RCW 48.02.010
Insurance commissioner.
(1) There shall be an insurance commissioner of this state who shall be elected at the time and in the manner that other state officers are elected.
(2) The commissioner in office at the effective date of this code shall continue in office for the remainder of the term for which he or she was elected and until his or her successor is duly elected and qualified.
(3) "Commissioner," where used in this code, means the insurance commissioner of this state.
[
2009 c 549 s 7001
; 1947 c 79 s .02.01; Rem. Supp. 1947 s 45.02.01.]
RCW 48.02.020
Term of office.
The term of office of the commissioner shall be four years, commencing on the Wednesday after the second Monday in January after his or her election.
[
2009 c 549 s 7002
; 1947 c 79 s .02.02; Rem. Supp. 1947 s 45.02.02.]
RCW 48.02.030
Bond.
Before entering upon his or her duties the commissioner shall execute a bond to the state in the sum of twenty-five thousand dollars, to be approved by the state treasurer and the attorney general, conditioned upon the faithful performance of the duties of his or her office.
[
2009 c 549 s 7003
; 1947 c 79 s .02.03; Rem. Supp. 1947 s 45.02.03.]
RCW 48.02.050
Seal.
The official seal of the commissioner shall be a vignette of George Washington, with the words "Insurance Commissioner, State of Washington" surrounding the vignette.
[1947 c 79 s .02.05; Rem. Supp. 1947 s 45.02.05.]
RCW 48.02.060
General powers and duties
—
State of emergency.
(1) The commissioner has the authority expressly conferred upon him or her by or reasonably implied from the provisions of this code.
(2) The commissioner must execute his or her duties and must enforce the provisions of this code.
(3) The commissioner may:
(a) Make reasonable rules for effectuating any provision of this code, except those relating to his or her election, qualifications, or compensation. Rules are not effective prior to their being filed for public inspection in the commissioner's office.
(b) Conduct investigations to determine whether any person has violated any provision of this code.
(c) Conduct examinations, investigations, hearings, in addition to those specifically provided for, useful and proper for the efficient administration of any provision of this code.
(4) When the governor proclaims a state of emergency under RCW 43.06.010
(12), the commissioner may issue an order that addresses any or all of the following matters related to insurance policies issued in this state:
(a) Reporting requirements for claims;
(b) Grace periods for payment of insurance premiums and performance of other duties by insureds;
(c) Temporary postponement of cancellations and nonrenewals; and
(d) Medical coverage to ensure access to care.
(5) An order by the commissioner under subsection (4) of this section may remain effective for not more than sixty days unless the commissioner extends the termination date for the order for an additional period of not more than thirty days. The commissioner may extend the order if, in the commissioner's judgment, the circumstances warrant an extension. An order of the commissioner under subsection (4) of this section is not effective after the related state of emergency is terminated by proclamation of the governor under RCW 43.06.210
. The order must specify, by line of insurance:
(a) The geographic areas in which the order applies, which must be within but may be less extensive than the geographic area specified in the governor's proclamation of a state of emergency and must be specific according to an appropriate means of delineation, such as the United States postal service zip codes or other appropriate means; and
(b) The date on which the order becomes effective and the date on which the order terminates.
(6) The commissioner may adopt rules that establish general criteria for orders issued under subsection (4) of this section and may adopt emergency rules applicable to a specific proclamation of a state of emergency by the governor.
(7) The rule-making authority set forth in subsection (6) of this section does not limit or affect the rule-making authority otherwise granted to the commissioner by law.
[
2010 c 27 s 1
;
2009 c 335 s 1
; 1947 c 79 s .02.06; Rem. Supp. 1947 s 45.02.06.]
RCW 48.02.062
Mental health services
—
Rules.
The insurance commissioner may adopt rules to implement RCW 48.21.241, 48.44.341, and
48.46.291, except that the rules do not apply to health benefit plans administered or operated under chapter
41.05
or
70.47
RCW.
[
2005 c 6 s 10
.]
NOTES:
Findings
—
Intent
—
Severability
—
2005 c 6:
See notes following RCW 41.05.600
.
RCW 48.02.065
Confidentiality of documents, materials, or other information
—
Public disclosure.
(1) Documents, materials, or other information as described in subsections (5), (6), (7), and (8) of this section are confidential by law and privileged, are not subject to public disclosure under chapter
42.56
RCW, and are not subject to subpoena directed to the commissioner or any person who received documents, materials, or other information while acting under the authority of the commissioner. The commissioner is authorized to use such documents, materials, or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties. The confidentiality and privilege created by this section and RCW 42.56.400
(8) applies only to the commissioner, any person acting under the authority of the commissioner, the national association of insurance commissioners and its affiliates and subsidiaries, regulatory and law enforcement officials of other states and nations, the federal government, and international authorities.
(2) Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner is permitted or required to testify in any private civil action concerning any confidential and privileged documents, materials, or information subject to subsection (1) of this section.
(3) The commissioner:
(a) May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to subsection (1) of this section, with (i) the national association of insurance commissioners and its affiliates and subsidiaries, (ii) regulatory and law enforcement officials of other states and nations, the federal government, and international authorities, and (iii) agencies of this state, if the recipient agrees to maintain the confidentiality and privileged status of the document, material, or other information;
(b) May receive documents, materials, or information, including otherwise either confidential or privileged, or both, documents, materials, or information, from (i) the national association of insurance commissioners and its affiliates and subsidiaries, and (ii) regulatory and law enforcement officials of other states and nations, the federal government, and international authorities and shall maintain as confidential and privileged any document, material, or information received that is either confidential or privileged, or both, under the laws of the jurisdiction that is the source of the document, material, or information; and
(c) May enter into agreements governing the sharing and use of information consistent with this subsection.
(4) No waiver of an existing privilege or claim of confidentiality in the documents, materials, or information may occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in subsection (3) of this section.
(5) Documents, materials, or information, which is either confidential or privileged, or both, which has been provided to the commissioner by (a) the national association of insurance commissioners and its affiliates and subsidiaries, (b) regulatory or law enforcement officials of other states and nations, the federal government, or international authorities, or (c) agencies of this state, is confidential and privileged only if the documents, materials, or information is protected from disclosure by the applicable laws of the jurisdiction that is the source of the document, material, or information.
(6) Working papers, documents, materials, or information produced by, obtained by, or disclosed to the commissioner or any other person in the course of a financial or market conduct examination, or in the course of financial analysis or market conduct desk audit, are not required to be disclosed by the commissioner unless cited by the commissioner in connection with an agency action as defined in RCW 34.05.010
(3). The commissioner shall notify a party that produced the documents, materials, or information five business days before disclosure in connection with an agency action. The notified party may seek injunctive relief in any Washington state superior court to prevent disclosure of any documents, materials, or information it believes is confidential or privileged. In civil actions between private parties or in criminal actions, disclosure to the commissioner under this section does not create any privilege or claim of confidentiality or waive any existing privilege or claim of confidentiality.
(7) Documents, materials, or information provided to the commissioner by the federal government related to emergency management, hazard mitigation, and the national flood insurance program are confidential by law and privileged, and are not subject to public disclosure under chapter
42.56
RCW.
(8) Data requested by the commissioner from property and casualty entities regulated by the commissioner for the purpose of understanding and studying insurance market conditions outside the context of market conduct action is confidential by law and privileged and is not subject to public disclosure under chapter
42.56
RCW. Nothing in this section prohibits the commissioner from preparing and publishing reports, analysis, or other documents using the data received from individual property and casualty companies so long as the data in the report is in aggregate form and does not permit the identification of information related to individual companies. Data in the aggregate form are deemed open records available for public inspection. Nothing in this section affects, limits, or amends the commissioner's authority under chapter
48.37
RCW.
(9)(a) After receipt of a public disclosure request, the commissioner shall disclose the documents, materials, or information under subsection (6) of this section that relate to a financial or market conduct examination undertaken as a result of a proposed change of control of a nonprofit or mutual health insurer governed in whole or in part by chapter
48.31B
RCW.
(b) The commissioner is not required to disclose the documents, materials, or information in (a) of this subsection if:
(i) The documents, materials, or information are otherwise privileged or exempted from public disclosure; or
(ii) The commissioner finds that the public interest in disclosure of the documents, materials, or information is outweighed by the public interest in nondisclosure in that particular instance.
(10) Any person may petition a Washington state superior court to allow inspection of information exempt from public disclosure under subsection (6) of this section when the information is connected to allegations of negligence or malfeasance by the commissioner related to a financial or market conduct examination. The court shall conduct an in-camera review after notifying the commissioner and every party that produced the information. The court may order the commissioner to allow the petitioner to have access to the information provided the petitioner maintains the confidentiality of the information. The petitioner must not disclose the information to any other person, except upon further order of the court. After conducting a regular hearing, the court may order that the information can be disclosed publicly if the court finds that there is a public interest in the disclosure of the information and the exemption of the information from public disclosure is clearly unnecessary to protect any individual's right of privacy or any vital governmental function.
[
2024 c 123 s 1
;
2015 c 122 s 15
;
2007 c 126 s 1
. Prior:
2005 c 274 s 309
;
2005 c 126 s 1
;
2001 c 57 s 1
.]
NOTES:
Effective dates
—
2015 c 122:
See note following RCW 48.31B.005
.
RCW 48.02.068
Confidentiality of personal health information
—
Public disclosure.
(1) All nonpublic personal health information obtained by, disclosed to, or in the custody of the commissioner, regardless of the form or medium, is confidential and is not subject to public disclosure under chapter
42.56
RCW. The commissioner shall not disclose nonpublic personal health information except in the furtherance of regulatory or legal action brought as a part of the commissioner's official duties.
(2) The following definitions apply only for the purposes of this section:
(a) "Health information" means any information or data, except age or gender, whether oral or recorded in any form or medium, created by or derived from a health care provider or a patient, or a policyholder or enrollee, that relates to:
(i) The past, present, or future physical, mental, or behavioral health or condition of an individual;
(ii) The provision of health care to an individual; or
(iii) Payment for the provision of health care to an individual.
(b) "Health care" means preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, services, procedures, tests, or counseling that:
(i) Relates to the physical, mental, or behavioral condition of an individual;
(ii) Affects the structure or function of the human body or any part of the human body, including the banking of blood, sperm, organs, or any other tissue; or
(iii) Prescribes, dispenses, or furnishes to an individual drugs or biologicals, or medical devices or health care equipment and supplies.
(c) "Nonpublic personal health information" means health information:
(i) That identifies an individual who is the subject of the information; or
(ii) With respect to which there is a reasonable basis to believe that the information could be used to identify an individual.
(d) "Patient" means an individual who is receiving, has received, or has sought health care. The term includes a deceased individual who has received health care.
(e) "Policyholder" or "enrollee" means a person who is covered by, enrolled in, has applied for, or purchased, an insurance policy, a health plan as defined in RCW 48.43.005, a group plan, or any other product regulated by the insurance commissioner. "Policyholder" or "enrollee" may include, without limitation, a subscriber, member, annuitant, beneficiary, spouse, or  dependent.
(3) The commissioner may:
(a) Share documents, materials, or other information, including the confidential documents, materials, or information subject to subsection (1) of this section, with (i) the national association of insurance commissioners and its affiliates and subsidiaries, and (ii) regulatory and law enforcement officials of this and other states and nations, the federal government, and international authorities, if the recipient agrees to maintain the confidentiality and privileged status of the document, material, or other information;
(b) Receive documents, materials, or information, including otherwise either confidential or privileged documents, materials, or information, from (i) the national association of insurance commissioners and its affiliates and subsidiaries, and (ii) regulatory and law enforcement officials of this and other states and nations, the federal government, and international authorities and must maintain as confidential or privileged any document, material, or information received that is either confidential or privileged, or both, under the laws of the jurisdiction that is the source of the document, material, or information; and
(c) Enter into agreements governing the sharing and use of information consistent with this subsection.
(4) No waiver of an existing claim of confidentiality or privilege in the documents, materials, or information may occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in subsection (3) of this section.
(5) The commissioner shall add language in large font to the release consumers use when filing complaints with the office, whether online or in writing, informing them that the office may share their personal health information with other entities and for the purposes authorized under subsection (3) of this section, and that the information will only be shared if it is to be held confidential by the other entity. Consumers shall be provided the opportunity to opt out at the time of filing their complaint, indicating that their personal health information may not be shared under subsection (3) of this section.
[
2017 c 193 s 1
.]
RCW 48.02.080
Enforcement.
(1) The commissioner may prosecute an action in any court of competent jurisdiction to enforce any order made by him or her pursuant to any provision of this code.
(2) If the commissioner has cause to believe that any person has violated any penal provision of this code or of other laws relating to insurance he or she shall certify the facts of the violation to the public prosecutor of the jurisdiction in which the offense was committed.
(3) If the commissioner has cause to believe that any person is violating or is about to violate any provision of this code or any regulation or order of the commissioner, he or she may:
(a) issue a cease and desist order; and/or
(b) bring an action in any court of competent jurisdiction to enjoin the person from continuing the violation or doing any action in furtherance thereof.
(4) The attorney general and the several prosecuting attorneys throughout the state shall prosecute or defend all proceedings brought pursuant to the provisions of this code when requested by the commissioner.
[
2009 c 549 s 7005
;
1967 c 150 s 1
; 1947 c 79 s .02.08; Rem. Supp. 1947 s 45.02.08.]
RCW 48.02.090
Deputies
—
Employees.
(1) The commissioner may appoint a chief deputy commissioner, who shall have power to perform any act or duty conferred upon the commissioner. The chief deputy commissioner shall take and subscribe the same oath of office as the commissioner, which oath shall be endorsed upon the certificate of his or her appointment and filed in the office of the secretary of state.
(2) The commissioner may appoint additional deputy commissioners for such purposes as he or she may designate.
(3) The commissioner shall be responsible for the official acts of his or her deputies, and may revoke at will the appointment of any deputy.
(4) The commissioner may employ examiners, and such actuarial, technical, and administrative assistants and clerks as he or she may need for proper discharge of his or her duties.
(5) The commissioner, or any deputy or employee of the commissioner, shall not be interested, directly or indirectly, in any insurer except as a policyholder; except, that as to such matters wherein a conflict of interests does not exist on the part of any such person, the commissioner may employ insurance actuaries or other technicians who are independently practicing their professions even though such persons are similarly employed by insurers.
(6) The commissioner may require any deputy or employee to be bonded as he or she shall deem proper but not to exceed in amount the sum of twenty-five thousand dollars. The cost of any such bond shall be borne by the state.
[
2009 c 549 s 7006
;
1949 c 190 s 1
; 1947 c 79 s .02.09; Rem. Supp. 1949 s 45.02.09.]
RCW 48.02.093
Health care authority ombuds
—
Retirees
—
Volunteer position.
There is established, within the office of the insurance commissioner, the volunteer position of health care authority ombuds to assist retirees enrolled in the public employees' benefits board program. The volunteer position shall be trained as part of the existing volunteer training provided to the statewide health insurance benefit advisors. The position shall help retirees with questions and concerns, assist the public employees' benefits board program with identification of retiree concerns, and maintain access to updated program information.
[
2013 c 23 s 101
;
2012 c 150 s 1
.]
RCW 48.02.100
Commissioner may delegate authority.
Any power or duty vested in the commissioner by any provision of this code may be exercised or discharged by any deputy, assistant, examiner, or employee of the commissioner acting in his or her name and by his or her authority.
[
2009 c 549 s 7007
; 1947 c 79 s .02.10; Rem. Supp. 1947 s 45.02.10.]
RCW 48.02.110
Office.
The commissioner shall have an office at the state capital, and may maintain such offices elsewhere in this state as he or she may deem necessary.
[
2009 c 549 s 7008
; 1947 c 79 s .02.11; Rem. Supp. 1947 s 45.02.11.]
RCW 48.02.120
Records
—
Public inspection.
(1) The commissioner shall preserve in permanent form records of his or her proceedings, hearings, investigations, and examinations, and shall file such records in his or her office.
(2) The records of the commissioner and insurance filings in his or her office shall be open to public inspection, except as otherwise provided by RCW 48.200.040
and
48.43.731
and this code.
(3) Except as provided in subsection (4) of this section, actuarial formulas, statistics, and assumptions submitted in support of a rate or form filing by an insurer, health care service contractor, or health maintenance organization or submitted to the commissioner upon his or her request shall be withheld from public inspection in order to preserve trade secrets or prevent unfair competition.
(4) For individual and small group health benefit plan rate filings submitted on or after July 1, 2011, subsection (3) of this section applies only to the numeric values of each small group rating factor used by a health carrier as authorized by RCW 48.21.045
(3)(a), 48.44.023
(3)(a), and
48.46.066
(3)(a). Subsection (3) of this section may continue to apply for a period of one year from the date a new individual or small group product filing is submitted or until the next rate filing for the product, whichever occurs earlier, if the commissioner determines that the proposed rate filing is for a new product that is distinct and unique from any of the carrier's currently or previously offered health benefit plans. Carriers must make a written request for a product classification as a new product under this subsection and must receive subsequent written approval by the commissioner for this subsection to apply.
(5) Unless the commissioner has determined that a filing is for a new product pursuant to subsection (4) of this section, for all individual or small group health benefit rate filings submitted on or after July 1, 2011, the health carrier must submit part I rate increase summary and part II written explanation of the rate increase as set forth by the department of health and human services at the time of filing, and the commissioner must:
(a) Make each filing and the part I rate increase summary and part II written explanation of the rate increase available for public inspection on the tenth calendar day after the commissioner determines that the rate filing is complete and accepts the filing for review through the electronic rate and form filing system; and
(b) Prepare a standardized rate summary form, to explain his or her findings after the rate review process is completed. The commissioner's summary form must be included as part of the rate filing documentation and available to the public electronically.
[
2020 c 240 s 7
;
2011 c 312 s 1
;
1985 c 264 s 2
;
1979 ex.s. c 130 s 1
; 1947 c 79 s .02.12; Rem. Supp. 1947 s 45.02.12.]
NOTES:
Rule making
—
Effective date
—
2020 c 240:
See RCW 48.200.900
and
48.200.901
.
RCW 48.02.122
Filings or actions affecting corporate or company name
—
Notice to secretary of state.
Whenever any documents are filed with the insurance commissioner which affect a corporate or company name, the insurance commissioner shall immediately notify the secretary of state of the filing. If any other action is taken by the insurance commissioner which affects a corporate or company name, the insurance commissioner shall immediately notify the secretary of state of the action. The insurance commissioner shall cooperate with the secretary of state to ascertain that there is no duplication of corporate or company names.
[
1998 c 23 s 19
.]
RCW 48.02.130
Certificates
—
Copies
—
Evidentiary effect.
(1) Any certificate or license issued by the commissioner shall bear the seal of his or her office.
(2) Copies of records or documents in his or her office certified to by the commissioner shall be received as evidence in all courts in the same manner and to the same effect as if they were the originals.
(3) When required for evidence in court, the commissioner shall furnish his or her certificate as to the authority of an insurer or other licensee in this state on any particular date, and the court shall receive the certificate in lieu of the commissioner's testimony.
[
2009 c 549 s 7009
; 1947 c 79 s .02.13; Rem. Supp. 1947 s 45.02.13.]
RCW 48.02.140
Interstate cooperation.
(1) The commissioner shall to the extent he or she deems useful for the proper discharge of his or her responsibilities under the provisions of this code:
(a) Consult and cooperate with the public officials having supervision over insurance in other states.
(b) Share jointly with other states in the employment of actuaries, statisticians, and other insurance technicians whose services or the products thereof are made available and are useful to the participating states and to the commissioner.
(c) Share jointly with other states in establishing and maintaining offices and clerical facilities for purposes useful to the participating states and to the commissioner.
(2) All arrangements made jointly with other states under items (b) and (c) of subsection (1) of this section shall be in writing executed on behalf of this state by the commissioner. Any such arrangement, as to participation of this state therein, shall be subject to termination by the commissioner at any time upon reasonable notice.
(3) For the purposes of this code "National Association of Insurance Commissioners" means that voluntary organization of the public officials having supervision of insurance in the respective states, districts, and territories of the United States, whatever other name such organization may hereafter adopt, and in the affairs of which each of such public officials is entitled to participate subject to the constitution and bylaws of such organization.
[
2009 c 549 s 7010
; 1947 c 79 s .02.14; Rem. Supp. 1947 s 45.02.14.]
RCW 48.02.150
Supplies.
The commissioner must purchase at the expense of the state, and in the manner provided by law, printing, books, reports, furniture, equipment, and supplies as he or she deems necessary to the proper discharge of his or her duties under this code.
[
2011 c 47 s 2
;
2009 c 549 s 7011
; 1947 c 79 s .02.15; Rem. Supp. 1947 s 45.02.15.]
RCW 48.02.160
Special duties.
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.
[
1988 c 248 s 1
; 1947 c 79 s .02.16; Rem. Supp. 1947 s 45.02.16.]
RCW 48.02.170
Annual report.
The commissioner shall, as soon as accurate preparation enables, prepare a report of his or her official transactions during the preceding fiscal year, containing information relative to insurance as the commissioner deems proper.
[
2009 c 549 s 7012
;
1987 c 505 s 53
;
1977 c 75 s 69
; 1947 c 79 s .02.17; Rem. Supp. 1947 s 45.02.17.]
RCW 48.02.180
Publication of insurance code and related statutes, manuals, etc.
—
Distribution
—
Sale.
(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.
[
2005 c 223 s 1
;
1981 c 339 s 1
;
1977 c 75 s 70
;
1959 c 225 s 1
.]
RCW 48.02.190
Operating costs of office
—
Insurance commissioner's regulatory account
—
Insurance commissioner's fraud account
—
Regulatory and insurance fraud surcharges.
(1) As used in this section:
(a) "Insurance fraud surcharge" means the fees imposed by subsection (2)(b) of this section.
(b) "Organization" means every insurer, as defined in RCW 48.01.050, having a certificate of authority to do business in this state, every health care service contractor, as defined in RCW 48.44.010, every health maintenance organization, as defined in RCW 48.46.020, or self-funded multiple employer welfare arrangement, as defined in RCW 48.125.010, registered to do business in this state. "Class one" organizations consist of all insurers as defined in RCW 48.01.050
. "Class two" organizations consist of all organizations registered under provisions of chapters
48.44
and
48.46
RCW. "Class three" organizations consist of self-funded multiple employer welfare arrangements as defined in RCW 48.125.010
.
(c)(i) "Receipts" means (A) net direct premiums consisting of direct gross premiums, as defined in RCW 48.18.170, paid for insurance written or renewed upon risks or property resident, situated, or to be performed in this state, less return premiums and premiums on policies not taken, dividends paid or credited to policyholders on direct business, and premiums received from policies or contracts issued in connection with qualified plans as defined in RCW 48.14.021, and (B) prepayments to health care service contractors, as defined in RCW 48.44.010, health maintenance organizations, as defined in RCW 48.46.020, or participant contributions to self-funded multiple employer welfare arrangements, as defined in RCW 48.125.010, less experience rating credits, dividends, prepayments returned to subscribers, and payments for contracts not taken.
(ii) Participant contributions, under chapter
48.125
RCW, used to determine the receipts in this state under this section are determined in the same manner as premiums taxable in this state are determined under RCW 48.14.090
.
(d) "Regulatory surcharge" means the fees imposed by subsection (2)(a) of this section.
(2) The annual cost of operating the office of the insurance commissioner is determined by legislative appropriation.
(a) A pro rata share of the cost, except for the cost of the insurance fraud program, is charged to all organizations as a regulatory surcharge. Each class of organization must contribute a sufficient amount to the insurance commissioner's regulatory account to pay the reasonable costs, including overhead, of regulating that class of organization.
(b) The annual cost of operating the insurance fraud program is charged to all organizations as an insurance fraud surcharge. Each class of organization must contribute a sufficient amount to the insurance commissioner's fraud account to pay the reasonable costs of the program, including overhead.
(3)(a) The regulatory surcharge is calculated separately for each class of organization. The regulatory surcharge collected from each organization is that portion of the cost of operating the insurance commissioner's office, except for the cost of operating the insurance fraud program, for that class of organization, for the ensuing fiscal year that is represented by the organization's portion of the receipts collected or received by all organizations within that class on business in this state during the previous calendar year. However, the regulatory surcharge must not exceed one-eighth of one percent of receipts and the minimum regulatory surcharge is one thousand dollars.
(b) The insurance fraud surcharge collected from each organization is the cost of operating the insurance fraud program for the ensuing fiscal year that is represented by the organization's portion of the receipts collected or received on business in this state during the previous calendar year. However, the insurance fraud surcharge may not exceed one one-hundredths of one percent of receipts and the minimum insurance fraud surcharge is one hundred dollars.
(4) The commissioner must annually, on or before July 1st, calculate and bill each organization for the amount of the regulatory and insurance fraud surcharges. The surcharges are due and payable no later than July 15th of each year. However, if the necessary financial records are not available or if the amount of the legislative appropriation is not determined in time to carry out such calculations and bill the surcharges within the time specified, the commissioner may use the surcharge factors for the prior year as the basis for the surcharges and, if necessary, the commissioner may impose supplemental fees to fully and properly charge the organizations. Any organization failing to pay the surcharges by July 31st must pay the same penalties as the penalties for failure to pay taxes when due under RCW 48.14.060
. The surcharges required by this section are in addition to all other taxes and fees now imposed or that may be subsequently imposed.
(5)(a) All moneys collected for the regulatory surcharge must be deposited in the insurance commissioner's regulatory account in the state treasury which is hereby created.
(b) All moneys collected for the insurance fraud surcharge must be deposited in the insurance commissioner's fraud account in the state treasury which is hereby created.
(6) Unexpended funds in the insurance commissioner's regulatory and fraud accounts at the close of a fiscal year are carried forward to the succeeding fiscal year and are used to reduce future regulatory and insurance fraud surcharges.
(7)(a) Each insurer may annually collect regulatory and insurance fraud surcharges remitted in preceding years by means of a policyholder surcharge on premiums charged for all kinds of insurance. The recoupment is at a uniform rate reasonably calculated to collect the regulatory and insurance fraud surcharges remitted by the insurer.
(b) If an insurer fails to collect the entire amount of the recoupment in the first year under this section, it may repeat the recoupment procedure provided for in this subsection (7) in succeeding years until the regulatory and insurance fraud surcharges are fully collected or a de minimis amount remains uncollected. Any such de minimis amount may be collected as provided in (d) of this subsection.
(c) The amount and nature of any recoupment must be separately stated on either a billing or policy declaration sent to an insured. The amount of the recoupment must not be considered a premium for any purpose, including the premium tax or agents' commissions.
(d) An insurer may elect not to collect the regulatory and insurance fraud surcharges from its insured. In such a case, the insurer may recoup the regulatory and insurance fraud surcharges through its rates, if the following requirements are met:
(i) The insurer remits the amount of the surcharges not collected by election under this subsection; and
(ii) The surcharges are not considered a premium for any purpose, including the premium tax or agents' commission.
[
2020 c 195 s 2
;
2011 c 47 s 3
;
2009 c 161 s 1
;
2008 c 328 s 6003
. Prior:
2007 c 468 s 1
;
2007 c 153 s 3
;
2004 c 260 s 22
;
2003 1st sp.s. c 25 s 923
;
2002 c 371 s 913
;
1987 c 505 s 54
;
1986 c 296 s 7
.]
NOTES:
Findings
—
2020 c 195:
"The legislature finds that insurance fraud is not a victimless crime. The national insurance crime bureau has recognized as much as seven hundred dollars per year may be added to the average Washington household's insurance premium costs due to fraudulent insurance claims. For the 2017-2019 biennium, the insurance commissioner's insurance fraud program, known as its criminal investigations unit, reviewed over four thousand five hundred referrals from over one hundred fifty companies. The adjudicated cases from this review resulted in almost two million dollars of restitution and projected insurance claim savings.
The legislature finds it is critical to continue protecting Washington state insurance consumers from the cost of insurance fraud by funding the insurance fraud program through an insurance fraud surcharge and creating the insurance commissioner's fraud account to better manage the accountability of the funds." [
2020 c 195 s 1
.]
Effective date
—
2020 c 195:
"This act takes effect July 1, 2020." [
2020 c 195 s 4
.]
Part headings not law
—
Severability
—
Effective date
—
2008 c 328:
See notes following RCW 43.155.050
.
Effective date
—
2004 c 260:
See RCW 48.125.901
.
Severability
—
Effective date
—
2003 1st sp.s. c 25:
See notes following RCW 19.28.351
.
Severability
—
Effective date
—
2002 c 371:
See notes following RCW 9.46.100
.
Severability
—
Effective date
—
1986 c 296:
See notes following RCW 48.14.020
.
RCW 48.02.200
When legal process against a person is served on the commission.
(1) Legal process against a person (a) for whom the commissioner has been appointed attorney for service of process, or (b) who may be served by service of process upon the commissioner, must be served upon the commissioner either by a person competent to serve a summons or by registered mail. At the time of service, the plaintiff must pay to the commissioner ten dollars, taxable as costs in the action.
(2) As soon as practicable, the commissioner must send or make available a copy of the process to the person on whose behalf he or she has been served by mail, electronic means, or other means reasonably calculated to give notice. The copy must be sent or made available in a manner that is secure and with a receipt that is verifiable.
(3) The commissioner must keep a record of the day and hour of service upon him or her of all legal process.
(4) Proceedings must not be had against the person, and the person must not be required to appear, plead, or answer until the expiration of forty days after the date of service upon the commissioner.
(5) The commissioner may adopt rules to implement this section.
[
2010 c 18 s 5
.]
NOTES:
Effective date
—
2010 c 18:
See note following RCW 48.15.070
.
RCW 48.02.220
Health care benefit managers
—
Registration
—
Enforcement authority
—
Rules.
(1) The commissioner shall accept registration of health care benefit managers as established in RCW 48.200.030
and receipts shall be deposited in the insurance commissioner's regulatory account.
(2) The commissioner shall have enforcement authority over chapter
48.200
RCW consistent with requirements established in RCW 48.200.290
.
(3) The commissioner may adopt rules to implement chapter
48.200
RCW and to establish registration and renewal fees that ensure the registration, renewal, and oversight activities are self-supporting.
[
2020 c 240 s 8
;
2016 c 210 s 5
.]
NOTES:
Rule making
—
Effective date
—
2020 c 240:
See RCW 48.200.900
and
48.200.901
.
RCW 48.02.250
Living organ donors
—
Discrimination prohibited.
(1) Notwithstanding any other provision of law, all insurers, fraternal benefit societies, health carriers including disability insurers, health maintenance organizations, and health care service contractors, and limited health care service contractors may not:
(a) Decline or limit coverage of a person under a policy or contract solely due to the status of the person as a living organ donor;
(b) Preclude a person from donating all or part of an organ as a condition of receiving or continuing to receive a policy or contract; or
(c) Otherwise discriminate in the offering, issuance, cancellation, amount of coverage, price, or any other condition of a policy or contract for a person based solely and without any additional actuarial risks upon the status of the person as a living organ donor. Except as provided in RCW 48.43.0128, 48.44.220, or
48.46.370, this subsection does not prohibit fair discrimination on the basis of sex, or marital status, or the presence of any sensory, mental, or physical handicap when bona fide statistical differences in risk or exposure have been substantiated.
(2) The commissioner shall make educational materials available to the health plans and the public on the access of living organ donors to insurance.
(3) The commissioner may adopt rules to implement this section.
(4) For purposes of this section, "living organ donor" means an individual who has donated all or part of an organ and is not deceased.
[
2021 c 172 s 1
.]
RCW 48.02.260
Petitions for removal related to email-based violations.
(1) The commissioner shall develop and implement a process for an affected licensee to petition the commissioner for the removal of any disciplinary investigations and orders on the affected licensee's public disciplinary record related solely to an email-based violation of RCW 48.15.103
or
48.17.475
as those sections existed prior to July 1, 2023. An affected licensee who petitions the commissioner shall provide documentation demonstrating that the disciplinary investigations and orders on the affected licensee's record were solely the result of an email-based violation of RCW 48.15.103
or
48.17.475
as those sections existed prior to July 1, 2023. Upon receipt of a petition with appropriate documentation, the commissioner shall immediately:
(a) Remove any related disciplinary investigations and orders from the affected licensee's public disciplinary record;
(b) Send a notice to the national insurance producer registry that the commissioner erroneously took administrative action against the affected licensee and request that the national insurance producer registry expunge any related record of the administrative action from the affected licensee's history; and
(c) Send to the affected licensee, by certified mail, a copy of the commissioner's notice to the national insurance producer registry.
(2) The commissioner shall identify the amount of money collected as fines from each affected licensee solely for email-based violations of RCW 48.15.103
or
48.17.475
as those sections existed prior to July 1, 2023, and, as soon as practicable, refund such money to each affected licensee from the existing operating budget for the commissioner's office.
(3) As used in this section:
(a) "Affected licensee" means any licensee regulated by the commissioner who was penalized by the commissioner solely for an email-based violation of RCW 48.15.103
or
48.17.475
as those sections existed prior to July 1, 2023.
(b) "Email-based violation" means a violation solely of RCW 48.15.103
or
48.17.475, as those sections existed prior to July 1, 2023, resulting from an affected licensee's failure to provide a timely response to an inquiry of the commissioner where such inquiry was only sent to the affected licensee by email. A violation of RCW 48.17.475
or
48.15.103
that is connected to a different violation of any insurance laws or rules is not an email-based violation subject to this section.
[
2023 c 27 s 5
.]
NOTES:
Effective date
—
2023 c 27:
See note following RCW 48.17.170
.