RCW 48.64.040 — Washington Code / Title 48 / Chapter 64 / Section 040
RCW 48.64.040: When chapter not applicable.
Status: in_force

This chapter does not apply to an affordable housing entity that: (1) Individually self-insures for property and liability risks; or (2) Participates in a risk pooling arrangement, including a risk retention group or a risk purchasing group, regulated under chapter 48.92 RCW, or is a captive insurer authorized in its state of domicile.(1) Unless the context clearly requires otherwise, in this section "dental care assistance plan" means any plan of dental insurance offered by an insurer as defined by chapter 48.01 RCW and any agreement for dental care benefits entered into or renewed after January 1, 1989, provided by a health care service contractor as defined by chapter 48.44 RCW. (2) Each employer, public or private, that offers its employees a dental care assistance plan and each employee benefits fund that offers its members a dental care assistance plan limiting the provider of dental care to designated providers or group of providers, shall make available to and inform its employees or members of the option of enrolling in an alternative dental care assistance plan that permits the employees or members to obtain dental care services from any licensed dental care provider of their choice. The portion of the premium paid by the employer for the limiting plan shall be comparable to, but in no case greater than, the portion of the premium paid by the employer for the other plan. If 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 the agreement. The provisions of this section are not mandatory if the employees are covered by Taft-Hartley health care trust, except that the labor-management trustees may contract with a dental care assistance plan if a feasibility study determines it is to the advantage of the members: PROVIDED, That this section shall only apply to employers with greater than twenty-five employees under coverage.
RCW 48.94.040 — Washington Code / Title 48 / Chapter 94 / Section 040
RCW 48.94.040: Restrictions on reinsurer—Financial condition of reinsurance intermediary-manager—Loss reserves—Retrocessions—Termination of contract—Board of directors.
Status: in_force

(1) A reinsurer may not engage the services of a person, firm, association, or corporation to act as a reinsurance intermediary-manager on its behalf unless the person is licensed as required by RCW 48.94.010 (2). (2) The reinsurer shall annually obtain a copy of statements of the financial condition of each reinsurance intermediary-manager that the reinsurer has had prepared by an independent certified accountant in a form acceptable to the commissioner. (3) If a reinsurance intermediary-manager establishes loss reserves, the reinsurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the reinsurance intermediary-manager. This opinion is in addition to any other required loss reserve certification. (4) Binding authority for all retrocessional contracts or participation in reinsurance syndicates must rest with an officer of the reinsurer who is not affiliated with the reinsurance intermediary-manager. (5) Within thirty days of termination of a contract with a reinsurance intermediary-manager, the reinsurer shall provide written notification of the termination to the commissioner. (6) A reinsurer may not appoint to its board of directors an officer, director, employee, controlling shareholder, or subproducer of its reinsurance intermediary-manager. This subsection does not apply to relationships governed by the insurer holding company act, chapter 48.31B RCW, or, if applicable, the producer-controlled property and casualty insurer act, chapter 48.97 RCW.
RCW 48.20.450 — Washington Code / Title 48 / Chapter 20 / Section 450
RCW 48.20.450: Standardization and simplification of terms and coverages—Disclosure requirements.
Status: in_force

The commissioner shall issue regulations to establish specific standards, including standards of full and fair disclosure, that set forth the manner, content, and required disclosure for the sale of individual policies of disability insurance which shall be in addition to and in accordance with applicable laws of this state, including RCW 48.20.450 through 48.20.480 , which may cover but shall not be limited to: (1) Terms of renewability; (2) Initial and subsequent conditions of eligibility; (3) Nonduplication of coverage provisions; (4) Coverage of dependents; (5) Preexisting conditions; (6) Termination of insurance; (7) Probationary periods; (8) Limitations; (9) Exceptions; (10) Reductions; (11) Elimination periods; (12) Requirements for replacement; (13) Recurrent conditions; and (14) The definition of terms including but not limited to the following: Hospital, accident, sickness, injury, physician, accidental means, total disability, partial disability, nervous disorder, guaranteed renewable, and noncancellable.
RCW 48.85.020 — Washington Code / Title 48 / Chapter 85 / Section 020
RCW 48.85.020: Protection of assets—Federal approval—Rules.
Status: in_force

The department of social and health services shall seek approval from the centers for medicare and medicaid services to allow the protection of an individual's assets as provided in this chapter. The department shall adopt all rules necessary to implement the Washington long-term care partnership program, which rules shall permit the exclusion of all or some of an individual's assets in a manner specified by the department in a determination of medicaid eligibility to the extent that private long-term care insurance provides payment or benefits for services.
RCW 48.21A.090 — Washington Code / Title 48 / Chapter 21A / Section 090
RCW 48.21A.090: Home health care, hospice care, optional coverage required—Standards, limitations, restrictions—Rules—Medicare supplemental contracts excluded.
Status: in_force

(1) Every insurer entering into or renewing extended health insurance 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 chapters 70.126 and 70.127 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 under chapter 70.127 RCW; (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 48.19.410 — Washington Code / Title 48 / Chapter 19 / Section 410
RCW 48.19.410: Examination of contracts.
Status: repealed

(1) The commissioner may permit the organization and operation of examining bureaus for the examination of policies, daily reports, binders, renewal certificates, endorsements, and other evidences of insurance or of the cancellation thereof, for the purpose of ascertaining that lawful rates are being charged. (2) A bureau shall examine documents with regard to such kinds of insurance as the commissioner may, after hearing, reasonably require to be submitted for examination. A bureau may examine documents as to such other kinds of insurance as the issuing insurers may voluntarily submit for examination. Upon request of the commissioner, a bureau shall also examine affidavits filed pursuant to RCW 48.15.040 , surplus lines contracts and related documents, and shall make recommendations to the commissioner to assist the commissioner in determining whether surplus lines have been procured in accordance with chapter 48.15 RCW and rules issued thereunder. (3) No bureau shall operate unless licensed by the commissioner as to the kinds of insurance as to which it is permitted so to examine. To qualify for a license a bureau shall: (a) Be owned in trust for the benefit of all the insurers regularly using its services, under a trust agreement approved by the commissioner. (b) Make its services available without discrimination to all authorized insurers applying therefor, subject to such reasonable rules and regulations as to the obligations of insurers using its services, as to the conduct of its affairs, and as to the correction of errors and omissions in documents examined by it as are approved by the commissioner. (c) Have no manager or other employee who is an employee of an insurer other than to the extent that he or she is an employee of the bureau owned by insurers through such trust agreement. (d) Pay to the commissioner a fee of ten dollars for issuance of its license. (4) Such license shall be of indefinite duration and shall remain in force until revoked by the commissioner or terminated at the request of the bureau. The commissioner may revoke the license, after hearing, (a) if the bureau is no longer qualified therefor; (b) if the bureau fails to comply with a proper order of the commissioner; (c) if the bureau violates or knowingly participates in the violation of any provision of this code. (5) Any person aggrieved by any rule, regulation, act or omission of a bureau may appeal to the commissioner therefrom. The commissioner shall hold a hearing upon such appeal, and shall make such order upon the hearing as he or she deems to be proper. (6) Every such bureau operating in this state shall be subject to the supervision of the commissioner, and the commissioner shall examine it as provided in chapter 48.03 RCW of this code. (7) Every examining bureau shall keep adequate records of the outstanding errors and omissions found in coverages examined by it and of its receipts and disbursements, and shall hold as confidential all information contained in documents submitted to it for examination. (8) The commissioner shall not license an additional bureau for the examination of documents relative to a kind of insurance if such documents are being examined by a then existing licensed bureau. Any examining bureau operating in this state immediately prior to the effective date of this code under any law of this state repealed as of such date, shall have prior right to apply for and secure a license under this section.
RCW 48.16.050 — Washington Code / Title 48 / Chapter 16 / Section 050
RCW 48.16.050: Commissioner's receipt—Records.
Status: in_force

(1) The commissioner shall deliver to the insurer a receipt for all funds and securities so deposited by it. (2) The commissioner or the designated depositary shall keep a record in permanent form of all funds and securities so deposited.
RCW 48.36A.310 — Washington Code / Title 48 / Chapter 36A / Section 310
RCW 48.36A.310: Deficiencies, noncompliance by societies—Actions against license.
Status: in_force

(1) The commissioner may refuse, suspend, or revoke a fraternal benefit society's license, if the society: (a) Has exceeded its powers; (b) Has failed to comply with any of the provisions of this chapter; (c) Is not fulfilling its contracts in good faith; (d) Is conducting its business fraudulently; (e) Has a membership of less than four hundred after an existence of one year or more; (f) Is found by the commissioner to be in such a condition that its further transaction of insurance in this state would be hazardous to certificate holders and the people in this state; (g) Refuses to remove or discharge a trustee, director, or officer who has been convicted of any crime involving fraud, dishonesty, or like moral turpitude; (h) Refuses to be examined, or if its trustees, directors, officers, employees, or representatives refuse to submit to examination or to produce its accounts, records, and files for examination by the commissioner when required, or refuse to perform any legal obligation relative to the examination; (i) Fails to pay any final judgment rendered against it in this state upon any certificate, or undertaking issued by it, within thirty days after the judgment became final or within thirty days after time for taking an appeal has expired, or within thirty days after dismissal of an appeal before final determination, whichever date is the later; (j) Is found by the commissioner, after investigation or upon receipt of reliable information, to be managed by persons, whether by its trustees, directors, officers, or by any other means, who are incompetent or untrustworthy or so lacking in fraternal benefit society managerial experience as to make a proposed operation hazardous to its members; or that there is good reason to believe it is affiliated directly or indirectly through ownership, control, or business relations, with any person or persons whose business operations are or have been found to be in violation of any law or rule, to the detriment of the members of the society or of the public, by bad faith or by manipulation of the assets, or of accounts, or of reinsurance of the society; or (k) Does business through insurance producers or other representatives in this state or in any other state who are not properly licensed under applicable laws and rules. (2) Nothing in this section shall prevent a society from continuing, in good faith, all contracts made in this state during the time the society was legally authorized to transact business herein.
RCW 48.31.415 — Washington Code / Title 48 / Chapter 31 / Section 415
RCW 48.31.415: Administrative supervision—Insurer may contest.
Status: in_force

During the period of administrative supervision the insurer may contest an action taken, proposed to be taken, or failed to be taken by the administrative supervisor specifying the manner wherein the action being complained of would not result in improving the condition of the insurer. Denial of the insurer's request upon reconsideration entitles the insurer to request a proceeding under chapters 48.04 and 34.05 RCW.
RCW 48.19.070 — Washington Code / Title 48 / Chapter 19 / Section 070
RCW 48.19.070: Special filings.
Status: in_force

The following special filings, when not covered by a previous filing, shall become effective when filed and shall be deemed to meet the requirements of this chapter until such time as the commissioner reviews the filing and for so long thereafter as the filing remains in effect: (1) Special filings with respect to surety or guaranty bonds required by law or by court or executive order or by order, rule or regulation of a public body. (2) Specific rates on inland marine risks individually rated by a rating organization, which risks are not reasonably susceptible to manual or schedule rating, and which risks by general custom of the business are not written according to manual rates or rating plans.
RCW 48.18.555 — Washington Code / Title 48 / Chapter 18 / Section 555
RCW 48.18.555: Property insurance—Actions resulting from arson or malicious mischief—Definitions.
Status: in_force

(1) For the purposes of this section: (a) "Arson" has the same meaning as in chapter 9A.48 RCW. (b) "Health care facility" has the same meaning as defined in RCW 48.43.005 . (c) "Health care provider" has the same meaning as defined in RCW 48.43.005 . (d) "Insured" means a current policyholder or a person or entity that is covered under the insurance policy. (e) A perpetrator does not have to be identified for an act of arson or malicious mischief to have occurred. (f) "Malicious mischief" has the same meaning as in chapter 9A.48 RCW. (g) "Underwriting action" means an insurer: (i) Cancels or refuses to renew an insurance policy; or (ii) Changes the terms or benefits in an insurance policy. (2) This section applies to property insurance policies if the insured is: (a) A health care facility; (b) A health care provider; or (c) A religious organization. (3) An insurer may not take an underwriting action on a policy described in subsection (2) of this section because an insured has made one or more insurance claims for any loss that occurred during the preceding sixty months that is the result of arson or malicious mischief. An insurer may take an underwriting action due to other factors that are not prohibited by this subsection. (4) If an insured sustains a loss that is the result of arson or malicious mischief, the insured must file a report with the police or other law enforcement authority within thirty days of discovery of the incident, and a law enforcement authority must determine that a crime has occurred. The report must contain sufficient information to provide an insurer with reasonable notice that the loss was the result of arson or malicious mischief. The insured has a duty to cooperate with any law enforcement official or insurer investigation. (5) Annually, each insurer must report underwriting actions to the commissioner if the insurer has taken an underwriting action against any insured who has filed a claim during the preceding sixty months that was the result of arson or malicious mischief. The report must include the policy number, name of the insured, location of the property, and the reason for the underwriting action.
RCW 48.20.262 — Washington Code / Title 48 / Chapter 20 / Section 262
RCW 48.20.262: Optional standard provision No. 22—Illegal occupation.
Status: in_force

There may be a provision as follows: ILLEGAL OCCUPATION: The insurer shall not be liable for any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation.
RCW 48.46.210 — Washington Code / Title 48 / Chapter 46 / Section 210
RCW 48.46.210: Compliance with federal funding requirements—Construction.
Status: in_force

Nothing in this chapter shall prohibit any health maintenance organization from meeting the requirements of any federal law which would authorize such health maintenance organization to receive federal financial assistance or enroll beneficiaries assisted by federal funds.
RCW 48.30.015 — Washington Code / Title 48 / Chapter 30 / Section 015
RCW 48.30.015: Unreasonable denial of a claim for coverage or payment of benefits.
Status: in_force

(1) Any first party claimant to a policy of insurance who is unreasonably denied a claim for coverage or payment of benefits by an insurer may bring an action in the superior court of this state to recover the actual damages sustained, together with the costs of the action, including reasonable attorneys' fees and litigation costs, as set forth in subsection (3) of this section. (2) The superior court may, after finding that an insurer has acted unreasonably in denying a claim for coverage or payment of benefits or has violated a rule in subsection (5) of this section, increase the total award of damages to an amount not to exceed three times the actual damages. (3) The superior court shall, after a finding of unreasonable denial of a claim for coverage or payment of benefits, or after a finding of a violation of a rule in subsection (5) of this section, award reasonable attorneys' fees and actual and statutory litigation costs, including expert witness fees, to the first party claimant of an insurance contract who is the prevailing party in such an action. (4) "First party claimant" means an individual, corporation, association, partnership, or other legal entity asserting a right to payment as a covered person under an insurance policy or insurance contract arising out of the occurrence of the contingency or loss covered by such a policy or contract. (5) A violation of any of the following is a violation for the purposes of subsections (2) and (3) of this section: (a) WAC 284-30-330, captioned "specific unfair claims settlement practices defined"; (b) WAC 284-30-350, captioned "misrepresentation of policy provisions"; (c) WAC 284-30-360, captioned "failure to acknowledge pertinent communications"; (d) WAC 284-30-370, captioned "standards for prompt investigation of claims"; (e) WAC 284-30-380, captioned "standards for prompt, fair and equitable settlements applicable to all insurers"; or (f) An unfair claims settlement practice rule adopted under RCW 48.30.010 by the insurance commissioner intending to implement this section. The rule must be codified in chapter 284-30 of the Washington Administrative Code. (6) This section does not limit a court's existing ability to make any other determination regarding an action for an unfair or deceptive practice of an insurer or provide for any other remedy that is available at law. (7) This section does not apply to a health plan offered by a health carrier. "Health plan" has the same meaning as in RCW 48.43.005 . "Health carrier" has the same meaning as in RCW 48.43.005 . (8)(a) Twenty days prior to filing an action based on this section, a first party claimant must provide written notice of the basis for the cause of action to the insurer and office of the insurance commissioner. Notice may be provided by regular mail, registered mail, or certified mail with return receipt requested. Proof of notice by mail may be made in the same manner as prescribed by court rule or statute for proof of service by mail. The insurer and insurance commissioner are deemed to have received notice three business days after the notice is mailed. (b) If the insurer fails to resolve the basis for the action within the twenty-day period after the written notice by the first party claimant, the first party claimant may bring the action without any further notice. (c) The first party claimant may bring an action after the required period of time in (a) of this subsection has elapsed. (d) If a written notice of claim is served under (a) of this subsection within the time prescribed for the filing of an action under this section, the statute of limitations for the action is tolled during the twenty-day period of time in (a) of this subsection.
RCW 48.46.063 — Washington Code / Title 48 / Chapter 46 / Section 063
RCW 48.46.063: 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 maintenance organization 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 maintenance organization 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 48.46.066 . (3) As used in this section and RCW 48.46.066 , "health benefit plan," "adjusted community rates," "small employer," and "wellness activities" mean the same as defined in RCW 48.43.005 .
RCW 48.20.162 — Washington Code / Title 48 / Chapter 20 / Section 162
RCW 48.20.162: Optional standard provisions.
Status: in_force

Except as provided in RCW 48.18.130 , no such policy delivered or issued for delivery to any person in this state shall contain provisions respecting the matters set forth in RCW 48.20.172 to *48.20.272, inclusive, unless such provisions are in the words in which the same appear in the applicable section; except, that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the commissioner which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption or, at the insurer's option, by such appropriate individual or group caption or subcaption as the commissioner may approve.
RCW 48.44.130 — Washington Code / Title 48 / Chapter 44 / Section 130
RCW 48.44.130: Future dividends or refunds—When permissible.
Status: in_force

No health care service contractor nor any individual acting on behalf thereof shall guarantee or agree to the payment of future dividends or future refunds of unused charges or savings in any specific or approximate amounts or percentages in respect to any contract being offered to the public, except in a group contract containing an experience refund provision.
RCW 48.23.340 — Washington Code / Title 48 / Chapter 23 / Section 340
RCW 48.23.340: Prohibited policy plans.
Status: in_force

No life insurer shall hereafter issue for delivery or deliver in this state any life insurance policy: (1) Issued under any plan for the segregation of policyholders into mathematical groups and providing benefits for a surviving policyholder of a group arising out of the death of another policyholder of such group, or under any other similar plan. (2) Providing benefits or values for surviving or continuing policyholders contingent upon the lapse or termination of the policies of other policyholders, whether by death or otherwise.
RCW 48.46.320 — Washington Code / Title 48 / Chapter 46 / Section 320
RCW 48.46.320: Dependent children, termination of coverage, conditions.
Status: in_force

Any health maintenance agreement which provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the agreement shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both: (1) Incapable of self-sustaining employment by reason of developmental or physical disability; and (2) chiefly dependent upon the subscriber for support and maintenance, if proof of such incapacity and dependency is furnished to the health maintenance organization by the enrolled participant within thirty-one days of the child's attainment of the limiting age and subsequently as required by the health maintenance organization but not more frequently than annually after the two-year period following the child's attainment of the limiting age.
RCW 48.44.400 — Washington Code / Title 48 / Chapter 44 / Section 400
RCW 48.44.400: Continuance provisions for former family members.
Status: in_force

After July 1, 1986, or on the next renewal date of the agreement, whichever is later, every health care service agreement issued, amended, or renewed for an individual and his or her dependents shall contain provisions to assure that the covered spouse and/or dependents, in the event that any cease to be a qualified family member by reason of termination of marriage or death of the principal enrollee, shall have the right to continue the health care service agreement without a physical examination, statement of health, or other proof of insurability.
RCW 48.102.130 — Washington Code / Title 48 / Chapter 102 / Section 130
RCW 48.102.130: Prohibited practices.
Status: in_force

(1) It is unlawful for any person to: (a) Enter into a life settlement contract if such person knows or reasonably should have known that the life insurance policy was obtained by means of a false, deceptive or misleading application for such policy; (b) Engage in any transaction, practice, or course of business if such person knows or reasonably should have known that the intent was to avoid the notice requirements of this chapter; (c) Engage in any fraudulent act or practice in connection with any transaction relating to any settlement involving an owner who is a resident of this state; (d) Issue, solicit, market, or otherwise promote the purchase of an insurance policy, not previously issued, for the sole purpose of, or with the primary emphasis on, settling the policy; (e) If providing premium financing, receive any proceeds, fees, or other consideration from the policy or owner of the policy that are in addition to the amounts required to pay principal, interest, and any costs or expenses incurred by the lender or borrower in connection with the premium finance agreement, except for the event of a default, unless either the default on such a loan or transfer of the policy occurs pursuant to an agreement or understanding with any other person for the purpose of evading regulation under this chapter. Any payments, charges, fees, or other amounts received by a person providing premium financing in violation of this subsection shall be remitted to the original owner of the policy or to the original owner's estate if the original owner is not living at the time of the determination of overpayment; (f) With respect to any settlement contract or insurance policy and a broker, knowingly solicit an offer from, effectuate a life settlement contract with, or make a sale to any provider, financing entity, or related provider trust that is controlling, controlled by, or under common control with such broker unless this relationship is disclosed to the owner; (g) With respect to any life settlement contract or insurance policy and a provider, knowingly enter into a life settlement contract with an owner, if, in connection with such life settlement contract, anything of value will be paid to a broker that is controlling, controlled by, or under common control with such provider or the financing entity or related provider trust that is involved in such settlement contract, unless this relationship is disclosed to the owner; (h) With respect to a provider, enter into a life settlement contract unless the life settlement promotional, advertising, and marketing materials, as may be prescribed by rule, have been filed with the commissioner. In no event shall any marketing materials expressly reference that the insurance is "free" for any period of time. The inclusion of any reference in the marketing materials that would cause an owner to reasonably believe that the insurance is free for any period of time is a violation of this chapter; (i) With respect to any life insurance producer, insurance company, broker, or provider make any statement or representation to the applicant or policyholder in connection with the sale or financing of a life insurance policy to the effect that the insurance is free or without cost to the policyholder for any period of time unless provided in the policy; or (j) With respect to an insurer, engage in any transaction, act, practice, or course of business or dealing which restricts, limits, or impairs in any way the lawful transfer of ownership, change of beneficiary, or assignment of a policy. (2) A violation of this section constitutes a fraudulent life settlement act.
RCW 48.90.040 — Washington Code / Title 48 / Chapter 90 / Section 040
RCW 48.90.040: Chapter exclusive.
Status: in_force

Except as provided in this chapter, self-insurance plans formed and implemented pursuant to this chapter shall be governed by this chapter and shall be exempt from all other provisions of the insurance laws of this state.
RCW 48.155.015 — Washington Code / Title 48 / Chapter 155 / Section 015
RCW 48.155.015: Application of chapter.
Status: in_force

(1) This chapter applies to all discount plans and all discount plan organizations doing business in or from this state or that affect subjects located wholly or in part or to be performed within this state, and all persons having to do with this business. (2) A discount plan organization that is a health carrier, as defined under RCW 48.43.005 , with a license, certificate of authority, or registration: (a) Is not required to obtain a license under RCW 48.155.020 , except that any of its affiliates that operate as a discount plan organization in this state must obtain a license under RCW 48.155.020 and comply with all other provisions of this chapter; (b) Is required to comply with RCW 48.155.060 through 48.155.090 and report, in the form and manner as the commissioner may require, any of the information described in RCW 48.155.110 (2) (b), (c), or (d) that is not otherwise already reported; and (c) Is subject to RCW 48.155.130 and 48.155.140 .
RCW 48.23.140 — Washington Code / Title 48 / Chapter 23 / Section 140
RCW 48.23.140: Standard provisions—Annuities, pure endowment contracts.
Status: in_force

No annuity or pure endowment contract, other than reversionary annuities, or survivorship annuities, or group annuities, shall be delivered or issued for delivery in this state unless it contains in substance each of the provisions specified in RCW 48.23.150 to 48.23.210 inclusive. Any of such provisions not applicable to single premium annuities or single premium pure endowment contracts shall not, to that extent, be incorporated therein. This section shall not apply to contracts for deferred annuities included in, or upon the lives of beneficiaries under, life insurance policies.
RCW 48.10.140 — Washington Code / Title 48 / Chapter 10 / Section 140
RCW 48.10.140: Attorney's bond.
Status: in_force

(1) Concurrently with the filing of the declaration provided for in RCW 48.10.090 , (or, if an existing domestic reciprocal insurer, within ninety days after the effective date of this code) the attorney of a domestic reciprocal shall file with the commissioner a bond running to the state of Washington. The bond shall be executed by the attorney and by an authorized corporate surety, and shall be subject to the commissioner's approval. (2) The bond shall be in the penal sum of twenty-five thousand dollars, conditioned that the attorney will faithfully account for all moneys and other property of the insurer coming into his or her hands, and that he or she will not withdraw or appropriate for his or her own use from the funds of the insurer any moneys or property to which he or she is not entitled under the power of attorney. (3) The bond shall provide that it is not subject to cancellation unless thirty days advance notice in writing of intent to cancel is given to both the attorney and the commissioner.
RCW 48.20.082 — Washington Code / Title 48 / Chapter 20 / Section 082
RCW 48.20.082: Standard provision No. 6—Notice of claim.
Status: in_force

There shall be a provision as follows: NOTICE OF CLAIM: Written notice of claim must be given to the insurer within twenty days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at . . . . . . . . . (insert the location of such office as the insurer may designate for the purpose), or to any authorized agent of the insurer, with information sufficient to identify the insured, shall be deemed notice to the insurer. (In a policy providing a loss-of-time benefit which may be payable for at least two years, an insurer may at its option insert the following between the first and second sentences of the above provision: "Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least two years, he or she shall at least once in every six months after having given notice of claim, give to the insurer notice of continuance of said disability, except in the event of legal incapacity. The period of six months following any filing of proof by the insured or any payment by the insurer on account of such claim or any denial of liability in whole or in part by the insurer shall be excluded in applying this provision. Delay in the giving of such notice shall not impair the insured's right to any indemnity which would otherwise have accrued during the period of six months preceding the date on which such notice is actually given.")
RCW 48.200.020 — Washington Code / Title 48 / Chapter 200 / Section 020
RCW 48.200.020: Definitions.
Status: in_force

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise. (1) "Affiliate" or "affiliated employer" means a person who directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, another specified person. (2) "Certification" has the same meaning as in RCW 48.43.005 . (3) "Covered person" has the same meaning as in RCW 48.43.005 . (4) "Employee benefits programs" means programs under both the public employees' benefits board established in RCW 41.05.055 and the school employees' benefits board established in RCW 41.05.740 . (5)(a) "Health care benefit manager" means a person or entity providing services to, or acting on behalf of, a health carrier or employee benefits programs, that directly or indirectly impacts the determination or utilization of benefits for, or patient access to, health care services, drugs, and supplies including, but not limited to: (i) Prior authorization or preauthorization of benefits or care; (ii) Certification of benefits or care; (iii) Medical necessity determinations; (iv) Utilization review; (v) Benefit determinations; (vi) Claims processing and repricing for services and procedures; (vii) Outcome management; (viii) Payment or authorization of payment to providers and facilities for services or procedures; (ix) Dispute resolution, grievances, or appeals relating to determinations or utilization of benefits; (x) Provider network management; or (xi) Disease management. (b) "Health care benefit manager" includes, but is not limited to, health care benefit managers that specialize in specific types of health care benefit management such as pharmacy benefit managers, radiology benefit managers, laboratory benefit managers, and mental health benefit managers. (c) "Health care benefit manager" does not include: (i) Health care service contractors as defined in RCW 48.44.010 ; (ii) Health maintenance organizations as defined in RCW 48.46.020 ; (iii) Issuers as defined in RCW 48.01.053 ; (iv) The public employees' benefits board established in RCW 41.05.055 ; (v) The school employees' benefits board established in RCW 41.05.740 ; (vi) Discount plans as defined in RCW 48.155.010 ; (vii) Direct patient-provider primary care practices as defined in RCW 48.150.010 ; (viii) An employer administering its employee benefit plan or the employee benefit plan of an affiliated employer under common management and control; (ix) A union, either on its own or jointly with an employer, administering a benefit plan on behalf of its members; (x) An insurance producer selling insurance or engaged in related activities within the scope of the producer's license; (xi) A creditor acting on behalf of its debtors with respect to insurance, covering a debt between the creditor and its debtors; (xii) A behavioral health administrative services organization or other county-managed entity that has been approved by the state health care authority to perform delegated functions on behalf of a carrier; (xiii) A hospital licensed under chapter 70.41 RCW or ambulatory surgical facility licensed under chapter 70.230 RCW, to the extent that it performs provider credentialing or recredentialing, but no other functions of a health care benefit manager as described in subsection (5)(a) of this section [(a) of this subsection]; (xiv) The Robert Bree collaborative under chapter 70.250 RCW; (xv) The health technology clinical committee established under RCW 70.14.090 ; (xvi) The prescription drug purchasing consortium established under RCW 70.14.060 ; or (xvii) Any other entity that performs provider credentialing or recredentialing, but no other functions of a health care benefit manager as described in subsection (5)(a) of this section [(a) of this subsection]. (6) "Health care provider" or "provider" has the same meaning as in RCW 48.43.005 . (7) "Health care service" has the same meaning as in RCW 48.43.005 . (8) "Health carrier" or "carrier" has the same meaning as in RCW 48.43.005 . (9) "Laboratory benefit manager" means a person or entity providing service to, or acting on behalf of, a health carrier, employee benefits programs, or another entity under contract with a carrier, that directly or indirectly impacts the determination or utilization of benefits for, or patient access to, health care services, drugs, and supplies relating to the use of clinical laboratory services and includes any requirement for a health care provider to submit a notification of an order for such services. (10) "Mail order pharmacy" means a pharmacy that primarily dispenses prescription drugs to patients through the mail or common carrier. (11) "Mental health benefit manager" means a person or entity providing service to, or acting on behalf of, a health carrier, employee benefits programs, or another entity under contract with a carrier, that directly or indirectly impacts the determination of utilization of benefits for, or patient access to, health care services, drugs, and supplies relating to the use of mental health services and includes any requirement for a health care provider to submit a notification of an order for such services. (12) "Network" means the group of participating providers, pharmacies, and suppliers providing health care services, drugs, or supplies to beneficiaries of a particular carrier or plan. (13) "Person" includes, as applicable, natural persons, licensed health care providers, carriers, corporations, companies, trusts, unincorporated associations, and partnerships. (14)(a) "Pharmacy benefit manager" means a person that contracts with pharmacies on behalf of a health carrier, employee benefits program, or medicaid managed care program to: (i) Process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists; (ii) Pay pharmacies or pharmacists for prescription drugs or medical supplies; (iii) Negotiate rebates, discounts, or other price concessions with manufacturers for drugs paid for or procured as described in this subsection; (iv) Establish or manage pharmacy networks; or (v) Make credentialing determinations. (b) "Pharmacy benefit manager" does not include a health care service contractor as defined in RCW 48.44.010 . (15) "Pharmacy network" means the pharmacies located in the state or licensed under chapter 18.64 RCW and contracted by a pharmacy benefit manager to dispense prescription drugs to covered persons. (16)(a) "Radiology benefit manager" means any person or entity providing service to, or acting on behalf of, a health carrier, employee benefits programs, or another entity under contract with a carrier, that directly or indirectly impacts the determination or utilization of benefits for, or patient access to, the services of a licensed radiologist or to advanced diagnostic imaging services including, but not limited to: (i) Processing claims for services and procedures performed by a licensed radiologist or advanced diagnostic imaging service provider; or (ii) Providing payment or payment authorization to radiology clinics, radiologists, or advanced diagnostic imaging service providers for services or procedures. (b) "Radiology benefit manager" does not include a health care service contractor as defined in RCW 48.44.010 , a health maintenance organization as defined in RCW 48.46.020 , or an issuer as defined in RCW 48.01.053 . (17) "Utilization review" has the same meaning as in RCW 48.43.005 .
RCW 48.18.190 — Washington Code / Title 48 / Chapter 18 / Section 190
RCW 48.18.190: Policy must contain entire contract.
Status: in_force

No agreement in conflict with, modifying, or extending any contract of insurance shall be valid unless in writing and made a part of the policy.
RCW 48.36A.040 — Washington Code / Title 48 / Chapter 36A / Section 040
RCW 48.36A.040: Definitions.
Status: in_force

As used in this chapter, the following terms have the meanings indicated unless the context clearly requires otherwise: (1) "Benefit contract" means the agreement for provision of benefits authorized by RCW 48.36A.160 , as that agreement is described in RCW 48.36A.190 (1). (2) "Benefit member" means an adult member who is designated by the laws or rules of the society to be a benefit member under a benefit contract. (3) "Certificate" means the document issued as written evidence of the benefit contract. (4) "Premiums" means premiums, rates, dues or other required contributions by whatever name known, which are payable under the certificate. (5) "Laws" means the society's articles of incorporation, constitution, and bylaws, however designated. (6) "Rules" means all rules, regulations, or resolutions adopted by the supreme governing body or board of directors which are intended to have general application to the members of the society. (7) "Society" means fraternal benefit society, unless otherwise indicated. (8) "Lodge" means subordinate member units of the society, known as camps, courts, councils, branches, or by any other designation.
RCW 48.46.470 — Washington Code / Title 48 / Chapter 46 / Section 470
RCW 48.46.470: Endorsement of modifications.
Status: in_force

If an individual health care service agreement is issued on any basis other than as applied for, an endorsement setting forth such modification must accompany and be attached to the agreement. No agreement shall be effective unless the endorsement is signed by the applicant, and a signed copy thereof returned to the health maintenance organization.
RCW 48.44.055 — Washington Code / Title 48 / Chapter 44 / Section 055
RCW 48.44.055: Plan for handling insolvency—Commissioner's review.
Status: in_force

Each health care service contractor shall have a plan for handling insolvency that allows for continuation of benefits for the duration of the contract period for which premiums have been paid and continuation of benefits to members who are confined on the date of insolvency in an inpatient facility until their discharge or expiration of benefits. The commissioner shall approve such a plan if it includes: (1) Insurance to cover the expenses to be paid for continued benefits after insolvency; (2) Provisions in provider contracts that obligate the provider to provide services for the duration of the period after the health care service contractor's insolvency for which premium payment has been made and until the enrolled participants are discharged from inpatient facilities; (3) Use of insolvency reserves established under RCW 48.44.030 ; (4) Acceptable letters of credit or approved surety bonds; or (5) Any other arrangements the commissioner and the organization mutually agree are appropriate to assure that the benefits are continued.
RCW 48.94.900 — Washington Code / Title 48 / Chapter 94 / Section 900
RCW 48.94.900: Short title.
Status: in_force

This chapter may be known and cited as the reinsurance intermediary act.
RCW 48.20.580 — Washington Code / Title 48 / Chapter 20 / Section 580
RCW 48.20.580: Mental health services—Definition—Coverage required, when.
Status: in_force

(1) For the purposes of this section, "mental health services" means: (a) For health benefit plans issued or renewed before January 1, 2021, medically necessary outpatient and inpatient services provided to treat mental disorders covered by the diagnostic categories listed in the most current version of the diagnostic and statistical manual of mental disorders, published by the American psychiatric association, on June 11, 2020, or such subsequent date as may be provided by the insurance commissioner by rule, consistent with the purposes of chapter 6, Laws of 2005, with the exception of the following categories, codes, and services: (i) Substance related disorders; (ii) life transition problems, currently referred to as "V" codes, and diagnostic codes 302 through 302.9 as found in the diagnostic and statistical manual of mental disorders, 4th edition, published by the American psychiatric association; (iii) skilled nursing facility services, home health care, residential treatment, and custodial care; and (iv) court-ordered treatment unless the insurer's medical director or designee determines the treatment to be medically necessary; and (b) For a health benefit plan or a plan deemed by the commissioner to have a short-term limited purpose or duration, or to be a student-only health plan that is guaranteed renewable while the covered person is enrolled as a regular, full-time undergraduate student at an accredited higher education institution, issued or renewed on or after January 1, 2021, medically necessary outpatient and inpatient services provided to treat mental health and substance use disorders covered by the diagnostic categories listed in the most current version of the diagnostic and statistical manual of mental disorders, published by the American psychiatric association, on June 11, 2020, or such subsequent date as may be provided by the insurance commissioner by rule, consistent with the purposes of chapter 6, Laws of 2005. (2) Each disability insurance contract providing coverage for medical and surgical services shall provide coverage for: (a) Mental health services. The copayment or coinsurance for mental health services may be no more than the copayment or coinsurance for medical and surgical services otherwise provided under the disability insurance contract. Wellness and preventive services that are provided or reimbursed at a lesser copayment, coinsurance, or other cost sharing than other medical and surgical services are excluded from this comparison. If the disability insurance contract imposes a maximum out-of-pocket limit or stop loss, it shall be a single limit or stop loss for medical, surgical, and mental health services. If the disability insurance contract imposes any deductible, mental health services shall be included with medical and surgical services for the purpose of meeting the deductible requirement. Treatment limitations or any other financial requirements on coverage for mental health services are only allowed if the same limitations or requirements are imposed on coverage for medical and surgical services; and (b) Prescription drugs intended to treat any of the disorders covered in subsection (1) of this section to the same extent, and under the same terms and conditions, as other prescription drugs covered by the disability insurance contract. (3) This section does not prohibit a requirement that mental health services be medically necessary, if a comparable requirement is applicable to medical and surgical services. (4) Nothing in this section shall be construed to prevent the management of mental health services if a comparable benefit management requirement is applicable to medical and surgical services.
RCW 48.06.010 — Washington Code / Title 48 / Chapter 06 / Section 010
RCW 48.06.010: Types of domestic insurers permitted.
Status: in_force

An insurer formed in this state shall be either (1) An incorporated stock insurer, or (2) An incorporated mutual insurer, or (3) An incorporated specific risks mutual property insurer, or (4) An incorporated mutual assessment property insurer only, or (5) An incorporated farm mutual assessment property insurer only, or (6) A reciprocal insurer, with respective powers, duties, and restrictions as provided in this code.
RCW 48.30.150 — Washington Code / Title 48 / Chapter 30 / Section 150
RCW 48.30.150: Illegal inducements.
Status: in_force

(1) No insurer, insurance producer, title insurance agent, or other person shall, as an inducement to insurance, or in connection with any insurance transaction, provide in any policy for, or offer, or sell, buy, or offer or promise to buy or give, or promise, or allow to, or on behalf of, the insured or prospective insured in any manner whatsoever: (a) Any shares of stock or other securities issued or at any time to be issued on any interest therein or rights thereto; or (b) Any special advisory board contract, or other contract, agreement, or understanding of any kind, offering, providing for, or promising any profits or special returns or special dividends; or (c) Any prizes, goods, wares, gift cards, gift certificates, or merchandise of an aggregate value in excess of one hundred dollars per person in the aggregate in any consecutive twelve-month period. This subsection (1)(c) does not apply to title insurers or title insurance agents. (2) Subsection (1) of this section shall not be deemed to prohibit the sale or purchase of securities as a condition to or in connection with surety insurance insuring the performance of an obligation as part of a plan of financing found by the commissioner to be designed and operated in good faith primarily for the purpose of such financing, nor shall it be deemed to prohibit the sale of redeemable securities of a registered investment company in the same transaction in which life insurance is sold. (3)(a) Subsection (1) of this section shall not be deemed to prohibit a health carrier or disability insurer from including as part of a group or individual health benefit plan or contract providing health benefits, a wellness program which meets the requirements for an exception from the prohibition against discrimination based on a health factor under the health insurance portability and accountability act (P.L. 104-191; 110 Stat. 1936) and regulations adopted pursuant to that act. (b) For purposes of this subsection: (i) "Health carrier" and "health benefit plan" have the same meaning as provided in RCW 48.43.005 ; and (ii) "wellness program" has the same meaning as provided in 45 C.F.R. 146.121(f). (4) Subsection (1) of this section does not prohibit an insurer from issuing any payment to offset documented expenses incurred by a group policyholder in changing coverages from one insurer to another as provided in RCW 48.30.140 . If an implementation credit is given to a group, the implementation credit is part of the premium for the purposes of RCW 48.14.020 and 48.14.0201 . This exception to subsection (1) of this section does not apply to "medicare supplemental insurance" or "medicare supplemental insurance policies" as defined in chapter 48.66 RCW. (5) Subsection (4) of this section does not apply to small groups as defined in RCW 48.43.005 . (6) Subsection (1) of this section does not apply to products or services related to any policy of life insurance that are intended to incent behavioral changes that improve the health and reduce the risk of death of the insured. (7) Subsection (1) of this section does not apply to a performance standard offered or provided in compliance with RCW 48.30.360 .
RCW 48.31.165 — Washington Code / Title 48 / Chapter 31 / Section 165
RCW 48.31.165: Domiciliary receiver not appointed—Court order to liquidate—Notice—Domiciliary receiver appointed in other state.
Status: in_force

(1) If no domiciliary receiver has been appointed, the commissioner may apply to the court for an order directing him or her to liquidate the assets found in this state of a foreign insurer or an alien insurer not domiciled in this state, on any of the grounds stated in: RCW 48.31.030 , except subsection (10) of that section; 48.31.050(2); or 48.31.080 . (2) When an order is sought under subsection (1) of this section, the court shall cause the insurer to be given thirty days' notice and time to respond, or a lesser period reasonable under the circumstances. (3) If it appears to the court that the best interests of creditors, policyholders, and the public require, the court may issue an order to liquidate in whatever terms it deems appropriate. The filing or recording of the order with the recorder of deeds of the county in which the principal business of the company in this state is located or the county in which its principal office or place of business in this state is located, imparts the same notice as a deed or other evidence of title duly filed or recorded with that recorder of deeds would have imparted. (4) If a domiciliary liquidator is appointed in a reciprocal state while a liquidation is proceeding under this section, the liquidator under this section shall thereafter act as ancillary receiver under RCW 48.99.030 . If a domiciliary liquidator is appointed in a nonreciprocal state while a liquidation is proceeding under this section, the liquidator under this section may petition the court for permission to act as ancillary receiver under RCW 48.99.030 . (5) On the same grounds as are specified in subsection (1) of this section, the commissioner may petition an appropriate federal court to be appointed receiver to liquidate that portion of the insurer's assets and business over which the court will exercise jurisdiction, or any lesser part thereof that the commissioner deems desirable for the protection of policyholders, creditors, and the public in this state. (6) The court may order the commissioner, when he or she has liquidated the assets of a foreign or alien insurer under this section, to pay claims of residents of this state against the insurer under those rules on the liquidation of insurers under this chapter that are otherwise compatible with this section.
RCW 48.10.170 — Washington Code / Title 48 / Chapter 10 / Section 170
RCW 48.10.170: Service of legal process.
Status: in_force

(1) Each authorized reciprocal insurer must appoint the commissioner as its attorney to receive service of, and upon whom service must be served, all legal process issued against it in this state upon causes of action arising within this state. Service upon the commissioner as attorney constitutes service upon the insurer. (2) With the appointment the insurer must designate the person to whom the commissioner must forward legal process so served upon him or her. (3) The appointment of the commissioner as attorney is irrevocable, binds any successor in interest or to the assets or liabilities of the insurer, and remains in effect as long as there is in force in this state any contract made by the insurer or liabilities or duties arising under that contract. (4) The service of process must be accomplished and processed in the manner prescribed under RCW 48.02.200 . (5) In lieu of service on the commissioner, legal process may be served upon a domestic reciprocal insurer by serving the insurer's attorney at his or her principal offices. (6) Any judgment against the insurer based upon legal process so served is binding upon each of the insurer's subscribers as their respective interests may appear and in an amount not exceeding their respective contingent liabilities.
RCW 48.155.070 — Washington Code / Title 48 / Chapter 155 / Section 070
RCW 48.155.070: Written health care provider agreements required—Terms—Internet website.
Status: in_force

(1)(a) A discount plan organization shall have a written health care provider agreement with all health care providers for whose health care services it provides access to a discount to its members. The written health care provider agreement may be entered into directly with the health care provider or indirectly with a health care provider network to which the health care provider belongs. (b) A health care provider agreement between a discount plan organization and a health care provider must provide the following: (i) A list of the health care services and products to be provided at a discount; (ii) The amount or amounts of the discounts or, alternatively, a fee schedule that reflects the health care provider's discounted rates; and (iii) That the health care provider may not charge members more than the discounted rates. (c) A health care provider agreement between a discount plan organization and a health care provider network must require that the health care provider network have written agreements with its health care providers that: (i) Contain the provisions described in (b) of this subsection; (ii) Authorize the health care provider network to contract with the discount plan organization on behalf of the health care provider; and (iii) Require the health care provider network to maintain an up-to-date list of its contracted health care providers and to provide the list on a monthly basis to the discount plan organization. (d) A health care provider agreement between a discount plan organization and an entity that contracts with a health care provider network must require that the entity, in its contract with the health care provider network, require the health care provider network to have written agreements with its health care providers that comply with (c) of this subsection. (e) The discount plan organization shall maintain a copy of each health care provider agreement into which it has entered and shall promptly furnish a copy of each agreement to the commissioner when requested. (2)(a) Each discount plan organization shall maintain on an internet website a list of the names and addresses of the health care providers with which it has a current provider agreement directly or through a health care provider network. This list must be updated every thirty days. The internet website address must be prominently displayed on all of its advertisements, marketing materials, brochures, and discount plan cards. (b) This subsection applies to those health care providers with which the discount plan organization has a current provider agreement directly as well as those health care providers that are members of a health care provider network with which the discount plan organization has a current provider agreement.
RCW 48.200.310 — Washington Code / Title 48 / Chapter 200 / Section 310
RCW 48.200.310: Prohibitions and duties.
Status: in_force

(1) A pharmacy benefit manager may not: (a) Reimburse a network pharmacy an amount less than the contract price between the pharmacy benefit manager and the insurer, third-party payor, or the prescription drug purchasing consortium the pharmacy benefit manager has contracted with; (b) Require a covered person to pay more at the point of sale for a covered prescription drug than is required under RCW 48.43.430 ; or (c) Require or coerce a patient to use their owned or affiliated pharmacies. (2) A pharmacy benefit manager shall: (a) Apply the same utilization review, fees, days allowance, and other conditions upon a covered person when the covered person obtains a prescription drug from a pharmacy that is included in the pharmacy benefit manager's pharmacy network, including mail order pharmacies; (b) Permit the covered person to receive delivery or mail order of a prescription drug through any network pharmacy that is not primarily engaged in dispensing prescription drugs to patients through the mail or common carrier; and (c) For new prescriptions issued after January 1, 2026, receive affirmative authorization from a covered person before filling prescriptions through a mail order pharmacy. (3) If a covered person is using a mail order pharmacy, the pharmacy benefit manager shall: (a) Allow for dispensing at local network pharmacies under the following circumstances to ensure patient access to prescription drugs: (i) If the prescription is delayed more than one day after the expected delivery date provided by the mail order pharmacy; or (ii) If the prescription drug arrives in an unusable condition; and (b) Ensure patients have easy and timely access to prescription counseling by a pharmacist.
RCW 48.09.340 — Washington Code / Title 48 / Chapter 09 / Section 340
RCW 48.09.340: Impairment of surplus.
Status: in_force

(1) If the assets of a domestic mutual insurer on the cash premium plan fall below the amount of its liabilities, plus the amount of any surplus required by this code for the kinds of insurance authorized to be transacted, the commissioner shall at once ascertain the amount of the deficiency and serve notice upon the insurer to cure the deficiency within ninety days after such service of notice. (2) If the deficiency is not made good in cash or in assets eligible under this code for the investment of the insurer's funds, and proof thereof filed with the commissioner within such ninety-day period, the insurer shall be deemed insolvent and shall be proceeded against as authorized by this code. (3) If the deficiency is not made good the insurer shall not issue or deliver any policy after the expiration of such ninety-day period. Any officer or director who violates or knowingly permits the violating of this provision shall be subject to a fine of from fifty dollars to one thousand dollars for each violation.
RCW 48.31.131 — Washington Code / Title 48 / Chapter 31 / Section 131
RCW 48.31.131: Appointment of liquidator—Actions at law or equity—Statute of limitations or defense of laches.
Status: in_force

(1) Upon issuance of an order appointing a liquidator of a domestic insurer or of an alien insurer domiciled in this state, an action at law or equity or in arbitration may not be brought against the insurer or liquidator, whether in this state or elsewhere, nor may such an existing action be maintained or further presented after issuance of the order. The courts of this state shall give full faith and credit to injunctions against the liquidator or the company when the injunctions are included in an order to liquidate an insurer issued under laws in other states corresponding to this subsection. Whenever, in the liquidator's judgment, protection of the estate of the insurer necessitates intervention in an action against the insurer that is pending outside this state, the liquidator may intervene in the action. The liquidator may defend an action in which he or she intervenes under this section at the expense of the estate of the insurer. (2) The liquidator may institute an action or proceeding pursuant to an order of rehabilitation, within the later of two years following entry of the order or two years of the date the liquidator discovers, or in the exercise of reasonable care should have discovered, the injury from which the action or proceeding arose and its cause. However, actions against former directors, officers, and employees brought pursuant to an order of rehabilitation for the benefit or the protection of subscribers, policy beneficiaries, or the general public is subject to the limitations period of RCW 4.16.160 . (3) A statute of limitation or defense of laches does not run with respect to an action against an insurer between the filing of a petition for liquidation against an insurer and the denial of the petition. An action against the insurer that might have been commenced when the petition was filed may be commenced for at least sixty days after the petition is denied. (4) A guaranty association or foreign guaranty association has standing to appear in a court proceeding concerning the liquidation of an insurer if the association is or may become liable to act as a result of the liquidation.
RCW 48.24.040 — Washington Code / Title 48 / Chapter 24 / Section 040
RCW 48.24.040: Debtor groups.
Status: in_force

The lives of a group of individuals may be insured under a policy issued to a creditor, who shall be deemed the policyholder, to insure debtors of the creditors, subject to the provisions of the insurance code relating to credit life insurance and credit accident and health insurance and to the following requirements: (1) The debtors eligible for insurance under the policy shall be all of the debtors of the creditor whose indebtedness is repayable in installments, or all of any class or classes thereof determined by conditions pertaining to the indebtedness or to the purchase giving rise to the indebtedness, except that nothing in this section shall preclude an insurer from excluding from the classes eligible for insurance classes of debtors determined by age. The policy may provide that the term "debtors" shall include the debtors of one or more subsidiary corporations, and the debtors of one or more affiliated corporations, proprietors or partnerships if the business of the policyholder and of such affiliated corporations, proprietors or partnerships is under common control through stock ownership, contract, or otherwise. (2) The premium for the policy shall be paid by the policyholder, either from the creditor's funds, or from charges collected from the insured debtors, or from both. A policy on which part or all of the premium is to be derived from the collection from the insured debtors of identifiable charges not required of uninsured debtors shall not include, in the class or classes of debtors eligible for insurance, debtors under obligations outstanding at its date of issue without evidence of individual insurability unless at least seventy-five percent of the then eligible debtors elect to pay the required charges. A policy on which no part of the premium is to be derived from the collection of such identifiable charges must insure all eligible debtors, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer. (3) The policy may be issued only if the group of eligible debtors is then receiving new entrants at the rate of at least one hundred persons yearly, or may reasonably be expected to receive at least one hundred new entrants during the first policy year, and only if the policy reserves to the insurer the right to require evidence of individual insurability if less than seventy-five percent of the new entrants become insured. (4) Payment by the debtor insured under any such group life insurance contract of the premium charged the creditor by the insurer for such insurance pertaining to the debtor, shall not be deemed to constitute a charge upon a loan in violation of any usury law.
RCW 48.18.103 — Washington Code / Title 48 / Chapter 18 / Section 103
RCW 48.18.103: Forms of commercial property casualty policies—Legislative intent—Issuance prior to filing—Disapproval by commissioner—Definition.
Status: in_force

(1) It is the intent of the legislature to assist the purchasers of commercial property casualty insurance by allowing policies to be issued more expeditiously and provide a more competitive market for forms. (2) Commercial property casualty policies may be issued prior to filing the forms. (3) All commercial property casualty forms must be filed with the commissioner within thirty days after an insurer issues any policy using them. This subsection does not apply to: (a) Types or classes of forms that the commissioner exempts from filing by rule; and (b) Manuscript policies, riders, or endorsements of unique character designed for and used with relation to insurance upon a particular subject. (4) If, within thirty days after a commercial property casualty form has been filed, the commissioner finds that the form does not meet the requirements of this chapter, the commissioner shall disapprove the form and give notice to the insurer or rating organization that made the filing, specifying how the form fails to meet the requirements and stating when, within a reasonable period thereafter, the form shall be deemed no longer effective. The commissioner may extend the time for review an additional fifteen days by giving notice to the insurer prior to the expiration of the original thirty-day period. (5) Upon a final determination of a disapproval of a policy form under subsection (4) of this section, the insurer must amend any previously issued disapproved form by endorsement to comply with the commissioner's disapproval. (6) For purposes of this section, "commercial property casualty" means insurance pertaining to a business, profession, occupation, nonprofit organization, or public entity for the lines of property and casualty insurance defined in RCW 48.11.040 , 48.11.050 , 48.11.060 , or 48.11.070 , but does not mean medical malpractice insurance or portable electronics insurance as defined in RCW 48.120.005 . (7) Except as provided in subsection (5) of this section, the disapproval shall not affect any contract made or issued prior to the expiration of the period set forth in the notice of disapproval. (8) Every member or subscriber to a rating organization must adhere to the form filings made on its behalf by the organization. An insurer may deviate from forms filed on its behalf by an organization only if the insurer files the forms with the commissioner in accordance with this chapter. (9) In the event a hearing is held on the actions of the commissioner under subsection (4) of this section, the burden of proof shall be on the commissioner.
RCW 48.21A.080 — Washington Code / Title 48 / Chapter 21A / Section 080
RCW 48.21A.080: Remedies.
Status: in_force

No act done, action taken or agreement made pursuant to the authority conferred by this chapter shall constitute a violation of or grounds for prosecution or civil proceedings under any other law of this state heretofore or hereafter enacted which does not specifically refer to insurance.
RCW 48.09.460 — Washington Code / Title 48 / Chapter 09 / Section 460
RCW 48.09.460: Foreign mutual insurers—Reorganization.
Status: in_force

(1) A foreign mutual insurer organized under the laws of any other state, that, if a domestic corporation, would be organized under RCW 48.09.010 , may reorganize by merging its policyholders' membership interests into an existing domestic mutual holding company in accordance with the requirements of any other law or regulation that applies to the foreign mutual insurer. The reorganization shall continue the corporate existence of the converting mutual insurer as a foreign stock insurance company subsidiary of the existing domestic mutual holding company or as a foreign stock insurance company subsidiary of an intermediate stock holding company. The reorganizing foreign mutual insurer may remain a foreign insurer after the restructuring and may be admitted to do business in this state if it meets the applicable requirements of this title. A foreign mutual insurer that is a party to the reorganization may at the same time redomesticate to this state by complying with the applicable requirements of this state and the foreign mutual insurer's state of domicile. (2) For the purposes of this section, "existing domestic mutual holding company" means a mutual holding company formed under this chapter.
RCW 48.110.090 — Washington Code / Title 48 / Chapter 110 / Section 090
RCW 48.110.090: Recordkeeping of service contract provider or protection product guarantee provider—Requirements—Duration—Form.
Status: in_force

(1) The service contract provider or protection product guarantee provider shall keep accurate accounts, books, and records concerning transactions regulated under this chapter. (2) The service contract provider's or protection product guarantee provider's accounts, books, and records shall include the following: (a) Copies of each type of service contract or protection product guarantees offered, issued, or sold; (b) The name and address of each service contract holder or protection product guarantee holder, to the extent that the name and address have been furnished by the service contract holder or protection product guarantee holder; (c) A list of the locations where the service contracts or protection products are marketed, sold, or offered for sale; and (d) Written claim files that contain at least the dates, amounts, and descriptions of claims related to the service contracts or protection products. (3) Except as provided in subsection (5) of this section, the service contract provider or protection product guarantee provider shall retain all records required to be maintained by subsection (1) of this section for at least six years after the specified coverage has expired. (4) The records required under this chapter may be, but are not required to be, maintained on a computer disk or other recordkeeping technology. If the records are maintained in other than hard copy, the records shall be capable of duplication to legible hard copy. (5) A service contract provider or protection product guarantee provider discontinuing business in this state shall maintain its records until it furnishes the commissioner satisfactory proof that it has discharged all obligations to service contract holders or protection product guarantee holders in this state.
RCW 48.07.203 — Washington Code / Title 48 / Chapter 07 / Section 203
RCW 48.07.203: Continuing operation in event of emergency—Written plan required.
Status: in_force

Each domestic insurer must create and maintain a written business continuity plan identifying procedures relating to a local, state, or national emergency or significant business disruption.
RCW 48.43.087 — Washington Code / Title 48 / Chapter 43 / Section 087
RCW 48.43.087: Contracting for services at enrollee's expense—Mental health care practitioner—Conditions—Exception.
Status: in_force

(1) For purposes of this section: (a) "Health carrier" includes disability insurers regulated under chapter 48.20 or 48.21 RCW, health care services contractors regulated under chapter 48.44 RCW, plans operating under the health care authority under chapter 41.05 RCW, the basic health plan operating under chapter 70.47 RCW, the state health insurance pool operating under chapter 48.41 RCW, insuring entities regulated under this chapter, and health maintenance organizations regulated under chapter 48.46 RCW. (b) "Intermediary" means a person duly authorized to negotiate and execute provider contracts with health carriers on behalf of mental health care practitioners. (c) Consistent with their lawful scopes of practice, "mental health care practitioners" includes only the following: Any generally recognized medical specialty of practitioners licensed under chapter 18.57 or 18.71 RCW who provide mental health services, advanced practice psychiatric nurses as authorized by the state board of nursing under chapter 18.79 RCW, psychologists licensed under chapter 18.83 RCW, and mental health counselors, marriage and family therapists, and social workers licensed under chapter 18.225 RCW. (d) "Mental health services" means outpatient services. (2) Consistent with federal and state law and rule, no contract between a mental health care practitioner and an intermediary or between a mental health care practitioner and a health carrier that is written, amended, or renewed after June 6, 1996, may contain a provision prohibiting a practitioner and an enrollee from agreeing to contract for services solely at the expense of the enrollee as follows: (a) On the exhaustion of the enrollee's mental health care coverage; (b) During an appeal or an adverse certification process; (c) When an enrollee's condition is excluded from coverage; or (d) For any other clinically appropriate reason at any time. (3) If a mental health care practitioner provides services to an enrollee during an appeal or adverse certification process, the practitioner must provide to the enrollee written notification that the enrollee is responsible for payment of these services, unless the health carrier elects to pay for services provided. (4) This section does not apply to a mental health care practitioner who is employed full time on the staff of a health carrier.
RCW 48.31.060 — Washington Code / Title 48 / Chapter 31 / Section 060
RCW 48.31.060: Liquidation—Order.
Status: in_force

(1) An order to liquidate the business of a domestic insurer shall direct the commissioner forthwith to take possession of the property of the insurer, to liquidate its business, to deal with the insurer's property and business in his or her own name as commissioner or in the name of the insurer as the court may direct, to give notice to all creditors who may have claims against the insurer to present such claims. (2) The commissioner may apply under this chapter for an order dissolving the corporate existence of a domestic insurer: (a) Upon his or her application for an order of liquidation of such insurer, or at any time after such order has been granted; or (b) Upon the grounds specified in item (3) of RCW 48.31.050 , regardless of whether an order of liquidation is sought or has been obtained.
RCW 48.23.040 — Washington Code / Title 48 / Chapter 23 / Section 040
RCW 48.23.040: Entire contract—Representations.
Status: in_force

In all such policies other than those containing a clause making the policy incontestable from date of issue, there shall be a provision that the policy and the application therefor, if a copy thereof has been endorsed upon or attached to the policy at issue and made a part thereof, shall constitute the entire contract between the parties, and that all statements made by the applicant or by the insured, shall, in the absence of fraud, be deemed representations and not warranties.
RCW 48.56.080 — Washington Code / Title 48 / Chapter 56 / Section 080
RCW 48.56.080: Premium finance agreement.
Status: in_force

(1) A premium finance agreement shall: (a) Be dated, signed by or on behalf of the insured, and the printed portion thereof shall be in at least eight point type; (b) Contain the name and place of business of the insurance producer negotiating the related insurance contract, the name and residence or the place of business of the premium finance company to which payments are to be made, a description of the insurance contracts involved and the amount of the premium therefor; and (c) Set forth the following items where applicable: (i) The total amount of the premiums; (ii) The amount of the down payment; (iii) The principal balance (the difference between items (i) and (ii)); (iv) The amount of the service charge; (v) The balance payable by the insured (sum of items (iii) and (iv)); and (vi) The number of installments required, the amount of each installment expressed in dollars, and the due date or period thereof. (2) The items set out in subsection (1)(c) of this section need not be stated in the sequence or order in which they appear in that subsection, and additional items may be included to explain the computations made in determining the amount to be paid by the insured. (3) The information required by subsection (1) of this section shall only be required in the initial agreement where the premium finance company and the insured enter into an open end credit transaction, which is defined as follows: A plan prescribing the terms of credit transactions which may be made thereunder from time to time and under the terms of which a finance charge may be computed on the outstanding unpaid balance from time to time thereunder. (4) A copy of the premium finance agreement shall be given to the insured at the time or within ten days of its execution, except where the application has been signed by the insured and all the finance charges are one dollar or less per payment. In addition, the premium finance company shall deliver or mail a copy of the premium finance agreement or notice identifying policy, insured, and insurance producer to each insurer that has premiums involved in the transaction, within thirty days of the execution of the premium finance agreement. (5) It shall be illegal for a premium finance company to offset funds of an insurance producer with funds belonging to an insured. Premiums advanced by a premium finance company are funds belonging to the insured and shall be held in a fiduciary relationship.
RCW 48.25.150 — Washington Code / Title 48 / Chapter 25 / Section 150
RCW 48.25.150: Beneficiary.
Status: in_force

(1) Each such policy shall have a space on the front or back page of the policy for the name of the beneficiary designated with a reservation of the right to designate or change the beneficiary after the issuance of the policy. (2) The policy may also provide that no designation or change of beneficiary shall be binding on the insurer until endorsed on the policy by the insurer, and that the insurer may refuse to endorse the name of any proposed beneficiary who does not appear to the insurer to have an insurable interest in the life of the insured.
RCW 48.28.030 — Washington Code / Title 48 / Chapter 28 / Section 030
RCW 48.28.030: Judicial bonds—Premium as part of recoverable costs.
Status: in_force

In any proceeding the party entitled to recover costs may include therein such reasonable sum as was paid to such surety insurer as premium for any bond or undertaking required therein, and as may be allowed by the court having jurisdiction of such proceeding.
RCW 48.64.130 — Washington Code / Title 48 / Chapter 64 / Section 130
RCW 48.64.130: Immunity from liability in civil actions—Filing, furnishing, or using information.
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 bulletins or arising 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 48.02.050 — Washington Code / Title 48 / Chapter 02 / Section 050
RCW 48.02.050: Seal.
Status: in_force

The official seal of the commissioner shall be a vignette of George Washington, with the words "Insurance Commissioner, State of Washington" surrounding the vignette.
RCW 48.13.470 — Washington Code / Title 48 / Chapter 13 / Section 470
RCW 48.13.470: Safeguarding securities—Broker executing a trade—Time limits.
Status: in_force

(1) A broker executing a securities trade pursuant to an order from a domestic insurance company shall send confirmation to the domestic insurance company or the clearing corporation confirming the order has been executed within twenty-four hours after order completion. (2) A broker may not hold in its own account for longer than seventy-two hours any securities bought or sold pursuant to an order from a domestic insurance company.
RCW 48.23.410 — Washington Code / Title 48 / Chapter 23 / Section 410
RCW 48.23.410: Short title.
Status: in_force

RCW 48.23.420 through * 48.23.520 shall be known as the standard nonforfeiture law for individual deferred annuities.
RCW 48.21.142 — Washington Code / Title 48 / Chapter 21 / Section 142
RCW 48.21.142: Chiropractic.
Status: in_force

Notwithstanding any provision of any group disability insurance contract or blanket disability insurance contract as provided for in this chapter, benefits shall not be denied thereunder for any health service performed by a holder of a license issued pursuant to chapter 18.25 RCW if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a holder of a license issued pursuant to chapter 18.71 RCW: PROVIDED, HOWEVER, That no provision of chapter 18.71 RCW shall be asserted to deny benefits under this section. The provisions of this section are intended to be remedial and procedural to the extent they do not impair the obligation of any existing contract.
RCW 48.31.021 — Washington Code / Title 48 / Chapter 31 / Section 021
RCW 48.31.021: Insurer—Self-funded multiple employer welfare arrangement.
Status: in_force

A self-funded multiple employer welfare arrangement, as defined in RCW 48.125.010 , is an insurer under this chapter.
RCW 48.36A.350 — Washington Code / Title 48 / Chapter 36A / Section 350
RCW 48.36A.350: Service of process upon commissioner.
Status: in_force

(1) Every society authorized to do business in this state must appoint the commissioner as its attorney to receive service of, and upon whom must be served, all legal process issued against it in this state upon causes of action arising within this state. Service upon the commissioner as attorney constitutes service upon the society. (2) With the appointment the society must designate the person to whom the commissioner must forward legal process so served upon him or her. (3) The appointment of the commissioner as attorney is irrevocable, binds any successor in interest or to the assets or liabilities of the society, and remains in effect as long as there is in force in this state any contract made by the society or liabilities or duties arising therefrom. (4) The service of process must be accomplished and processed in the manner prescribed under RCW 48.02.200 .
RCW 48.50.020 — Washington Code / Title 48 / Chapter 50 / Section 020
RCW 48.50.020: Definitions.
Status: in_force

As used in this chapter the following terms have the meanings indicated unless the context clearly requires otherwise. (1) "Authorized agency" means a public agency or its official representative having legal authority to investigate criminal activity or the cause of a fire or to initiate criminal proceedings, including the following persons and agencies: (a) The chief of the Washington state patrol and the director of fire protection; (b) The prosecuting attorney of the county where the criminal activity occurred; (c) State, county, and local law enforcement agencies; (d) The state attorney general; (e) The federal bureau of investigation, or any other federal law enforcement agency; (f) The United States attorney's office; and (g) The office of the insurance commissioner. (2) "Insurer" means any insurer, as defined in RCW 48.01.050 and any self-insurer. (3) "Relevant information" means information having any tendency to make the existence of any fact that is of consequence to the investigation or determination of criminal activity or the cause of any fire more probable or less probable than it would be without the information.
RCW 48.07.160 — Washington Code / Title 48 / Chapter 07 / Section 160
RCW 48.07.160: Continuing operation in event of emergency—Declaration of purpose—"Insurer" defined.
Status: in_force

It is desirable for the general welfare and in particular for the welfare of insurance beneficiaries, policyholders, claimants, subscribers, and others that the business of domestic insurers be continued notwithstanding the event of a local, state, or national emergency. The purpose of this section, RCW 48.07.170 through 48.07.200 , and 48.07.203 is to facilitate the continued operation of domestic insurers in the event that a local, state, or national emergency is so disruptive of normal business and commerce as to make it impossible or impracticable for a domestic insurer to conduct its business in accord with applicable provisions of law, its bylaws, or its charter. When used in this section, RCW 48.07.170 through 48.07.200 , and 48.07.203 the word "insurer" means the same as defined in RCW 48.01.053 [ 48.01.050 ].
RCW 48.43.757 — Washington Code / Title 48 / Chapter 43 / Section 757
RCW 48.43.757: Health care provider credentialing applications—Reimbursement requirements.
Status: in_force

(1) If a carrier approves a health care provider's credentialing application, upon completion of the credentialing process, the carrier must reimburse a health care provider under the following circumstances: (a) When credentialing a new health care provider through a new provider contract, the carrier must reimburse the health care provider for covered services provided to the carrier's enrollee retroactively to the date of contract effectiveness if the credentialing process extends beyond the effective date of the new contract. (b) When credentialing a provider to be added to an approved and in-use provider contract where a relationship existed between the carrier and the health care provider or the entity for whom the health care provider is employed or engaged at the time the health care provider submitted the completed credentialing application, the carrier must reimburse the health care provider for covered health care services provided to the carrier's enrollees during the credentialing process beginning when the health care provider submitted a completed credentialing application to the carrier. (2) The health carrier must reimburse the health care provider at the contracted rate for the applicable health benefit plan that the health care provider would have been paid at the time the services were provided if the health care provider were fully credentialed by the carrier. (3) Nothing in this section requires reimbursement of health care provider-rendered services that are not benefits or services covered by the health carrier's health benefit plan. (4) Nothing in this section requires a health carrier to pay reimbursement for any covered medical services provided by a health care provider applicant if the health care provider's credentialing application is not approved or if the carrier and health care provider do not enter into a contractual relationship.
RCW 48.13.900 — Washington Code / Title 48 / Chapter 13 / Section 900
RCW 48.13.900: Effective date—2011 c 188.
Status: in_force

This act takes effect July 1, 2012.
RCW 48.49.140 — Washington Code / Title 48 / Chapter 49 / Section 140
RCW 48.49.140: Liberal construction of chapter to promote public interest.
Status: in_force

This chapter must be liberally construed to promote the public interest by ensuring that consumers are not billed out-of-network charges and do not receive additional bills from providers under the circumstances described in RCW 48.49.020 .
RCW 48.16.120 — Washington Code / Title 48 / Chapter 16 / Section 120
RCW 48.16.120: Voluntary excess deposits.
Status: in_force

An insurer may deposit and maintain on deposit with the commissioner funds and eligible securities in amount exceeding its required deposit under this code by not more than one hundred thousand dollars, for the purpose of absorbing fluctuations in the value of securities held in its required deposit, and to facilitate the exchange and substitution of such required securities. During the solvency of the insurer any such excess deposit or any part thereof shall be released to it upon its request. During the insolvency of the insurer such excess deposit shall be released only as provided in RCW 48.16.100 .
RCW 48.94.020 — Washington Code / Title 48 / Chapter 94 / Section 020
RCW 48.94.020: Accounts and records maintained by reinsurance intermediary-broker—Access by insurer.
Status: in_force

(1) For at least ten years after expiration of each contract of reinsurance transacted by the reinsurance intermediary-broker, the reinsurance intermediary-broker shall keep a complete record for each transaction showing: (a) The type of contract, limits, underwriting restrictions, classes, or risks and territory; (b) Period of coverage, including effective and expiration dates, cancellation provisions, and notice required of cancellation; (c) Reporting and settlement requirements of balances; (d) Rate used to compute the reinsurance premium; (e) Names and addresses of assuming reinsurers; (f) Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the reinsurance intermediary-broker; (g) Related correspondence and memoranda; (h) Proof of placement; (i) Details regarding retrocessions handled by the reinsurance intermediary-broker including the identity of retrocessionaires and percentage of each contract assumed or ceded; (j) Financial records, including but not limited to, premium and loss accounts; and (k) When the reinsurance intermediary-broker procures a reinsurance contract on behalf of a licensed ceding insurer: (i) Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or (ii) If placed through a representative of the assuming reinsurer, other than an employee, written evidence that the reinsurer has delegated binding authority to the representative. (2) The insurer has access and the right to copy and audit all accounts and records maintained by the reinsurance intermediary-broker related to its business in a form usable by the insurer.
RCW 48.05A.035 — Washington Code / Title 48 / Chapter 05A / Section 035
RCW 48.05A.035: ORSA summary report must be consistent with ORSA guidance manual.
Status: in_force

(1) The ORSA summary report shall be prepared consistent with the ORSA guidance manual, subject to the requirements of subsection (2) of this section. Documentation and supporting information must be maintained and made available upon examination or upon the request of the commissioner. (2) The review of the ORSA summary report, and any additional requests for information, must be made using similar procedures currently used in the analysis and examination of multistate or global insurers and insurance groups.
RCW 48.05A.045 — Washington Code / Title 48 / Chapter 05A / Section 045
RCW 48.05A.045: Failure to report—Fines.
Status: in_force

The commissioner must require any insurer failing, without just cause, to file the ORSA summary report as required in this chapter, after notice and hearing, to pay a fine of five hundred dollars for each day's delay, to be recovered by the commissioner and the fine collected must be transferred to the treasurer for deposit into the state general fund. The maximum fine under this section is one hundred thousand dollars. The commissioner may reduce the fine if the insurer demonstrates to the commissioner that the imposition of the fine would constitute a financial hardship to the insurer.
RCW 48.29.455 — Washington Code / Title 48 / Chapter 29 / Section 455
RCW 48.29.455: Rating organizations—Members and subscribers—Appeal to commissioner.
Status: in_force

(1) Any member of or subscriber to a rating organization may appeal to the commissioner from the rating organization's action or decision in approving or rejecting any proposed change in or addition to the rating organization's filings. The commissioner shall, after a hearing on the appeal: (a) Issue an order approving the rating organization's action or decision or directing it to give further consideration to such proposal; or (b) If the appeal is from the rating organization's action or decision in rejecting a proposed addition to its filings, the commissioner may, upon finding that the action or decision was unreasonable, issue an order directing the rating organization to make an addition to its filings, on behalf of its subscribers, in a manner consistent with the commissioner's findings, within a reasonable time after the issuance of such order. (2) If such appeal is based upon the rating organization's failure to make a filing on behalf of such subscriber which is based on a system of expense provisions that differs from the system of expense provisions included in a filing made by the rating organization, the commissioner shall, if the appeal is granted, order the rating organization to make the requested filing for use by the appellant. (3) In deciding the appeal the commissioner shall apply the standards set forth in RCW 48.29.143 and 48.29.147 for rate filings, and the standards set forth in RCW 48.18.100 and 48.18.110 for form filings.
RCW 48.25.170 — Washington Code / Title 48 / Chapter 25 / Section 170
RCW 48.25.170: Payment of premiums direct.
Status: in_force

In the case of weekly premium policies, there may be a provision that upon proper notice to the insurer while premiums on the policy are not in default beyond the grace period, of the intention to pay future premiums directly to the insurer at its home office or any office designated by the insurer for the purpose, the insurer will, at the end of each period of a year from the due date of the first premium so paid, for which period such premiums are so paid continuously without default beyond the grace period, refund a stated percentage of the premiums in an amount which fairly represents the savings in collection expense.
RCW 48.49.070 — Washington Code / Title 48 / Chapter 49 / Section 070
RCW 48.49.070: Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.
Status: in_force

(1)(a) A hospital, ambulatory surgical facility, behavioral health emergency services provider, or ground ambulance services organization must post the following information on its website, if one is available: (i) The listing of the carrier health plan provider networks with which the hospital, ambulatory surgical facility, behavioral health emergency services provider, or ground ambulance services organization is an in-network provider, based upon the information provided by the carrier pursuant to RCW 48.43.730 (7); and (ii) The notice of consumer rights developed under RCW 48.49.060 . (b) If the hospital, ambulatory surgical facility, behavioral health emergency services provider, or ground ambulance services organization does not maintain a website, this information must be provided to consumers upon an oral or written request. (2) Posting or otherwise providing the information required in this section does not relieve a hospital, ambulatory surgical facility, behavioral health emergency services provider, or ground ambulance services organization of its obligation to comply with the provisions of this chapter. (3) Not less than 30 days prior to executing a contract with a carrier, a hospital or ambulatory surgical facility must provide the carrier with a list of the nonemployed providers or provider groups contracted to provide emergency medicine, anesthesiology, pathology, radiology, neonatology, surgery, hospitalist, intensivist, and diagnostic services, including radiology and laboratory services at the hospital or ambulatory surgical facility. The hospital or ambulatory surgical facility must notify the carrier within thirty days of a removal from or addition to the nonemployed provider list. A hospital or ambulatory surgical facility also must provide an updated list of these providers within 14 calendar days of a request for an updated list by a carrier.
RCW 48.84.020 — Washington Code / Title 48 / Chapter 84 / Section 020
RCW 48.84.020: Definitions.
Status: in_force

Unless the context requires otherwise, the definitions in this section apply throughout this chapter. (1) "Long-term care insurance" or "long-term care benefit contract" means any insurance policy or benefit contract primarily advertised, marketed, offered, or designed to provide coverage or services for either institutional or community-based convalescent, custodial, chronic, or terminally ill care. Such terms do not include and this chapter shall not apply to policies or contracts governed by chapter 48.66 RCW and continuing care retirement communities. (2) "Loss ratio" means the incurred claims plus or minus the increase or decrease in reserves as a percentage of the earned premiums, or the projected incurred claims plus or minus the increase or decrease in projected reserves as a percentage of projected earned premiums, as defined by the commissioner. (3) "Preexisting condition" means a covered person's medical condition that caused that person to have received medical advice or treatment during the specified time period before the effective date of coverage. (4) "Medicare" means Title XVIII of the United States social security act, or its successor program. (5) "Medicaid" means Title XIX of the United States social security act, or its successor program. (6) "Nursing home" means a nursing home as defined in RCW 18.51.010 .
RCW 48.31B.040 — Washington Code / Title 48 / Chapter 31B / Section 040
RCW 48.31B.040: Rule making.
Status: in_force

The commissioner may, in accordance with the administrative procedure act, chapter 34.05 RCW, adopt rules interpreting and implementing this chapter.
RCW 48.66.920 — Washington Code / Title 48 / Chapter 66 / Section 920
RCW 48.66.920: 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 48.88.030 — Washington Code / Title 48 / Chapter 88 / Section 030
RCW 48.88.030: Plan for joint underwriting association.
Status: in_force

The commissioner shall approve by July 1, 1986, a reasonable plan for the establishment of a nonprofit, joint underwriting association for day care insurance, subject to the conditions and limitations contained in this chapter.
RCW 48.12.060 — Washington Code / Title 48 / Chapter 12 / Section 060
RCW 48.12.060: Reserve—Disability insurance.
Status: in_force

For all disability insurance policies the insurer shall maintain an active life reserve which shall place a sound value on its liabilities under such policies and be not less than the reserve according to appropriate standards set forth in regulations issued by the commissioner and, in no event, less in the aggregate than the pro rata gross unearned premiums for such policies.
RCW 48.22.110 — Washington Code / Title 48 / Chapter 22 / Section 110
RCW 48.22.110: Vendor single-interest or collateral protection coverage—Definitions.
Status: in_force

Unless the context clearly requires otherwise, the definitions in this section apply throughout this section and RCW 48.22.115 through 48.22.135 . (1) "Borrower" means a person who receives a loan or enters into a retail installment contract under chapter 63.14 RCW to purchase a motor vehicle or vessel in which the secured party holds an interest. (2) "Motor vehicle" means a motor vehicle in this state subject to registration under *chapter 46.16 RCW, except motor vehicles governed by RCW 46.16A.170 or registered with the Washington utilities and transportation commission as common or contract carriers. (3) "Secured party" means a person, corporation, association, partnership, or venture that possesses a bona fide security interest in a motor vehicle or vessel. (4) "Vendor single-interest" or "collateral protection coverage" means insurance coverage insuring primarily or solely the interest of a secured party but which may include the interest of the borrower in a motor vehicle or vessel serving as collateral and obtained by the secured party or its agent after the borrower has failed to obtain or maintain insurance coverage required by the financing agreement for the motor vehicle or vessel. Vendor single-interest or collateral protection coverage does not include insurance coverage purchased by a secured party for which the borrower is not charged. (5) "Vessel" means a vessel as defined in RCW 88.02.310 and includes personal watercraft as defined in RCW 79A.60.010 .
RCW 48.01.060 — Washington Code / Title 48 / Chapter 01 / Section 060
RCW 48.01.060: "Insurance transaction" defined.
Status: in_force

"Insurance transaction" includes any: (1) Solicitation. (2) Negotiations preliminary to execution. (3) Execution of an insurance contract. (4) Transaction of matters subsequent to execution of the contract and arising out of it. (5) Insuring.
RCW 48.38.060 — Washington Code / Title 48 / Chapter 38 / Section 060
RCW 48.38.060: Hearings and appeals provisions inapplicable.
Status: in_force

For purposes of this chapter, the provisions of chapter 48.04 RCW are applicable.
RCW 48.20.232 — Washington Code / Title 48 / Chapter 20 / Section 232
RCW 48.20.232: Optional standard provision No. 19—Unpaid premium.
Status: in_force

There may be a provision as follows: UNPAID PREMIUM: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom.
RCW 48.125.040 — Washington Code / Title 48 / Chapter 125 / Section 040
RCW 48.125.040: Certificate of authority—Continued compliance with certain conditions—Commissioner's discretion.
Status: in_force

(1) In addition to the requirements under RCW 48.125.030 , self-funded multiple employer welfare arrangements are subject to the following requirements: (a) Arrangements must maintain a calendar year for operations and reporting purposes; (b) Arrangements must satisfy one of the following requirements: (i)(A) The arrangement must deposit two hundred thousand dollars with the commissioner to be used for the payment of claims in the event that the arrangement becomes insolvent; and (B) The arrangement must submit to the commissioner a written plan of operation that, in the reasonable discretion of the commissioner, ensures the financial integrity of the arrangement; or (ii) The arrangement demonstrates to the reasonable satisfaction of the commissioner the ability of the arrangement to remain financially solvent, for which purpose the commissioner may consider: (A) The pro forma financial statements of the arrangement; (B) The types and levels of excess of loss insurance coverage, including the attachment points of the coverage and whether the points are reflected as annual or monthly levels; (C) Whether a deposit is required for each employee covered under the arrangement equal to at least one month's cost of providing benefits under the arrangement; (D) The experience of the individuals who will be involved in the management of the arrangement, including employees, independent contractors, and consultants; and (E) Other factors as reasonably determined by the commissioner to be relevant to a determination of whether the arrangement is able to operate in a financially solvent manner. (2) The commissioner may require that the articles, bylaws, agreements, trusts, or other documents or instruments describing the rights and obligations of the employers, employees, and beneficiaries of the arrangement provide that employers participating in the arrangement are subject to pro rata assessment for all liabilities of the arrangement. (3) Self-funded multiple employer welfare arrangements with fewer than one thousand covered persons are required to have aggregate stop loss coverage, with an attachment point of one hundred twenty-five percent of expected claims. If the arrangement is allowed to assess the participating employers to cover actual or projected claims in excess of plan assets, then the attachment point shall be increased by the amount of the allowable assessments. If the required attachment point exceeds one hundred seventy-five percent of expected claims, aggregate stop loss coverage shall be waived. Arrangements with one thousand covered persons or more are not required to have aggregate stop loss coverage. (4) The arrangement must demonstrate continued compliance with respect to the conditions set forth in this section as a condition of receiving and maintaining a certificate of authority. The commissioner may waive continued compliance with respect to the conditions in this section at any time after the commissioner has granted a certificate of authority to an arrangement.
RCW 48.19.200 — Washington Code / Title 48 / Chapter 19 / Section 200
RCW 48.19.200: Notice of changes.
Status: in_force

Every rating organization shall notify the commissioner promptly of every change in (1) its constitution, its articles of agreement or association, or its certificate of incorporation, or trust agreement, and its bylaws, rules and regulations governing the conduct of its business; (2) its list of members and subscribers; (3) the name and address of the resident of this state designated by it upon whom notices or orders of the commissioner or process affecting such rating organization may be served.
RCW 48.09.290 — Washington Code / Title 48 / Chapter 09 / Section 290
RCW 48.09.290: Revocation of right to issue nonassessable policies.
Status: in_force

(1) The commissioner shall revoke the authority of a domestic mutual insurer so to extinguish the contingent liability of its members if (a) at any time the insurer's assets are less than the sum of its liabilities and the surplus required for such authority, or (b) the insurer, by resolution of its directors approved by its members, requests that the authority be revoked. (2) Upon revocation of such authority for any cause, the insurer shall not thereafter issue any policies without contingent liability, nor renew any policies then in force without written endorsement thereon providing for contingent liability.
RCW 48.31.111 — Washington Code / Title 48 / Chapter 31 / Section 111
RCW 48.31.111: Commencement of delinquency proceeding by commissioner—Jurisdiction of courts.
Status: in_force

(1) A delinquency proceeding may not be commenced under this chapter by anyone other than the commissioner of this state, and no court has jurisdiction to entertain a proceeding commenced by another person. (2) No court of this state has jurisdiction to entertain a complaint praying for the dissolution, liquidation, rehabilitation, sequestration, conservation, or receivership of an insurer, or praying for an injunction or restraining order or other relief preliminary to, incidental to, or relating to the proceedings, other than in accordance with this chapter. (3) In addition to other grounds for jurisdiction provided by the law of this state, a court of this state having jurisdiction of the subject matter has jurisdiction over a person served under the rules of civil procedure or other applicable provisions of law in an action brought by the receiver of a domestic insurer or an alien insurer domiciled in this state: (a) If the person served is an insurance producer, title insurance agent, surplus line broker, or other person who has written policies of insurance for or has acted in any manner on behalf of an insurer against which a delinquency proceeding has been instituted, in an action resulting from or incident to such a relationship with the insurer; (b) If the person served is a reinsurer who has entered into a contract of reinsurance with an insurer against which a delinquency proceeding has been instituted, or is an insurance producer of or for the reinsurer, in an action on or incident to the reinsurance contract; (c) If the person served is or has been an officer, director, manager, trustee, organizer, promoter, or other person in a position of comparable authority or influence over an insurer against which a delinquency proceeding has been instituted, in an action resulting from or incident to such a relationship with the insurer; (d) If the person served is or was at the time of the institution of the delinquency proceeding against the insurer holding assets in which the receiver claims an interest on behalf of the insurer, in an action concerning the assets; or (e) If the person served is obligated to the insurer in any way, in an action on or incident to the obligation. (4) If the court on motion of a party finds that an action should as a matter of substantial justice be tried in a forum outside this state, the court may enter an appropriate order to stay further proceedings on the action in this state.
RCW 48.44.380 — Washington Code / Title 48 / Chapter 44 / Section 380
RCW 48.44.380: Conversion contract—Restrictions and requirements—Rules.
Status: in_force

(1) A health care service contractor shall not require proof of insurability as a condition for issuance of the conversion contract. (2) A conversion contract may not contain an exclusion for preexisting conditions for any applicant. (3) A health care service contractor must offer at least three contract benefit plans that comply with the following: (a) A major medical plan with a five thousand dollar deductible per person; (b) A comprehensive medical plan with a five hundred dollar deductible per person; and (c) A basic medical plan with a one thousand dollar deductible per person. (4) The insurance commissioner may revise the deductible amounts in subsection (3) of this section from time to time to reflect changing health care costs. (5) The insurance commissioner shall adopt rules to establish minimum benefit standards for conversion contracts. (6) The commissioner shall adopt rules to establish specific standards for conversion contract provisions. These rules may include but are not limited to: (a) Terms of renewability; (b) Nonduplication of coverage; (c) Benefit limitations, exceptions, and reductions; and (d) Definitions of terms.
RCW 48.19.490 — Washington Code / Title 48 / Chapter 19 / Section 490
RCW 48.19.490: Automobile insurance—Continued eligibility for discount.
Status: in_force

Each participant shall take an approved course every two years to continue to be eligible for the discount on insurance.
RCW 48.31.184 — Washington Code / Title 48 / Chapter 31 / Section 184
RCW 48.31.184: Ancillary receiver in another state or foreign country—Failure to transfer assets.
Status: in_force

If an ancillary receiver in another state or foreign country, whether called by that name or not, fails to transfer to the domiciliary liquidator in this state assets within his or her control other than special deposits, diminished only by the expenses of the ancillary receivership, if any, then the claims filed in the ancillary receivership, other than special deposit claims or secured claims, shall be placed in the class of claims under RCW 48.31.280 (8).
RCW 48.190.110 — Washington Code / Title 48 / Chapter 190 / Section 110
RCW 48.190.110: Fees.
Status: in_force

(1) The state risk manager shall establish and charge an investigation fee in an amount necessary to cover the costs for the initial review and approval of a joint self-insurance program. The fee must accompany the initial submission of the plan of operation and management. (2) The costs of subsequent reviews and investigations must be charged to the joint self-insurance program being reviewed or investigated in accordance with the actual time and expenses incurred in the review or investigation. (3) Any program failing to remit its assessment when due is subject to denial of permission to operate or to a cease and desist order until the assessment is paid.
RCW 48.12.070 — Washington Code / Title 48 / Chapter 12 / Section 070
RCW 48.12.070: Loss records.
Status: in_force

An insurer shall maintain a complete and itemized record showing all losses and claims as to which it has received notice, including with regard to property, casualty, surety, and marine and transportation insurances, all notices received of the occurrence of any event which may result in a loss.
RCW 48.205.050 — Washington Code / Title 48 / Chapter 205 / Section 050
RCW 48.205.050: Exclusions—Waiting periods—Requirements.
Status: in_force

(1) A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is being made. (2)(a) A pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident. Waiting periods for accidents are prohibited. Waiting periods may not be applied to renewals of existing coverage. (b) A pet insurer utilizing a waiting period permitted in (a) of this subsection shall include a provision in its policy that allows the waiting periods to be waived upon completion of a medical examination. Pet insurers may require the examination to be conducted by a licensed veterinarian after the purchase of the policy. (c) A medical examination under (b) of this subsection must be paid for by the policyholder, unless the policy specifies that the pet insurer will pay for the examination. (d) A pet insurer can specify elements to be included as part of the examination and require documentation thereof, provided the specifications do not unreasonably restrict a consumer's ability to waive the waiting periods listed in (a) of this subsection. (3) A pet insurer may not require a veterinary examination of the covered pet for the insured to have their policy renewed. (4) If a pet insurer includes any prescriptive, wellness, or noninsurance benefits in the policy form, then it is made part of the policy contract and must follow all applicable laws and regulations in the insurance code. (5) An insured's eligibility to purchase a pet insurance policy must not be based on participation, or lack of participation, in a separate wellness program.
RCW 48.10.050 — Washington Code / Title 48 / Chapter 10 / Section 050
RCW 48.10.050: Insuring powers of reciprocals.
Status: in_force

(1) A reciprocal insurer may, upon qualifying therefor as provided by this code, transact any kind or kinds of insurance defined by this code, other than life or title insurances. (2) A reciprocal insurer may purchase reinsurance upon the risk of any subscriber, and may grant reinsurance as to any kind of insurance which it is authorized to transact direct.
RCW 48.32A.015 — Washington Code / Title 48 / Chapter 32A / Section 015
RCW 48.32A.015: Purpose.
Status: in_force

(1) The purpose of this chapter is to protect, subject to certain limitations, the persons specified in RCW 48.32A.025 (1) against failure in the performance of contractual obligations, under life insurance, disability insurance, health benefit plans, and certificates of coverage, and annuity policies, plans, or contracts specified in RCW 48.32A.025 (2), because of the impairment or insolvency of the member insurer that issued the policies, plans, or contracts. (2) To provide this protection, an association of member insurers is created to pay benefits and to continue coverages as limited by this chapter, and members of the association are subject to assessment to provide funds to carry out the purpose of this chapter.
RCW 48.36A.380 — Washington Code / Title 48 / Chapter 36A / Section 380
RCW 48.36A.380: World War I societies.
Status: in_force

Any corporation, society, order, or voluntary association operating as set forth in RCW 48.36A.010 , 48.36A.020 , and 48.36A.030 , organized during the war in which the United States entered on April 6, 1917, with the purposes of assisting the government of the United States in maintaining and increasing the production of commodities essential for the prosecution of that war, and of developing loyalty to the United States, or whose membership is limited to veterans of that war, may be licensed under the provisions of this chapter and shall have all the privileges and shall be subject to all the provisions and regulations of this chapter, except that the provisions of this chapter requiring death benefits of at least one thousand dollars, medical examinations, and valuations of benefit certificates, shall not apply to such society, but the society may provide benefits in case of death or disability resulting solely from accidents in an amount not exceeding one thousand dollars and may also provide for death or funeral benefits, or both, not exceeding one hundred dollars each, and for sick or disability benefits not exceeding five hundred dollars to any one person, in any one year. Any corporation, society, order, or voluntary association organized under the provisions of this section shall file with the insurance commissioner a copy of all its rates and policy forms. Rates and policy forms must be approved by the insurance commissioner before becoming effective. All rates and forms approved by the commissioner shall be observed by the society until amended rates or forms shall have been filed with and approved by the insurance commissioner.
RCW 48.05.475 — Washington Code / Title 48 / Chapter 05 / Section 475
RCW 48.05.475: RBC report from foreign or alien insurers—Request of commissioner—Commissioner's options.
Status: in_force

(1) Any foreign or alien insurer shall, upon the written request of the commissioner, submit to the commissioner an RBC report as of the end of the calendar year just ended by the later of: (a) The date an RBC report would be required to be filed by a domestic insurer under RCW 48.05.435 ; or (b) Fifteen days after the request is received by the foreign or alien insurer. Any foreign or alien insurer shall, at the written request of the commissioner, promptly submit to the commissioner a copy of any RBC plan that is filed with the insurance commissioner of any other state. (2) In the event of a company action level event, regulatory action level event, or authorized control level event with respect to any foreign or alien insurer as determined under the RBC statute applicable in the state of domicile of the insurer or, if no RBC statute is in force in that state, under the provisions of RCW 48.05.430 through * 48.05.490 , if the insurance commissioner of the state of domicile of the foreign or alien insurer fails to require the foreign or alien insurer to file an RBC plan in the manner specified under that state's RBC statute, the commissioner may require the foreign or alien insurer to file an RBC plan. In this event, the failure of the foreign or alien insurer to file an RBC plan is grounds to order the insurer to cease and desist from writing new insurance business in this state. (3) In the event of a mandatory control level event with respect to any foreign or alien insurer, if no domiciliary receiver has been appointed with respect to the foreign or alien insurer under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign or alien insurer, the commissioner may apply for an order under RCW 48.31.080 or 48.31.090 to conserve the assets within this state of foreign or alien insurers, and the occurrence of the mandatory control level event is considered adequate grounds for the application.
RCW 48.31.070 — Washington Code / Title 48 / Chapter 31 / Section 070
RCW 48.31.070: Liquidation—Alien insurers.
Status: in_force

An order to liquidate the business of the United States branch of an alien insurer having trusteed assets in this state shall be in the same terms as those prescribed for domestic insurers, except that only the assets of the business of such United States branch shall be included therein.
RCW 48.44.344 — Washington Code / Title 48 / Chapter 44 / Section 344
RCW 48.44.344: Benefits for prenatal diagnosis of congenital disorders—Contracts entered into or renewed on or after January 1, 1990.
Status: in_force

On or after January 1, 1990, every group health care services contract entered into or renewed that covers hospital, medical, or surgical expenses on a group basis, and which provides benefits for pregnancy, childbirth, or related medical conditions to enrollees of such groups, shall offer benefits for prenatal diagnosis of congenital disorders of the fetus by means of screening and diagnostic procedures during pregnancy to such enrollees when those services are determined to be medically necessary by the health care service contractor in accord with standards set in rule by the board of health. Every group health care services contractor shall communicate the availability of such coverage to all group health care service contract holders and to all groups with whom they are negotiating.
RCW 48.200.901 — Washington Code / Title 48 / Chapter 200 / Section 901
RCW 48.200.901: Effective date—2020 c 240.
Status: in_force

Sections 1 through 19 of this act take effect January 1, 2022.
RCW 48.46.280 — Washington Code / Title 48 / Chapter 46 / Section 280
RCW 48.46.280: Reconstructive breast surgery.
Status: in_force

(1) Any health care service plan issued, amended, or renewed after July 24, 1983, shall provide coverage for reconstructive breast surgery resulting from a mastectomy which resulted from disease, illness, or injury. (2) Any health care service plan issued, amended, or renewed after January 1, 1986, shall provide coverage for all stages of one reconstructive breast reduction on the nondiseased breast to make it equal in size with the diseased breast after definitive reconstructive surgery on the diseased breast has been performed.
RCW 48.212.150 — Washington Code / Title 48 / Chapter 212 / Section 150
RCW 48.212.150: Nonforfeiture benefit option—Offer required—Rules.
Status: in_force

(1) Except as provided by this section, a supplemental 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 supplemental 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 supplemental long-term care insurance as defined in RCW 48.212.020 (5)(d) other than to a continuing care retirement community or other similar entity, the offering must 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 supplemental 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 48.43.215 — Washington Code / Title 48 / Chapter 43 / Section 215
RCW 48.43.215: Report of a material acquisition or disposition of assets—Information required.
Status: in_force

(1) The following information is required to be disclosed in any report of a material acquisition or disposition of assets: (a) Date of the transaction; (b) Manner of acquisition or disposition; (c) Description of the assets involved; (d) Nature and amount of the consideration given or received; (e) Purpose of or reason for the transaction; (f) Manner by which the amount of consideration was determined; (g) Gain or loss recognized or realized as a result of the transaction; and (h) Names of the persons from whom the assets were acquired or to whom they were disposed. (2) Certified health plans are required to report material acquisitions and dispositions on a nonconsolidated basis unless the certified health plan is part of a consolidated group of insurers that utilizes a pooling arrangement or one hundred percent reinsurance agreement that affects the solvency and integrity of the certified health plan's reserves and such certified health plan ceded substantially all of its direct and assumed business to the pool. A certified health plan has ceded substantially all of its direct and assumed business to a pool if the certified health plan has less than one million dollars total direct plus assumed written premiums during a calendar year that are not subject to a pooling arrangement and the net income of the business not subject to the pooling arrangement represents less than five percent of the certified health plan's net worth.
RCW 48.10.120 — Washington Code / Title 48 / Chapter 10 / Section 120
RCW 48.10.120: Power of attorney.
Status: reserved

(1) The rights and powers of the attorney of a reciprocal insurer shall be as provided in the power of attorney given it by the subscribers. (2) The power of attorney must set forth: (a) The powers of the attorney; (b) that the attorney is empowered to accept service of process on behalf of the insurer and to authorize the commissioner to receive service of process in actions against the insurer upon contracts exchanged; (c) the services to be performed by the attorney in general; (d) the maximum amount to be deducted from advance premiums or deposits to be paid to the attorney; (e) except as to nonassessable policies, a provision for a contingent several liability of each subscriber in a specified amount which amount shall be not less than one nor more than ten times the premium or premium deposit stated in the policy. (3) The power of attorney may: (a) Provide for the right of substitution of the attorney and revocation of the power of attorney and rights thereunder; (b) impose such restrictions upon the exercise of the power as are agreed upon by the subscribers; (c) provide for the exercise of any right reserved to the subscribers directly or through their advisory committee; (d) contain other lawful provisions deemed advisable. (4) The terms of any power of attorney or agreement collateral thereto shall be reasonable and equitable, and no such power or agreement or any amendment thereof, shall be used or be effective in this state until approved by the commissioner.
RCW 48.43.009 — Washington Code / Title 48 / Chapter 43 / Section 009
RCW 48.43.009: Health care sharing ministries.
Status: in_force

Health care sharing ministries are not health carriers as defined in RCW 48.43.005 or insurers as defined in RCW 48.01.050 . For purposes of this section, "health care sharing ministry" has the same meaning as in 26 U.S.C. Sec. 5000A.
RCW 48.39.020 — Washington Code / Title 48 / Chapter 39 / Section 020
RCW 48.39.020: Payor may require provider to extend payor's medicaid rates—Limitations.
Status: in_force

A payor may require a health care provider to extend the payor's medicaid rates, or some percentage above the payor's medicaid rates, that govern a health benefit program administered by a public purchaser to a commercial plan or line of business offered by a payor that is not administered by a public purchaser only if the health care provider has expressly agreed in writing to the extension. For the purposes of this section, "administered by a public purchaser" does not include commercial coverage offered through the Washington health benefit exchange. Nothing in this section prohibits a payor from utilizing medicaid rates, or some percentage above medicaid rates, as a base when negotiating payment rates with a health care provider.
RCW 48.83.060 — Washington Code / Title 48 / Chapter 83 / Section 060
RCW 48.83.060: Right to return policy or certificate—Refund.
Status: in_force

(1) Long-term care insurance applicants may return a policy or certificate for any reason within thirty days after its delivery and to have the premium refunded. (2) All long-term care insurance policies and certificates shall have a notice prominently printed on or attached to the first page of the policy stating that the applicant may return the policy or certificate within thirty days after its delivery and to have the premium refunded. (3) Refunds or denials of applications must be made within thirty days of the return or denial. (4) This section shall not apply to certificates issued pursuant to a policy issued to a group defined in RCW 48.83.020 (6)(a).
RCW 48.31.240 — Washington Code / Title 48 / Chapter 31 / Section 240
RCW 48.31.240: Borrowing on pledge of assets.
Status: in_force

For the purpose of facilitating the rehabilitation, liquidation, conservation or dissolution of an insurer pursuant to this chapter the commissioner may, subject to the approval of the court, borrow money and execute, acknowledge and deliver notes or other evidences of indebtedness therefor and secure the repayment of the same by the mortgage, pledge, assignment, transfer in trust, or hypothecation of any or all of the property whether real, personal or mixed of such insurer, and the commissioner, subject to the approval of the court, shall have power to take any and all other action necessary and proper to consummate any such loans and to provide for the repayment thereof. The commissioner shall be under no obligation personally or in his or her official capacity as commissioner to repay any loan made pursuant to this section.
RCW 48.155.060 — Washington Code / Title 48 / Chapter 155 / Section 060
RCW 48.155.060: Charges and fees—When writing is required—Cancellation.
Status: in_force

(1) A discount plan organization may charge a periodic charge as well as a reasonable one-time processing fee of no more than thirty dollars for a discount plan, or such other amount as established by rule, but may not require payment of these or any other charges or fees by direct debit from a banking, credit, or debit card account unless that method of payment is clearly and conspicuously disclosed to the prospective member. All charges and fees must be provided in writing to the member when the member first joins the plan. (2) When a marketer or discount plan organization solicits a discount plan in conjunction with any other product, all charges that a member or prospective member must pay for each discount plan must be provided in writing as a separate item to the member or prospective member, unless the entire amount of the periodic charge which includes the periodic discount plan charge will be refunded if the member cancels his or her membership in the discount plan organization within the first thirty days after the date of receipt of the written documents for the discount plan as provided in subsection (3) of this section. (3)(a)(i) If a member cancels his or her membership in the discount plan organization within the first thirty days after the date of receipt of the written documents for the discount plan described in RCW 48.155.090 (4), the member must receive a reimbursement of all periodic charges upon return of the discount plan card to the discount plan organization. (ii)(A) Cancellation occurs when notice of cancellation is given to the discount plan organization. (B) Notice of cancellation is given when delivered by hand or deposited in a mailbox, properly addressed and postage prepaid to the mailing address of the discount plan organization, or emailed to the email address of the discount plan organization. (iii) A discount plan organization shall return in full any periodic charge charged or collected after the member has given the discount plan organization notice of cancellation. (b) If the discount plan organization cancels a membership for any reason other than nonpayment of charges by the member, the discount plan organization shall make a pro rata reimbursement of all periodic charges to the member.
RCW 48.22.085 — Washington Code / Title 48 / Chapter 22 / Section 085
RCW 48.22.085: Automobile liability insurance policy—Optional coverage for personal injury protection—Rejection by insured.
Status: in_force

(1) No new automobile liability insurance policy or renewal of such an existing policy may be issued unless personal injury protection coverage is offered as an optional coverage. (2) A named insured may reject, in writing, personal injury protection coverage and the requirements of subsection (1) of this section shall not apply. If a named insured rejects personal injury protection coverage: (a) That rejection is valid and binding as to all levels of coverage and on all persons who might have otherwise been insured under such coverage; and (b) The insurer is not required to include personal injury protection coverage in any supplemental, renewal, or replacement policy unless a named insured subsequently requests such coverage in writing. (3) The coverage under this section may be excluded as provided for under *RCW 48.177.010 (6).
RCW 48.29.193 — Washington Code / Title 48 / Chapter 29 / Section 193
RCW 48.29.193: Escrow services—Schedule of fees filed with commissioner.
Status: in_force

(1) Each title insurer and title insurance agent shall immediately file with the commissioner a schedule of its fees for providing escrow services. (2) The schedule shall: (a) Be dated to show the date the fees for providing escrow services are to become effective, which date shall be no earlier than fifteen days after the schedule has been filed with the commissioner; and (b) Set forth the total fees for providing escrow services by clearly stating the amounts to be charged for the escrow services, the manner in which the fees for the escrow services are to be determined, and any charges that will be charged to the consumer that are not included in the total escrow fee.
RCW 48.13.465 — Washington Code / Title 48 / Chapter 13 / Section 465
RCW 48.13.465: Safeguarding securities—Requirement to receive a confirmation.
Status: in_force

A domestic insurance company using the methods of holding securities under RCW 48.13.460 (2) or (3) is required to receive a confirmation from: (1) The custodian whenever securities are received or surrendered pursuant to the domestic insurance company's instructions to a securities broker; or (2) The securities broker provided that the domestic insurance company has given the custodian and the securities broker matching instructions authorizing the transaction, which have been confirmed by the custodian prior to surrendering funds or securities to conduct the transaction.
RCW 48.10.090 — Washington Code / Title 48 / Chapter 10 / Section 090
RCW 48.10.090: Organization of reciprocal.
Status: in_force

(1) Twenty-five or more persons domiciled in this state may organize a domestic reciprocal insurer and in compliance with this code make application to the commissioner for a certificate of authority to transact insurance. (2) When applying for a certificate of authority, the original subscribers and the proposed attorney shall fulfill the requirements of and shall execute and file with the commissioner a declaration setting forth: (a) the name of the insurer; (b) the location of the insurer's principal office, which shall be the same as that of the attorney and shall be maintained within this state; (c) the kinds of insurance proposed to be transacted; (d) the names and addresses of the original subscribers; (e) the designation and appointment of the proposed attorney and a copy of the power of attorney; (f) the names and addresses of the officers and directors of the attorney, if a corporation, or of its members, if a firm; (g) the powers of the subscribers' advisory committee and the names and terms of office of the members thereof; (h) that all moneys paid to the reciprocal, after deducting therefrom any sum payable to the attorney, shall be held in the name of the insurer and for the purposes specified in the subscriber's agreement; (i) a copy of the subscriber's agreement; (j) a statement that each of the original subscribers has in good faith applied for insurance of the kind proposed to be transacted, and that the insurer has received from each such subscriber the full premium or premium deposit required for the policy applied for, for a term of not less than six months at the rate theretofore filed with and approved by the commissioner; (k) a statement of the financial condition of the insurer, a schedule of its assets, and a statement that the surplus as required by RCW 48.10.070 is on hand; (l) a copy of each policy, endorsement, and application form it then proposes to issue or use. Such declaration shall be acknowledged by each such subscriber and by the attorney in the manner required for the acknowledgment of deeds to real estate.
RCW 48.180.010 — Washington Code / Title 48 / Chapter 180 / Section 010
RCW 48.180.010: Definitions.
Status: in_force

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise. (1) "Nonprofit corporation" or "corporation" has the same meaning as defined in RCW 24.03A.010 . (2) "Property and liability risks" includes the risk of property damage or loss sustained by a nonprofit corporation and the risk of claims arising from the tortious or negligent conduct or any error or omission of the entity, its officers, employees, agents, or volunteers as a result of a claim that may be made against the entity. (3) "Self-insurance" means a formal program of advance funding and management of entity financial exposure to a risk of loss that is not transferred through the purchase of an insurance policy or contract. (4) "State risk manager" means the risk manager of the office of risk management within the department of enterprise services.
RCW 48.23A.090 — Washington Code / Title 48 / Chapter 23A / Section 090
RCW 48.23A.090: Violations—RCW 48.30.010(1).
Status: in_force

In addition to any other penalties provided by law, an insurer or producer that violates a requirement of this chapter is guilty of a violation of RCW 48.30.010 (1).
RCW 48.18.370 — Washington Code / Title 48 / Chapter 18 / Section 370
RCW 48.18.370: Payment discharges insurer—Life and disability.
Status: in_force

Whenever the proceeds of, or payments under a life or disability insurance policy, heretofore or hereafter issued, become payable and the insurer makes payment thereof in accordance with the terms of the policy, or in accordance with any written assignment thereof pursuant to RCW 48.18.360 , the person then designated in the policy or by such assignment as being entitled thereto, shall be entitled to receive such proceeds or payments and to give full acquittance therefor, and such payment shall fully discharge the insurer from all claims under the policy unless, before payment is made, the insurer has received at its home office, written notice by or on behalf of some other person that such other person claims to be entitled to such payment or some interest in the policy.
RCW 48.92.070 — Washington Code / Title 48 / Chapter 92 / Section 070
RCW 48.92.070: Purchasing groups—Exempt from certain laws.
Status: in_force

A purchasing group and its insurer or insurers are subject to all applicable laws of this state, except that a purchasing group and its insurer or insurers are exempt, in regard to liability insurance for the purchasing group, from any law that: (1) Prohibits the establishment of a purchasing group; (2) Makes it unlawful for an insurer to provide or offer to provide insurance on a basis providing, to a purchasing group or its members, advantages based on their loss and expense experience not afforded to other persons with respect to rates, policy forms, coverages, or other matters; (3) Prohibits a purchasing group or its members from purchasing insurance on a group basis described in subsection (2) of this section; (4) Prohibits a purchasing group from obtaining insurance on a group basis because the group has not been in existence for a minimum period of time or because any member has not belonged to the group for a minimum period of time; (5) Requires that a purchasing group must have a minimum number of members, common ownership or affiliation, or certain legal form; (6) Requires that a certain percentage of a purchasing group must obtain insurance on a group basis; (7) Otherwise discriminates against a purchasing group or any of its members.
RCW 48.25.160 — Washington Code / Title 48 / Chapter 25 / Section 160
RCW 48.25.160: Facility of payment clause.
Status: in_force

Such a policy may also provide that if the beneficiary designated in the policy does not surrender the policy with due proof of death within the period stated in the policy, which shall not be less than thirty days after the death of the insured, or if the beneficiary is the estate of the insured or is a minor, or dies before the insured or is not legally competent to give a valid release, then the insurer may make payment thereunder to the executor or administrator of the insured, or to any of the insured's relatives by blood or legal adoption or connection by marriage, or to any person appearing to the insurer to be equitably entitled thereto by reason of having been named beneficiary, or by reason of having incurred expense for the maintenance, medical attention or burial of the insured. Such policy may also include a similar provision applicable to any other payment due under the policy.
RCW 48.31.420 — Washington Code / Title 48 / Chapter 31 / Section 420
RCW 48.31.420: Administrative supervision—No limitation on judicial proceedings.
Status: in_force

RCW 48.31.020 , 48.31.115 , 48.31.400 through 48.31.415 , 48.31.425 , and 48.31.435 do not preclude the commissioner from initiating judicial proceedings to place an insurer in rehabilitation or liquidation proceedings or other delinquency proceedings, however designated under the laws of this state, regardless of whether the commissioner has previously initiated administrative supervision proceedings under this chapter against the insurer.
RCW 48.97.901 — Washington Code / Title 48 / Chapter 97 / Section 901
RCW 48.97.901: Severability—Implementation—1993 c 462.
Status: in_force

See RCW 48.31B.901 and 48.31B.902 .
RCW 48.05.120 — Washington Code / Title 48 / Chapter 05 / Section 120
RCW 48.05.120: Certificate of authority—Duration, renewal, amendment.
Status: in_force

(1) All certificates of authority shall continue in force until suspended, revoked, or not renewed. A certificate shall be subject to renewal annually on the first day of July upon application of the insurer and payment of the fee therefor. If not so renewed, the certificate shall expire as of the thirtieth day of June next preceding. (2) The commissioner may amend a certificate of authority at any time in accordance with changes in the insurer's charter or insuring powers.(1) Subject to the availability of funds appropriated for this specific purpose, except where inconsistent with federal law or regulations applicable to federal benefit programs, agencies shall amend their rules to reflect the intent of the legislature to ensure that all privileges, immunities, rights, benefits, or responsibilities granted or imposed by statute to an individual because that individual is or was a spouse in a marital relationship are granted or imposed on equivalent terms to an individual because that individual is or was in a state registered domestic partnership. (2) Except where inconsistent with federal law or regulations applicable to federal benefit programs, all agency orders creating new rules, or amending existing rules, shall be formulated to reflect the intent stated in subsection (1) of this section. (3) No agency rule is invalid because it does not comply with this section.
RCW 48.23.110 — Washington Code / Title 48 / Chapter 23 / Section 110
RCW 48.23.110: Table of installments.
Status: in_force

If the policy provides for payment of its proceeds in installments or as an annuity, a table showing the amount and period of such installments or annuity shall be included in the policy. Except, that if in the judgment of the commissioner it is not practical to include certain tables in the policy, the requirements of this section may be met as to such policy by the insurer filing such tables with the commissioner.
RCW 48.02.160 — Washington Code / Title 48 / Chapter 02 / Section 160
RCW 48.02.160: Special duties.
Status: in_force

The commissioner shall: (1) Obtain and publish for the use of courts and appraisers throughout the state, tables showing the average expectancy of life and values of annuities and of life and term estates. (2) Disseminate information concerning the insurance laws of this state. (3) Provide assistance to members of the public in obtaining information about insurance products and in resolving complaints involving insurers and other licensees.
RCW 48.12.470 — Washington Code / Title 48 / Chapter 12 / Section 470
RCW 48.12.470: Credit for reinsurance—Accounting or financial statement—After December 31, 1996.
Status: in_force

Credit for reinsurance, as either an asset or a deduction, is prohibited in an accounting or financial statement of the ceding insurer in respect to the reinsurance contract unless, in such contract, the reinsurer undertakes to indemnify the ceding insurer against all or a part of the loss or liability arising out of the original insurance. This section only applies to those reinsurance contracts entered into after December 31, 1996.
RCW 48.21A.050 — Washington Code / Title 48 / Chapter 21A / Section 050
RCW 48.21A.050: Powers and duties of associations.
Status: in_force

Any association formed for the purposes of this chapter may hold title to property, may enter into contracts, and may limit the liability of its members to their respective pro rata shares of the liability of such association. Any such association may sue and be sued in its associate name and for such purpose only shall be treated as a domestic corporation. Service of process against such association, made upon a managing agent, any member thereof or any agent authorized by appointment to receive service of process, shall have the same force and effect as if such service had been made upon all members of the association. Such association's books and records shall also be subject to examination under the provisions of RCW 48.03.010 through 48.03.070 , inclusive, either separately or concurrently with examination of any of its member insurers.
RCW 48.19.250 — Washington Code / Title 48 / Chapter 19 / Section 250
RCW 48.19.250: Cooperative activities.
Status: in_force

(1) Cooperation among rating organizations or among rating organizations and insurers in rate making or in other matters within the scope of this chapter is hereby authorized, if the filings resulting from such cooperation are subject to all the provisions of this chapter which are applicable to filings generally. (2) The commissioner may review such cooperative activities and practices and if, after a hearing, he or she finds that any such activity or practice is unfair or unreasonable or otherwise inconsistent with the provisions of this code, he or she may issue a written order specifying in what respect such activity or practice is so unfair, unreasonable, or inconsistent, and requiring the discontinuance of such activity or practice.
RCW 48.46.070 — Washington Code / Title 48 / Chapter 46 / Section 070
RCW 48.46.070: Governing body.
Status: in_force

(1) The members of the governing body of a health maintenance organization shall be nominated by the voting members or by the enrolled participants and providers, and shall be elected by the enrolled participants or voting members pursuant to the provisions of their bylaws, which shall not be restricted to providers. At least one-third of such body shall consist of consumers who are substantially representative of the enrolled population of such organization: PROVIDED, HOWEVER, That any organization that is a qualified health maintenance organization under P.L. 93-222 (Title XIII, section 1310(d) of the public health services [service] act) is deemed to have satisfied these governing body requirements and the requirements of RCW 48.46.030 (2). (2) For health maintenance organizations formed by public institutions of higher education or public hospital districts, the governing body shall be advised by an advisory board consisting of at least two-thirds consumers who are elected by the voting members or the enrolled participants and are substantially representative of the enrolled population.
RCW 48.46.340 — Washington Code / Title 48 / Chapter 46 / Section 340
RCW 48.46.340: Return of agreement within ten days.
Status: in_force

Every subscriber of an individual health maintenance agreement may return the agreement to the health maintenance organization or the insurance producer through whom it was purchased within ten days of its delivery to the subscriber if, after examination of the agreement, the subscriber is not satisfied with it for any reason. The health maintenance organization shall refund promptly any fee paid for the agreement. Upon such return of the agreement, it shall be void from the beginning and the parties shall be in the same position as if no agreement had been issued. Notice of the substance of this section shall be printed on the face of each such agreement or be attached thereto.
RCW 48.41.050 — Washington Code / Title 48 / Chapter 41 / Section 050
RCW 48.41.050: Operation plan—Contents.
Status: in_force

The plan of operation submitted by the board to the commissioner shall: (1) Establish procedures for the handling and accounting of assets and moneys of the pool; (2) Establish regular times and places for meetings of the board of directors; (3) Establish procedures for records to be kept of all financial transactions and for an annual fiscal reporting to the commissioner; (4) Contain additional provisions necessary and proper for the execution of the powers and duties of the pool; (5) Establish procedures for the collection of assessments from all members to provide for claims paid under the plan and for administrative expenses incurred or estimated to be incurred during the period for which the assessment is made; (6) Establish the amount of assessment pursuant to RCW 48.41.060 , which shall occur after March 1st of each calendar year, and which shall be due and payable within thirty days of the receipt of the assessment notice; (7) Select an administrator in accordance with RCW 48.41.080 ; (8) Develop and implement a program to publicize the existence of the plan, the eligibility requirements and procedures for enrollment, and to maintain public awareness of the plan; and (9) Establish procedures under which applicants and participants may have grievances reviewed by an impartial body and reported to the board.
RCW 48.21A.010 — Washington Code / Title 48 / Chapter 21A / Section 010
RCW 48.21A.010: Declaration of purpose.
Status: in_force

It is the purpose of this chapter to provide a means of more adequately meeting the needs of persons who are sixty-five years of age or older and their spouses for insurance coverage against financial loss from accident or disease through the combined resources and experience of a number of insurers; to make possible the fullest extension of such coverage by encouraging insurers to combine their resources and experience and to exercise their collective efforts in the development and offering of policies of such insurance to all applicants; and to regulate the joint activities herein authorized in accordance with the intent of Congress as expressed in the Act of Congress of March 9, 1945 (Public Law 15, 79th Congress), as amended.
RCW 48.74.026 — Washington Code / Title 48 / Chapter 74 / Section 026
RCW 48.74.026: Confidentiality of material submitted under RCW 48.74.025.
Status: in_force

(1)(a) The opinion and memorandum in support of the opinion submitted to the commissioner under RCW 48.74.025 are confidential and privileged, are exempt from disclosure pursuant to chapter 42.56 RCW, are not subject to subpoena, and are not subject to discovery or admissible in evidence in any private civil action, only if and to the extent that the opinion and memorandum supporting the opinion independently qualify for exemption from disclosure as documents, materials, or information in the possession of the commissioner pursuant to a financial conduct examination. (b) If independently qualifying for exemption from disclosure, as provided in (a) of this subsection, the provisions of RCW 48.02.065 apply to the opinion and memorandum in support of the opinion to the same extent as documents, materials, and information in possession of the commissioner pursuant to a financial conduct examination. (2) In addition to the provisions of RCW 48.02.065 , (a) through (c) of this subsection apply to the opinion and memorandum in support of the opinion submitted to the commissioner under RCW 48.74.025 . (a) A memorandum in support of the opinion, and any other material provided by the company to the commissioner in connection with the memorandum, may be subject to subpoena for the purpose of defending an action seeking damages from the actuary submitting the memorandum by reason of an action required by this section or by rules adopted under this section. (b) A memorandum or other material may otherwise be released by the commissioner with the written consent of the company or to the American academy of actuaries upon request stating that the memorandum or other material is required for the purpose of professional disciplinary proceedings and setting forth procedures satisfactory to the commissioner for preserving the confidentiality of the memorandum or other material. (c) Once any portion of the confidential memorandum is cited by the company in its marketing or is cited before a governmental agency other than a state insurance department or is released by the company to the news media, all portions of the confidential memorandum are no longer confidential. (3) Included in those agencies or organizations with which the commissioner may share the opinion and memorandum in support of the opinion, as provided in this section and RCW 48.02.065 , is the office of the attorney general for purposes of investigating any consumer protection or antitrust action.
RCW 48.17.063 — Washington Code / Title 48 / Chapter 17 / Section 063
RCW 48.17.063: Unlicensed activities—Acts committed in this state—Sanctions.
Status: in_force

(1) 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 an insurance contract, health care services contract, or health maintenance agreement. (2) Any person who knowingly violates RCW 48.17.060 is guilty of a class B felony punishable under chapter 9A.20 RCW. (3) 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. (4)(a) If the commissioner has cause to believe that any person has violated the provisions of RCW 48.17.060 , the commissioner may: (i) Issue and enforce a cease and desist order in accordance with the provisions of RCW 48.02.080 ; (ii) Suspend or revoke a license; and/or (iii) 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 48.43.605 — Washington Code / Title 48 / Chapter 43 / Section 605
RCW 48.43.605: Overpayment recovery—Health care provider.
Status: in_force

(1) Except in the case of fraud, or as provided in subsection (2) of this section, a health care provider may not: (a) Request additional payment from a carrier to satisfy a claim unless he or she does so in writing to the carrier within twenty-four months after the date that the claim was denied or payment intended to satisfy the claim was made; or (b) request that the additional payment be made any sooner than six months after receipt of the request. Any such request must specify why the provider believes the carrier owes the additional payment. (2) A health care provider may not, if doing so for reasons related to coordination of benefits with another carrier or entity responsible for payment of a claim: (a) Request additional payment from a carrier to satisfy a claim unless he or she does so in writing to the carrier within thirty months after the date the claim was denied or payment intended to satisfy the claim was made; or (b) request that the additional payment be made any sooner than six months after receipt of the request. Any such request must specify why the provider believes the carrier owes the additional payment, and include the name and mailing address of any entity that has disclaimed responsibility for payment of the claim. (3) If a contract between a carrier and a health care provider conflicts with this section, this section shall prevail. However, nothing in this section prohibits a carrier from choosing at any time to make additional payments to a provider to satisfy a claim. (4) This section does not apply to claims for health care services provided through dental only health carriers, health care services provided under Title XVIII (medicare) of the social security act, or medicare supplemental plans regulated under chapter 48.66 RCW.
RCW 48.125.110 — Washington Code / Title 48 / Chapter 125 / Section 110
RCW 48.125.110: Certificate of authority—Failure to obtain.
Status: in_force

A self-funded multiple employer welfare arrangement organized, operated, providing benefits, or maintained in this state without a certificate of authority is in violation of this title.
RCW 48.43.076 — Washington Code / Title 48 / Chapter 43 / Section 076
RCW 48.43.076: Digital breast examinations—Cost sharing.
Status: in_force

(1) Except as provided in subsection (2) of this section, for nongrandfathered health plans issued or renewed on or after January 1, 2024, that include coverage of supplemental breast examinations and diagnostic breast examinations, health carriers may not impose cost sharing for such examinations. (2) For a health plan that provides coverage of supplemental breast examinations and diagnostic breast examinations and is offered as a qualifying health plan for a health savings account, the health carrier shall establish the plan's cost sharing for the coverage of the services described in this section at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions from their health savings account under internal revenue service laws and regulations. (3) For purposes of this section: (a) "Diagnostic breast examination" means a medically necessary and appropriate examination of the breast, including an examination using diagnostic mammography, digital breast tomosynthesis, also called three dimensional mammography, breast magnetic resonance imaging, or breast ultrasound, that is used to evaluate an abnormality: (i) Seen or suspected from a screening examination for breast cancer; or (ii) Detected by another means of examination. (b) "Supplemental breast examination" means a medically necessary and appropriate examination of the breast, including an examination using breast magnetic resonance imaging or breast ultrasound, that is: (i) Used to screen for breast cancer when there is no abnormality seen or suspected; and (ii) Based on personal or family medical history, or additional factors that may increase the individual's risk of breast cancer.
RCW 48.05.105 — Washington Code / Title 48 / Chapter 05 / Section 105
RCW 48.05.105: Foreign or alien insurers—Three years active transacting required—Exception.
Status: in_force

(1) No certificate of authority shall be granted to a foreign or alien applicant that has not actively transacted for three years the classes of insurance for which it seeks to be admitted. (2) Subsection (1) of this section does not apply to the following: (a) Any subsidiary of a seasoned, reputable insurer that has held a certificate of authority in this state for at least three years; or (b) Any applicant that: (i) Has surplus of not less than twenty-five million dollars; and (ii) Has made a deposit with the commissioner in the amount of one million dollars for the sole benefit of the applicant's Washington policyholders. (3) The commissioner shall release the deposit to an authorized insurer who originally met the requirement in subsection (2)(b)(ii) of this section, in accordance with chapter 48.16 RCW, if: (a) The certificate of authority was issued at least three years prior to application for release of the deposit; and (b) The insurer is in good standing with the commissioner.
RCW 48.18.350 — Washington Code / Title 48 / Chapter 18 / Section 350
RCW 48.18.350: Breach of warranty prior to loss—Effect.
Status: in_force

If any breach of a warranty or condition in any insurance contract occurs prior to a loss under the contract, such breach shall not avoid the contract nor avail the insurer to avoid liability, unless the breach exists at the time of the loss.
RCW 48.10.230 — Washington Code / Title 48 / Chapter 10 / Section 230
RCW 48.10.230: Subscribers' advisory committee.
Status: in_force

(1) The advisory committee of a domestic reciprocal insurer exercising the subscribers' rights shall be selected under such rules as the subscribers adopt. (2) Not less than three-fourths of such committee shall be composed of subscribers other than the attorney, or any person employed by, representing, or having a financial interest in the attorney. (3) The committee shall: (a) Supervise the finances of the insurer; (b) supervise the insurer's operations to such extent as to assure their conformity with the subscribers' agreement and power of attorney; (c) procure the audit of the accounts and records of the insurer and of the attorney at the expense of the insurer; (d) have such additional powers and functions as may be conferred by the subscribers' agreement.
RCW 48.18A.035 — Washington Code / Title 48 / Chapter 18A / Section 035
RCW 48.18A.035: Return of policy and refund of premium—Notice required—Effect of return.
Status: in_force

Every individual variable contract issued shall have printed on its face or attached thereto a notice stating in substance that the policy owner shall be permitted to return the policy within ten days after it is received by the policy owner and to have the market value of the assets purchased by its premium, less taxes and investment brokerage commissions, if any, refunded, if, after examination of the policy, the policy owner is not satisfied with it for any reason. An additional ten percent penalty shall be added to any premium refund due which is not paid within thirty days of return of the policy to the insurer or insurance producer. If a policy owner pursuant to such notice returns the policy to the insurer at its home or branch office or to the insurance producer through whom it was purchased, it shall be void from the beginning and the parties shall be in the same position as if no policy had been issued.
RCW 48.25.900 — Washington Code / Title 48 / Chapter 25 / Section 900
RCW 48.25.900: 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 48.11.040 — Washington Code / Title 48 / Chapter 11 / Section 040
RCW 48.11.040: "Property insurance" defined.
Status: in_force

"Property insurance" is insurance against loss of or damage to real or personal property of every kind and any interest therein, from any or all hazard or cause, and against loss consequential upon such loss or damage.
RCW 48.23.270 — Washington Code / Title 48 / Chapter 23 / Section 270
RCW 48.23.270: Incontestability after reinstatement.
Status: in_force

The reinstatement of any policy of life insurance or contract of annuity hereafter delivered or issued for delivery in this state may be contestable on account of fraud or misrepresentation of facts material to the reinstatement only for the same period following reinstatement as the policy provides with respect to contestability after original issuance.
RCW 48.25.180 — Washington Code / Title 48 / Chapter 25 / Section 180
RCW 48.25.180: Conversion—Weekly premium policies.
Status: in_force

There shall be a provision in the case of weekly premium policies granting, upon proper written request and upon presentation of evidence of the insurability of the insured satisfactory to the insurer, the privilege of converting his or her weekly premium industrial insurance to any form of life insurance with less frequent premium payments regularly issued by the insurer, in accordance with terms and conditions agreed upon with the insurer. The privilege of making such conversion need be granted only if the insurer's weekly premium industrial policies on the life insured, in force as premium paying insurance and on which conversion is requested, grant benefits in event of death, exclusive of additional accidental death benefits and exclusive of any dividend additions, in an amount not less than the minimum amount of such insurance with less frequent premium payments issued by the insurer at the age of the insured on the plan of industrial or ordinary insurance desired.
RCW 48.24.110 — Washington Code / Title 48 / Chapter 24 / Section 110
RCW 48.24.110: Grace period.
Status: in_force

There shall be a provision that the policyholder is entitled to a grace period of thirty-one days for the payment of any premium due except the first, during which grace period the death benefit coverage shall continue in force, unless the policyholder has given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during such grace period.
RCW 48.20.500 — Washington Code / Title 48 / Chapter 20 / Section 500
RCW 48.20.500: Coverage for adopted children.
Status: in_force

(1) Any disability insurance contract providing hospital and medical expenses and health care services, delivered or issued for delivery in this state, which provides coverage for dependent children, as defined in the contract of the insured, shall cover adoptive children placed with the insured 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 contract may require that notification of placement of a child for adoption and payment of the required premium must be furnished to the insurer. The notification period shall be no less than sixty days from the date of placement.
RCW 48.02.180 — Washington Code / Title 48 / Chapter 02 / Section 180
RCW 48.02.180: Publication of insurance code and related statutes, manuals, etc.—Distribution—Sale.
Status: in_force

(1) The commissioner may periodically prepare and publish: (a) Title 48 RCW, Title 284 WAC, insurance bulletins and technical assistance advisories, and other laws, rules, or regulations relevant to the regulation of insurance; (b) Manuals and other material relating to examinations for licensure; and (c) Any other publications authorized under Title 48 RCW. (2) The commissioner may provide copies of the publications referred to in subsection (1)(a) of this section free of charge to: (a) Public offices and officers in this state; (b) Public officials of other states and jurisdictions that regulate insurance; (c) The library of congress; and (d) Officers of the armed forces of the United States of America located at military installations in this state who are concerned with insurance transactions at or involving the military installations. (3) Except as provided in subsection (2) of this section, the commissioner shall sell the publications referred to in subsection (1) of this section. The commissioner may charge a reasonable price that is not less than the cost of publication, handling, and distribution. The commissioner shall promptly deposit all funds received under this subsection with the state treasurer to the credit of the insurance commissioner's regulatory account. For appropriation purposes, the funds received and deposited by the commissioner are a recovery of a previous expenditure.
RCW 48.10.320 — Washington Code / Title 48 / Chapter 10 / Section 320
RCW 48.10.320: Distribution of assets upon liquidation.
Status: in_force

Upon the liquidation of a domestic reciprocal insurer, its assets remaining after discharge of its indebtedness and policy obligations, the return of any contribution of the attorney to its surplus made as provided in RCW 48.10.190 , and the return of any unused deposits, savings, or credits, shall be distributed to its subscribers who were such within the twelve months prior to the last termination of its certificate of authority according to such formula as may have been approved by the commissioner.
RCW 48.23.380 — Washington Code / Title 48 / Chapter 23 / Section 380
RCW 48.23.380: Return of policy and refund of premium—Grace period—Notice—Effect.
Status: in_force

(1) Every individual life insurance policy issued after September 1, 1977, shall have printed on its face or attached thereto a notice stating in substance that the policy owner shall be permitted to return the policy within ten days after it is received by the policy owner and to have the premium paid refunded if, after examination of the policy, the policy owner is not satisfied with it for any reason. An additional ten percent penalty shall be added to any premium refund due which is not paid within thirty days of return of the policy to the insurer or insurance producer. If a policy owner pursuant to such notice, returns the policy to the insurer at its home or branch office or to the insurance producer through whom it was purchased, it shall be void from the beginning and the parties shall be in the same position as if no policy had been issued. (2) This section shall not apply to individual life insurance policies issued in connection with a credit transaction or issued under a contractual policy change or conversion privilege provision contained in a policy. (3) No later than January 1, 2010, or when the insurer has used all of its existing paper individual life insurance policy forms which were in its possession on July 1, 2009, whichever is earlier, the notice required by subsection (1) of this section shall use the term insurance producer in place of agent.
RCW 48.185.010 — Washington Code / Title 48 / Chapter 185 / Section 010
RCW 48.185.010: Certain property and casualty insurance information—May be mailed, delivered, or posted on website—Requirements to post on website.
Status: in_force

(1) Notwithstanding any other provisions of this chapter, standard property and casualty insurance policy forms and endorsements that do not contain personally identifiable information may be mailed, delivered, or posted on the insurer's website. If the insurer elects to post insurance policy forms and endorsements on its website in lieu of mailing or delivering them to the insured, it must comply with all of the following conditions: (a) The policy forms and endorsements must be accessible to the insured and the producer of record and remain that way for as long as the policy is in force; (b) After the expiration of the policy, the insurer must archive its expired policy forms and endorsements for a period of six years or other period required by law, and make them available upon request; (c) The policy forms and endorsements must be posted in a manner that enables the insured and producer of record to print and save the policy form and endorsements using programs or applications that are widely available on the internet and free to use; (d) The insurer must provide the following information in, or simultaneous with, each declarations page provided at the time of issuance of the initial policy and any renewals of that policy: (i) A description of the exact policy and endorsement forms purchased by the insured; (ii) A description of the insured's right to receive, upon request and without charge, a paper copy of the policy and endorsements by mail; (iii) The internet address where their policy and endorsements are posted; (iv) The insurer, upon request and without charge, mails a paper copy of the insured's policy and endorsements to the insured; and (v) Notice, in the manner in which the insurer customarily communicates with the insured, of any changes to the forms or endorsements, the insured's right to obtain, upon request and without charge, a paper copy of such forms or endorsements, and the internet address where such forms or endorsements are posted. (2) Nothing in this section affects the timing or content of any disclosure or other document required to be provided or made available to any insured under applicable law.
RCW 48.44.037 — Washington Code / Title 48 / Chapter 44 / Section 037
RCW 48.44.037: Minimum net worth—Requirement to maintain—Determination of amount.
Status: in_force

(1) Except as provided in subsection (2) of this section, every health care service contractor must have and maintain a minimum net worth equal to the greater of: (a) Three million dollars; or (b) Two percent of the annual premium earned, as reported on the most recent annual financial statement filed with the commissioner, on the first one hundred fifty million dollars of premium and one percent of the annual premium on the premium in excess of one hundred fifty million dollars. (2) A health care service contractor registered before July 27, 1997, that, on July 27, 1997, has a minimum net worth equal to or greater than that required by subsection (1) of this section must continue to have and maintain the minimum net worth required by subsection (1) of this section. A health care service contractor registered before July 27, 1997, that, on July 27, 1997, does not have the minimum net worth required by subsection (1) of this section must have and maintain a minimum net worth of: (a) The amount required immediately prior to July 27, 1997, until December 31, 1997; (b) Fifty percent of the amount required by subsection (1) of this section by December 31, 1997; (c) Seventy-five percent of the amount required by subsection (1) of this section by December 31, 1998; and (d) One hundred percent of the amount required by subsection (1) of this section by December 31, 1999. (3)(a) In determining net worth, no debt shall be considered fully subordinated unless the subordination is in a form acceptable to the commissioner. An interest obligation relating to the repayment of a subordinated debt must be similarly subordinated. (b) The interest expenses relating to the repayment of a fully subordinated debt shall not be considered uncovered expenditures. (c) A subordinated debt incurred by a note meeting the requirement of this section, and otherwise acceptable to the commissioner, shall not be considered a liability and shall be recorded as equity. (4) Every health care service contractor shall, when determining liabilities, include an amount estimated in the aggregate to provide for any unearned premium and for the payment of all claims for health care expenditures which have been incurred, whether reported or unreported, which are unpaid and for which the organization is or may be liable, and to provide for the expense of adjustment or settlement of the claims. Liabilities shall be computed in accordance with regulations adopted by the commissioner upon reasonable consideration of the ascertained experience and character of the health care service contractor. (5) All income from reserves on deposit with the commissioner shall belong to the depositing health care service contractor and shall be paid to it as it becomes available. (6) Any funded reserve required by this chapter shall be considered an asset of the health care service contractor in determining the organization's net worth. (7) A health care service contractor that has made a securities deposit with the commissioner may, at its option, withdraw the securities deposit or any part thereof after first having deposited or provided in lieu thereof an approved surety bond, a deposit of cash or securities, or any combination of these or other deposits of equal amount and value to that withdrawn. Any securities and surety bond shall be subject to approval by the commissioner before being substituted.
RCW 48.19.060 — Washington Code / Title 48 / Chapter 19 / Section 060
RCW 48.19.060: Filings—Review, waiting period, disapproval.
Status: in_force

(1) The commissioner shall review a filing as soon as reasonably possible after made, to determine whether it meets the requirements of this chapter. (2) Except as provided in RCW 48.19.070 and 48.19.043 : (a) No such filing shall become effective within thirty days after the date of filing with the commissioner, which period may be extended by the commissioner for an additional period not to exceed fifteen days if he or she gives notice within such waiting period to the insurer or rating organization which made the filing that he or she needs such additional time for the consideration of the filing. The commissioner may, upon application and for cause shown, waive such waiting period or part thereof as to a filing that he or she has not disapproved. (b) A filing shall be deemed to meet the requirements of this chapter unless disapproved by the commissioner within the waiting period or any extension thereof. (3) Medical malpractice insurance rate filings are subject to the provisions of this section.
RCW 48.46.292 — Washington Code / Title 48 / Chapter 46 / Section 292
RCW 48.46.292: Mental health treatment—Waiver of preauthorization for persons involuntarily committed.
Status: in_force

A health maintenance organization providing services or benefits for hospital or medical care coverage in this state shall waive a preauthorization from the health maintenance organization before an enrolled participant or the enrolled participant's covered dependents receive mental health treatment rendered by a state hospital as defined in RCW 72.23.010 if the enrolled participant or the enrolled participant's covered dependents are involuntarily committed to a state hospital as defined in RCW 72.23.010 .
RCW 48.10.110 — Washington Code / Title 48 / Chapter 10 / Section 110
RCW 48.10.110: Certificate of authority.
Status: in_force

(1) The certificate of authority of a reciprocal insurer shall be issued to its attorney in the name of the insurer. (2) The commissioner may refuse, suspend, or revoke the certificate of authority, in addition to other grounds therefor, for failure of its attorney to comply with any provision of this code.
RCW 48.56.090 — Washington Code / Title 48 / Chapter 56 / Section 090
RCW 48.56.090: Service charge.
Status: in_force

(1) A premium finance company shall not charge, contract for, receive, or collect a service charge other than as permitted by this chapter. (2) The service charge is to be computed on the balance of the premiums due (after subtracting the down payment made by the insured in accordance with the premium finance agreement) from the effective date of the insurance coverage, for which the premiums are being advanced, to and including the date when the final installment of the premium finance agreement is payable. (3) The service charge shall be a maximum of ten dollars per one hundred dollars per year plus an acquisition charge of ten dollars per premium finance agreement which need not be refunded upon cancellation or prepayment.
RCW 48.20.393 — Washington Code / Title 48 / Chapter 20 / Section 393
RCW 48.20.393: Mammograms—Insurance coverage.
Status: in_force

Each disability insurance policy issued or renewed after January 1, 1990, that provides coverage for hospital or medical expenses shall provide coverage for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or *advanced registered nurse practitioner as authorized by the state board of nursing pursuant to chapter 18.79 RCW or physician assistant pursuant to chapter 18.71A RCW. This section shall not be construed to prevent the application of standard policy provisions, other than the cost-sharing prohibition provided in RCW 48.43.076 , that are applicable to other benefits. This section does not limit the authority of an insurer to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.
RCW 48.19.280 — Washington Code / Title 48 / Chapter 19 / Section 280
RCW 48.19.280: Deviations.
Status: in_force

(1) Every member or subscriber to a rating organization shall adhere to the filings made on its behalf by such organization. Deviations from the organization's filings are permitted only when filed with the commissioner in accordance with this chapter. (2) Every such deviation shall terminate upon a material change of the basic rate from which the deviation is made. The commissioner shall determine whether a change of the basic rate is so material as to require such termination of deviations.
RCW 48.17.160 — Washington Code / Title 48 / Chapter 17 / Section 160
RCW 48.17.160: Appointment of agents—Approval—Termination—Fees.
Status: in_force

(1) An insurance producer or title insurance agent shall not act as an agent of an insurer unless the insurance producer or title insurance agent becomes an appointed agent of that insurer. An insurance producer who is not acting as an agent of an insurer is not required to become appointed. (2) To appoint an insurance producer or title insurance agent as its agent, the appointing insurer shall file, in a format approved by the commissioner, a notice of appointment within fifteen days from the date the agency contract is executed or the first insurance application is submitted, whichever is earlier. (3) Upon receipt of the notice of appointment, the commissioner shall verify within a reasonable time, not to exceed thirty days, that the insurance producer or title insurance agent is eligible for appointment. If the insurance producer or title insurance agent is determined to be ineligible for appointment, the commissioner shall notify the insurer within ten days of the determination. (4) An insurer shall pay an appointment fee, in the amount and method of payment set forth in RCW 48.14.010 , for each insurance producer or title insurance agent appointed by the insurer. (5) Contingent upon payment of the appointment renewal fee as set forth in RCW 48.14.010 , an appointment shall be effective until terminated by the insurer, insurance producer, or title insurance agent and notice has been given to the commissioner as required by RCW 48.17.595 .
RCW 48.05A.020 — Washington Code / Title 48 / Chapter 05A / Section 020
RCW 48.05A.020: Must conduct an ORSA at least annually.
Status: in_force

Subject to RCW 48.05A.030 , an insurer, or the insurance group of which the insurer is a member, must regularly conduct an ORSA consistent with a process comparable to the ORSA guidance manual. The ORSA must be conducted annually but also at any time when there are significant changes to the risk profile of the insurer or the insurance group of which the insurer is a member.
RCW 48.44.325 — Washington Code / Title 48 / Chapter 44 / Section 325
RCW 48.44.325: Mammograms—Insurance coverage.
Status: in_force

Each health care service contract issued or renewed after January 1, 1990, that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or *advanced registered nurse practitioner as authorized by the state board of nursing pursuant to chapter 18.79 RCW or physician assistant pursuant to chapter 18.71A RCW. This section shall not be construed to prevent the application of standard contract provisions, other than the cost-sharing prohibition provided in RCW 48.43.076 , that are applicable to other benefits. This section does not limit the authority of a contractor to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.
RCW 48.23.330 — Washington Code / Title 48 / Chapter 23 / Section 330
RCW 48.23.330: Trafficking in dividend rights.
Status: in_force

No life insurer nor any of its representatives, agents, or affiliates, shall buy, take by assignment other than in connection with policy loans, or otherwise deal or traffic in any rights to dividends existing under participating life insurance policies issued by the insurer.