reglab/housing_qa huggingface dataset:
WA Rev Code § 48.20.435 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.435 - Option to cover dependents under age twenty-six.

RCW 48.20.435 Option to cover dependents under age twenty-six.(1) Each disability insurance contract that is not grandfathered and that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six.(2) Each grandfathered disability insurance contract that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six unless the child is eligible to enroll in an eligible health plan sponsored by the child's employer or the child's spouse's employer.(3) As used in this section, "grandfathered" has the same meaning as "grandfathered health plan" in RCW 48.43.005.[ 2012 c 211 § 15; 2011 c 314 § 1; 2007 c 259 § 19.]NOTES:Effective date—2007 c 259 §§ 18-22: See note following RCW 41.05.095.Severability—Subheadings not law—2007 c 259: See notes following RCW 41.05.033.
WA Rev Code § 48.20.450 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.450 - Standardization and simplification of terms and coverages—Disclosure requirements.

RCW 48.20.450 Standardization and simplification of terms and coverages—Disclosure requirements.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.[ 1985 c 264 § 11; 1975 1st ex.s. c 266 § 16.]NOTES:Purpose—1975 1st ex.s. c 266: "The purpose of *sections 14 through 18 of this 1975 amendatory act is to provide reasonable standardization and simplification of terms and coverages of individual disability insurance policies to facilitate public understanding and comparison, to eliminate provisions contained in individual disability insurance policies which may be misleading or unreasonably confusing in connection either with the purchase of such coverages or with the settlement of claims, and to provide for full disclosure in the sale of disability coverages." [ 1975 1st ex.s. c 266 § 15.]*Reviser's note: During the course of passage of 1975 1st ex.s. c 266 [Substitute House Bill No. 198], the section numbering was changed, but the internal references were not changed accordingly. Thus the reference "sections 14 through 18 of this 1975 amendatory act" appears to be erroneous. Reference to "sections 15 through 19," codified herein as this section and RCW 48.20.450 through 48.20.480, was apparently intended.Severability—1975 1st ex.s. c 266: See note following RCW 48.01.010.
WA Rev Code § 48.20.460 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.460 - Standardization and simplification—Minimum standards for benefits and coverages.

RCW 48.20.460 Standardization and simplification—Minimum standards for benefits and coverages.(1) The commissioner shall issue regulations to establish minimum standards for benefits under each of the following categories of coverage in individual policies, other than conversion policies issued pursuant to a contractual conversion privilege under a group policy, of disability insurance:(a) Basic hospital expense coverage;(b) Basic medical-surgical expense coverage;(c) Hospital confinement indemnity coverage;(d) Major medical expense coverage;(e) Disability income protection coverage;(f) Accident only coverage;(g) Specified disease or specified accident coverage;(h) Medicare supplemental coverage; and(i) Limited benefit coverage.(2) Nothing in this section shall preclude the issuance of any policy which combines two or more of the categories of coverage enumerated in items (a) through (f) of subsection (1) of this section.(3) No policy shall be delivered or issued for delivery in this state which does not meet the prescribed minimum standards for the categories of coverage listed in items (a) through (i) of subsection (1) of this section, unless the commissioner finds such policy will be in the public interest and such policy meets the requirements set forth in RCW 48.18.110.(4) The commissioner shall prescribe the method of identification of policies based upon coverages provided.[ 1981 c 339 § 19; 1975 1st ex.s. c 266 § 17.]NOTES:Severability—1975 1st ex.s. c 266: See note following RCW 48.01.010.
WA Rev Code § 48.20.470 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.470 - Standardization and simplification—Outline of coverage—Format and contents.

RCW 48.20.470 Standardization and simplification—Outline of coverage—Format and contents.(1) No policy of individual disability insurance shall be delivered or issued for delivery in this state unless an outline of coverage described in subsection (2) of this section is furnished to the applicant in accord with such rules or regulations as the commissioner shall prescribe.(2) The commissioner shall prescribe the format and content of the outline of coverage required by subsection (1) of this section. "Format" means style, arrangement, and overall appearance, including such items as the size, color, and prominence of type and the arrangement of text and captions. Such outline of coverage shall include:(a) A statement identifying the applicable category or categories of coverage provided by the policy as prescribed in RCW 48.20.450;(b) A description of the principal benefits and coverage provided in the policy;(c) A statement of the exceptions, reductions and limitations contained in the policy;(d) A statement of the renewal provisions including any reservation by the insurer of a right to change premiums; and(e) A statement that the outline is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.[ 1985 c 264 § 12; 1975 1st ex.s. c 266 § 18.]NOTES:Severability—1975 1st ex.s. c 266: See note following RCW 48.01.010.
WA Rev Code § 48.20.480 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.480 - Standardization and simplification—Simplified application form—Coverage of loss from preexisting health condition.

RCW 48.20.480 Standardization and simplification—Simplified application form—Coverage of loss from preexisting health condition.Notwithstanding the provisions of RCW 48.20.052, if an insurer elects to use a simplified application form, with or without a question as to the applicant's health at the time of application, but without any questions concerning the insured's health history or medical treatment history, the policy must cover any loss occurring after twelve months from any preexisting condition not specifically excluded from coverage by terms of the policy, and, except as so provided, the policy shall not include wording that would permit a defense based upon preexisting conditions.[ 1975 1st ex.s. c 266 § 19.]NOTES:Severability—1975 1st ex.s. c 266: See note following RCW 48.01.010.
WA Rev Code § 48.20.490 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.490 - Continuation of coverage by former spouse and dependents.

RCW 48.20.490 Continuation of coverage by former spouse and dependents.Every policy of disability insurance issued, amended, or renewed after June 12, 1980, for an individual and his/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 insured, shall have the right to continue the policy coverage without a physical examination, statement of health, or other proof of insurability.[ 1980 c 10 § 1.]
WA Rev Code § 48.20.500 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.500 - Coverage for adopted children.

RCW 48.20.500 Coverage for adopted children.(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.[ 1986 c 140 § 2.]NOTES:Effective date, application—Severability—1986 c 140: See notes following RCW 48.01.180.
WA Rev Code § 48.20.510 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.510 - Cancellation of rider.

RCW 48.20.510 Cancellation of rider.Upon application by an insured, a rider shall be canceled if at least five years after its issuance, no health care services have been received by the insured during that time for the condition specified in the rider, and a physician, selected by the carrier for that purpose, agrees in writing to the full medical recovery of the insured from that condition, such agreement not to be unreasonably withheld. The option of the insured to apply for cancellation shall be disclosed on the face of the rider in clear and conspicuous language.For purposes of this section, a rider is a legal document that modifies a contract to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.[ 1987 c 37 § 1.]
WA Rev Code § 48.20.520 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.520 - Phenylketonuria.

RCW 48.20.520 Phenylketonuria.(1) The legislature finds that:(a) Phenylketonuria is a rare inherited genetic disorder.(b) Children with phenylketonuria are unable to metabolize an essential amino acid, phenylalanine, which is found in the proteins of most food.(c) To remain healthy, children with phenylketonuria must maintain a strict diet and ingest a mineral and vitamin-enriched formula.(d) Children who do not maintain their diets with the formula acquire severe mental and physical difficulties.(e) Originally, the formulas were listed as prescription drugs but were reclassified as medical foods to increase their availability.(2) Subject to requirements and exceptions which may be established by rules adopted by the commissioner, any disability insurance contract delivered or issued for delivery or renewed in this state on or after September 1, 1988, that insures for hospital or medical expenses shall provide coverage for the formulas necessary for the treatment of phenylketonuria.[ 1988 c 173 § 1.]
WA Rev Code § 48.20.525 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.525 - Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.

RCW 48.20.525 Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.Disability insurance companies who through an authorized representative have first approved, by any means, an individual prescription claim as eligible may not reject that claim at some later date. Pharmacists or drug dispensing outlets who obtain preapproval of claims shall keep a written record of the preapproval that consists of identification by name and telephone number of the person who approved the claim.[ 1993 c 253 § 2.]NOTES:Findings—1993 c 253: "The legislature finds that many health care insurance entities are initially approving claims as eligible under an identified program, over the telephone, but denying those same claims when they are submitted for payment. The legislature finds this to be an untenable situation for the providers." [ 1993 c 253 § 1.]Effective date—1993 c 253: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately [May 7, 1993]." [ 1993 c 253 § 6.]
WA Rev Code § 48.20.530 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.530 - Nonresident pharmacies.

RCW 48.20.530 Nonresident pharmacies.For the purposes of this chapter, a nonresident pharmacy is defined as any pharmacy located outside this state that ships, mails, or delivers, in any manner, except when delivered in person to an enrolled participant or his/her representative, controlled substances, legend drugs, or devices into this state.After October 1, 1991, an insurer providing coverage of prescription drugs from nonresident pharmacies may only provide coverage from licensed nonresident pharmacies. The insurers shall obtain proof of current licensure in conformity with this section and RCW 18.64.350 through 18.64.400 from the nonresident pharmacy and keep that proof of licensure on file.The department of health may request from the insurer the proof of current licensure for all nonresident pharmacies through which the insurer is providing coverage for prescription drugs to residents of the state of Washington. This information, which may constitute a full or partial customer list, shall be confidential and exempt from public disclosure, and from the requirements of chapter 42.56 RCW. The board or the department shall not be restricted in the disclosure of the name of a nonresident pharmacy that is or has been licensed under RCW 18.64.360 or 18.64.370 or of the identity of a nonresident pharmacy disciplined under RCW 18.64.350 through 18.64.400.[ 2005 c 274 § 310; 1991 c 87 § 7.]NOTES:Effective date—1991 c 87: See note following RCW 18.64.350.
WA Rev Code § 48.20.550 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.550 - Fixed payment insurance—Standard disclosure form.

RCW 48.20.550 Fixed payment insurance—Standard disclosure form.The commissioner shall adopt rules setting forth the content of a standard disclosure form to be provided to all applicants for individual, illness-triggered fixed payment insurance, hospital confinement fixed payment insurance, or other fixed payment insurance. The standard disclosure shall provide information regarding the level, type, and amount of benefits provided and the limitations, exclusions, and exceptions under the policy, as well as additional information to enhance consumer understanding. The disclosure shall specifically disclose that the coverage is not comprehensive in nature and will not cover the cost of most hospital and other medical services. Such disclosure form must be filed for approval with the commissioner prior to use. The standard disclosure forms must be provided at the time of solicitation and completion of the application form. All advertising and marketing materials other than the standard disclosure form must be filed with the commissioner at least thirty days prior to use.[ 2007 c 296 § 2.]
WA Rev Code § 48.20.555 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.555 - Fixed payment insurance—Benefit restrictions.

RCW 48.20.555 Fixed payment insurance—Benefit restrictions.Illness-triggered fixed payment insurance, hospital confinement fixed payment insurance, or other fixed payment insurance policies are not considered to provide coverage for hospital or medical expenses under this chapter, if the benefits provided are a fixed dollar amount that is paid regardless of the amount charged. The benefits may not be related to, or be a percentage of, the amount charged by the provider of service and must be offered as an independent and noncoordinated benefit with any other health plan as defined in *RCW 48.43.005(19).[ 2007 c 296 § 3.]NOTES:*Reviser's note: RCW 48.43.005 was amended by 2011 c 314 § 3 and by 2011 c 315 § 2, changing subsection (19) to subsection (24). RCW 48.43.005 was subsequently amended by 2012 c 87 § 1, changing subsection (24) to subsection (26). RCW 48.43.005 was subsequently alphabetized pursuant to RCW 1.08.015(2)(k), changing subsection (26) to subsection (27), and effective January 1, 2020, changing subsection (26) to subsection (29).
WA Rev Code § 48.20.900 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.20 - Disability Insurance.|48.20.900 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.

RCW 48.20.900 Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.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.[ 2009 c 521 § 115.]
WA Rev Code § 48.21.010 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.21 - Group and Blanket Disability Insurance.|48.21.010 - "Group disability insurance" defined—Issuance.

RCW 48.21.010 "Group disability insurance" defined—Issuance.(1) Group disability insurance is that form of disability insurance, including stop loss insurance as defined in RCW 48.11.030, provided by a master policy issued to an employer, to a trustee appointed by an employer or employers, or to an association of employers formed for purposes other than obtaining such insurance, covering, with or without their dependents, the employees, or specified categories of the employees, of such employers or their subsidiaries or affiliates, or issued to a labor union, or to an association of employees formed for purposes other than obtaining such insurance, covering, with or without their dependents, the members, or specified categories of the members, of the labor union or association, or issued pursuant to RCW 48.21.030. Group disability insurance includes the following groups that qualify for group life insurance:RCW 48.24.020, 48.24.035, 48.24.040, 48.24.045, 48.24.050, 48.24.060, 48.24.070, 48.24.080, 48.24.090, and 48.24.095. A group under RCW 48.24.027 does not qualify as a group for the purposes of this chapter.(2) Group disability insurance for lines of coverage identified in *RCW 48.43.005(26) (e), (h), (k), and (m) offered to a resident of this state under a group disability insurance policy may be issued to a group other than the groups described in subsection (1) of this section subject to the requirements in this subsection.(a) A group disability insurance policy offered under this subsection may not be delivered in this state unless the commissioner finds that:(i) The issuance of the group policy is not contrary to the best interest of the public;(ii) The issuance of the group policy would result in economies of acquisition or administration; and(iii) The benefits are reasonable in relation to the premium charged.(b) A group disability insurance coverage may not be offered under this subsection in this state by an insurer under a policy issued in another state unless the commissioner or the insurance commissioner of another state having requirements substantially similar to those contained in this subsection has made a determination that the requirements have been met.[ 2016 c 65 § 1; 2011 c 81 § 1; 2010 c 13 § 3; 1992 c 226 § 2; 1949 c 190 § 27; 1947 c 79 § .21.01; Rem. Supp. 1949 § 45.21.01.]NOTES:*Reviser's note: RCW 48.43.005 was alphabetized pursuant to RCW 1.08.015(2)(k), changing subsection (26) to subsection (27), and effective January 1, 2020, changing subsection (26) to subsection (29).Application—1992 c 226: See note following RCW 48.11.030.
WA Rev Code § 48.21.015 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.21 - Group and Blanket Disability Insurance.|48.21.015 - "Group stop loss insurance" defined for the purpose of exemption—Scope of application.

RCW 48.21.015 "Group stop loss insurance" defined for the purpose of exemption—Scope of application.Group stop loss insurance is exempt from all sections of this chapter and chapter 48.32A RCW except for RCW 48.21.010 and this section. For the purpose of this exemption, group stop loss is further defined as follows:(1) The policy must be issued to and insure the employer, the trustee or other sponsor of the plan, or the plan itself, but not the employees, members, or participants;(2) Payment by the insurer must be made to the employer, the trustee, or other sponsor of the plan or the plan itself, but not to the employees, members, participants, or health care providers;(3) The policy must contain a provision that establishes an aggregate attaching point or retention that is at the minimum one hundred twenty percent of the expected claims; and(4) The policy may provide for an individual attaching point or retention that is not less than five percent of the expected claims or one hundred thousand dollars, whichever is less.[ 2000 c 80 § 8; 1992 c 226 § 3.]NOTES:Application—1992 c 226: See note following RCW 48.11.030.
WA Rev Code § 48.21.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.21 - Group and Blanket Disability Insurance.|48.21.020 - "Employees," "employer" defined.

RCW 48.21.020 "Employees," "employer" defined.The term "employees" as used in this chapter shall be deemed to include as employees of a single employer, the compensated officers, managers, and employees of the employer and of subsidiary or affiliated corporations of a corporation employer, and the individual proprietors, partners, and employees of individuals and firms of which the business is controlled by the insured employer through stock ownership, contract or otherwise. The term "employer" as used in this chapter shall be deemed to include any municipal corporation or governmental unit, agency or department thereof as well as private individuals, firms, corporations and other persons.[1947 c 79 § .21.02; Rem. Supp. 1947 § 45.21.02.]
WA Rev Code § 48.21.030 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.21 - Group and Blanket Disability Insurance.|48.21.030 - Health care groups.

RCW 48.21.030 Health care groups.A policy of group disability insurance may be issued to a corporation, as policyholder, existing primarily for the purpose of assisting individuals who are its subscribers in securing medical, hospital, dental, and other health care services for themselves and their dependents, covering all and not less than five hundred such subscribers and dependents, with respect only to medical, hospital, dental, and other health care services.[1947 c 79 § .21.03; Rem. Supp. 1947 § 45.21.03.]