization need not offer a conversion agreement to: (a) A person whose coverage under the group agreement ended when the person's employment or membership was terminated for misconduct: PROVIDED, That when a person's employment or membership is terminated for misconduct, a conversion policy shall be offered to the spouse and/or dependents of the terminated employee or member. The policy shall include in the conversion provisions the same conversion rights and conditions which are available to employees or members and their spouses and/or dependents who are terminated for reasons other than misconduct; (b) A person who is eligible for federal medicare coverage; or (c) A person who is covered under another group plan, policy, contract, or agreement providing benefits for hospital or medical care. (3) To obtain the conversion agreement, a person must submit a written application and the first premium payment for the conversion agreement not later than thirty-one days after the date the person's eligibility for group coverage terminates or thirty-one days after the date the person received notice of termination of coverage, whichever is later. The conversion agreement shall become effective without lapse of coverage, immediately following termination of coverage under the group agreement. (4) If a health maintenance organization or group agreement holder does not renew, cancels, or otherwise terminates the group agreement, the health maintenance organization must offer a conversion agreement to any person who was covered under the terminated agreement unless the person is eligible to obtain group benefits for hospital or medical care within thirty-one days after such nonrenewal, cancellation, or termination of the group agreement or thirty-one days after the date the person received notice of termination of coverage, whichever is later. (5) The health maintenance organization shall determine the premium for the conversion agreement in accordance with the organization's table of premium rates applicable to the age and class of risk of each person to be covered under the agreement and the type and amount of benefits provided.
RCW 48.88.050 — Washington Code / Title 48 / Chapter 88 / Section 050
RCW 48.88.050: Policies—Liability limits—Rating plan.
Status: in_force

Any licensee may apply to the association to purchase day care insurance, and the association shall offer a policy with liability limits of at least one hundred thousand dollars per occurrence. The commissioner shall require the use of a rating plan for day care insurance that permits rates to be modified for individual licensees according to the type, size and past loss experience of the licensee including any other difference among licensees that can be demonstrated to have a probable effect upon losses.
RCW 48.21.147 — Washington Code / Title 48 / Chapter 21 / Section 147
RCW 48.21.147: Dental services that are not subject to contract or provider agreement.
Status: in_force

(1) Notwithstanding any other provisions of law, no group disability insurance contract or blanket disability insurance contract of any disability insurer as provided for in this chapter subject to the jurisdiction of the state of Washington that covers any dental services, and no contract or participating provider agreement with a dentist may: (a) Require, directly or indirectly, that a dentist who is a participating provider provide services to a subscriber at a fee set by, or at a fee subject to the approval of, the disability insurer unless the dental services are covered services, including services that would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods, or frequency limitations, under the applicable group plan or disability insurance policy; nor (b) Prohibit, directly or indirectly, a dentist who is a participating provider from offering or providing to a subscriber dental services that are not covered services on any terms or conditions acceptable to the dentist and the subscriber. (2) For the purposes of this section, "covered services" means dental services that are reimbursable under the applicable insurance policy, group plan, or subscriber agreement or would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods or frequency limitations.
RCW 48.21.110 — Washington Code / Title 48 / Chapter 21 / Section 110
RCW 48.21.110: Payment of benefits.
Status: in_force

The benefits payable under any policy or contract of group or blanket disability insurance shall be payable to the employee or other insured member of the group or to the beneficiary designated by him or her, other than the policyholder, employer or the association or any officer thereof as such, subject to provisions of the policy in the event there is no designated beneficiary as to all or any part of any sum payable at the death of the individual insured. The policy may provide that any hospital, medical, or surgical benefits thereunder may be made payable jointly to the insured employee or member and the person furnishing such hospital, medical, or surgical services.It is unlawful for any person to act as an employee of a commercial pesticide applicator and apply pesticides manually or as the operator directly in charge of any apparatus which is licensed or should be licensed under this chapter for the application of any pesticide, without having obtained a commercial pesticide operator license from the director. The commercial pesticide operator license is in addition to any other license or permit required by law for the operation or use of any such apparatus. Application for a commercial operator license must be accompanied by a fee of seventy-eight dollars. This section does not apply to any individual who is a licensed commercial pesticide applicator.
RCW 48.02.170 — Washington Code / Title 48 / Chapter 02 / Section 170
RCW 48.02.170: Annual report.
Status: in_force

The commissioner shall, as soon as accurate preparation enables, prepare a report of his or her official transactions during the preceding fiscal year, containing information relative to insurance as the commissioner deems proper.
RCW 48.46.350 — Washington Code / Title 48 / Chapter 46 / Section 350
RCW 48.46.350: Chemical dependency treatment.
Status: in_force

Each group agreement for health care services that is delivered or issued for delivery or renewed on or after January 1, 1988, must contain provisions providing benefits for the treatment of chemical dependency rendered to covered persons by a provider which is an "approved substance use disorder treatment program" under *RCW 70.96A.020 (2). However, this section does not apply to any agreement written as supplemental coverage to any federal or state programs of health care including, but not limited to, Title XVIII health insurance for the aged, which is commonly referred to as Medicare, Parts A&B, and amendments thereto. Treatment must be covered under the chemical dependency coverage if treatment is rendered by the health maintenance organization or if the health maintenance organization refers the enrolled participant or the enrolled participant's dependents to a physician licensed under chapter 18.57 or 18.71 RCW, or to a qualified counselor employed by an approved substance use disorder treatment program described in *RCW 70.96A.020 (2). In all cases, a health maintenance organization retains the right to diagnose the presence of chemical dependency and select the modality of treatment that best serves the interest of the health maintenance organization's enrolled participant, or the enrolled participant's covered dependent.