reglab/housing_qa huggingface dataset:
WA Rev Code § 48.46.325 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.325 - Option to cover child under age twenty-six.

RCW 48.46.325 Option to cover child under age twenty-six.(1) Each individual health maintenance agreement 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 group health maintenance agreement that is not grandfathered and that provides coverage for a participating member's child must offer each participating member the option of covering any child under the age of twenty-six.(3) Each grandfathered individual or group health maintenance agreement that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six, unless that child is eligible to enroll in an eligible health plan sponsored by the child's employer or the child's spouse's employer.(4) As used in this section, "grandfathered" has the same meaning as "grandfathered health plan" in RCW 48.43.005.[ 2012 c 211 § 19; 2011 c 314 § 8; 2007 c 259 § 22.]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 § 48.46.340 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.340 - Return of agreement within ten days.

RCW 48.46.340 Return of agreement within ten days.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.[ 2008 c 217 § 58; 1983 c 106 § 12.]NOTES:Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
WA Rev Code § 48.46.350 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.350 - Chemical dependency treatment.

RCW 48.46.350 Chemical dependency treatment.Each group agreement for health care services that is delivered or issued for delivery or renewed on or after January 1, 1988, must contain provisions providing benefits for the treatment of chemical dependency rendered to covered persons by a provider which is an "approved substance use disorder treatment program" under *RCW 70.96A.020(2). However, this section does not apply to any agreement written as supplemental coverage to any federal or state programs of health care including, but not limited to, Title XVIII health insurance for the aged, which is commonly referred to as Medicare, Parts A&B, and amendments thereto. Treatment must be covered under the chemical dependency coverage if treatment is rendered by the health maintenance organization or if the health maintenance organization refers the enrolled participant or the enrolled participant's dependents to a physician licensed under chapter 18.57 or 18.71 RCW, or to a qualified counselor employed by an approved substance use disorder treatment program described in *RCW 70.96A.020(2). In all cases, a health maintenance organization retains the right to diagnose the presence of chemical dependency and select the modality of treatment that best serves the interest of the health maintenance organization's enrolled participant, or the enrolled participant's covered dependent.[ 2018 c 201 § 8013; 2003 c 248 § 19; 1990 1st ex.s. c 3 § 14; 1987 c 458 § 18; 1983 c 106 § 13.]NOTES:*Reviser's note: RCW 70.96A.020 was repealed by 2016 sp.s. c 29 § 301.Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.Effective date—Severability—1987 c 458: See notes following RCW 48.21.160.Chemical dependency benefits, rules: RCW 48.21.197.
WA Rev Code § 48.46.355 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.355 - "Chemical dependency" defined.

RCW 48.46.355 "Chemical dependency" defined.For the purposes of RCW 48.46.350, "chemical dependency" means an illness characterized by a physiological of psychological dependency, or both, on a controlled substance regulated under chapter 69.50 RCW and/or alcoholic beverages. It is further characterized by a frequent or intense pattern of pathological use to the extent the user exhibits a loss of self-control over the amount and circumstances of use; develops symptoms of tolerance or physiological and/or psychological withdrawal if use of the controlled substance or alcoholic beverage is reduced or discontinued; and the user's health is substantially impaired or endangered or his or her social or economic function is substantially disrupted.[ 1987 c 458 § 19.]NOTES:Effective date—Severability—1987 c 458: See notes following RCW 48.21.160.
WA Rev Code § 48.46.360 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.360 - Payment of cost of agreement directly to holder during labor dispute—Changes restricted—Notice to employee.

RCW 48.46.360 Payment of cost of agreement directly to holder during labor dispute—Changes restricted—Notice to employee.Any employee whose compensation includes a health maintenance agreement, the cost of which is paid in full or in part by an employer including the state of Washington, its political subdivisions, or municipal corporations, or paid by payroll deduction, may pay the cost as it becomes due directly to the agreement holder whenever the employee's compensation is suspended or terminated directly or indirectly as a result of a strike, lockout, or other labor dispute, for a period not exceeding six months and at the rate and coverages as the health maintenance agreement provides. During that period of time, such agreement may not be altered or changed. Nothing in this section impairs the right of the health maintenance organization to make normal decreases or increases in the cost of the health maintenance agreement upon expiration and renewal of the agreement, in accordance with the agreement. Thereafter, if such health maintenance agreement is no longer available, the employee shall be given the opportunity to convert as specified in RCW 48.46.450 and 48.46.460. When the employee's compensation is so suspended or terminated, the employee shall be notified immediately by the agreement holder in writing, by mail addressed to the address last of record with the agreement holder, that the employee may pay the cost of the health maintenance agreement to the agreement holder as it becomes due as provided in this section. Payment must be made when due or the coverage may be terminated by the health maintenance organization.[ 1985 c 7 § 116; 1983 c 106 § 14.]
WA Rev Code § 48.46.370 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.370 - Coverage not denied for disability.

RCW 48.46.370 Coverage not denied for disability.No health maintenance organization may deny coverage to a person solely on account of the presence of any disability. Nothing in this section may be construed as limiting a health maintenance organization's authority to deny or otherwise limit coverage to a person when the person because of a medical condition does not meet the essential eligibility requirements established by the health maintenance organization for purposes of determining coverage for any person.[ 2020 c 274 § 39; 1983 c 106 § 15.]
WA Rev Code § 48.46.375 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.375 - Benefits for prenatal diagnosis of congenital disorders—Agreements entered into or renewed on or after January 1, 1990.

RCW 48.46.375 Benefits for prenatal diagnosis of congenital disorders—Agreements entered into or renewed on or after January 1, 1990.On or after January 1, 1990, every group health maintenance agreement entered into or renewed that covers hospital, medical, or surgical expenses 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 maintenance organization in accord with standards set in rule by the board of health: PROVIDED, That such procedures shall be covered only if rendered directly by the health maintenance organization or upon referral by the health maintenance organization. Every group health maintenance organization shall communicate the availability of such coverage to all groups covered and to all groups with whom they are negotiating.[ 1988 c 276 § 8.]NOTES:Prenatal testing—Limitation on changes to coverage: RCW 48.42.090.
WA Rev Code § 48.46.380 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.380 - Notice of reason for cancellation, denial, or refusal to renew agreement.

RCW 48.46.380 Notice of reason for cancellation, denial, or refusal to renew agreement.Every authorized health maintenance organization, upon canceling, denying, or refusing to renew any individual health maintenance agreement, shall, upon written request, directly notify in writing the applicant or enrolled participant as appropriate, of the reasons for the action by the health maintenance organization. Any benefits, terms, rates, or conditions of such agreement which are restricted, excluded, modified, increased, or reduced shall, upon written request, be set forth in writing and supplied to the individual. The written communications required by this section shall be phrased in simple language which is readily understandable to a person of average intelligence, education, and reading ability.[ 1993 c 492 § 291; 1983 c 106 § 16.]NOTES:Findings—Intent—1993 c 492: See notes following RCW 43.20.050.Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
WA Rev Code § 48.46.390 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.390 - Providing information on cancellation or refusal—No liability for insurance commissioner or health maintenance organization.

RCW 48.46.390 Providing information on cancellation or refusal—No liability for insurance commissioner or health maintenance organization.With respect to the provisions of health maintenance agreements as set forth in RCW 48.46.380, there shall be no liability on the part of, and no cause of action of any nature shall arise against, the insurance commissioner, the commissioner's agents, or members of the commissioner's staff, or against any health maintenance organization, its authorized representative, its agents, its employees, for providing to the health maintenance organization information as to reasons for cancellation or refusal to issue or renew, for libel or slander on the basis of any statement made by any of them in any written notice of cancellation or refusal to issue or renew, or in any other communications, oral or written, specifying the reasons for cancellation or refusal to issue or renew or the providing of information pertaining thereto, or for statements made or evidence submitted in any hearing conducted in connection therewith.[ 1983 c 106 § 17.]
WA Rev Code § 48.46.400 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.400 - False or misleading advertising prohibited.

RCW 48.46.400 False or misleading advertising prohibited.No person may knowingly make, publish, or disseminate any false, deceptive, or misleading representation or advertising in the conduct of the business of a health maintenance organization, or relative to the business of a health maintenance organization or to any person engaged therein.[ 1983 c 106 § 18.]
WA Rev Code § 48.46.410 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.410 - Misrepresentations to induce termination or retention of agreement prohibited.

RCW 48.46.410 Misrepresentations to induce termination or retention of agreement prohibited.No health maintenance organization nor any person representing a health maintenance organization may by misrepresentation or misleading comparisons induce or attempt to induce any member of a health maintenance organization to terminate or retain an agreement or membership in the organization.[ 1983 c 106 § 19.]
WA Rev Code § 48.46.420 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.420 - Penalty for violations.

RCW 48.46.420 Penalty for violations.(1) Except as otherwise provided in this chapter, any health maintenance organization which, or person who, violates any provision of this chapter is guilty of a gross misdemeanor.(2) A health maintenance organization that fails to comply with the net worth requirements of this chapter must cure that defect in compliance with an order of the commissioner rendered in conformity with rules adopted pursuant to chapter 34.05 RCW. The commissioner is authorized to take appropriate action to assure that the continued operation of the health maintenance organization will not be hazardous to its enrolled participants.[ 2003 c 250 § 12; 1990 c 119 § 10; 1983 c 106 § 20.]NOTES:Severability—2003 c 250: See note following RCW 48.01.080.
WA Rev Code § 48.46.430 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.430 - Enforcement authority of commissioner.

RCW 48.46.430 Enforcement authority of commissioner.For the purposes of this chapter, the insurance commissioner shall have the same powers and duties of enforcement as are provided in RCW 48.02.080.[ 1983 c 106 § 21.]
WA Rev Code § 48.46.440 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.440 - Continuation option to be offered.

RCW 48.46.440 Continuation option to be offered.Every health maintenance organization that issues agreements providing group coverage for hospital or medical care shall offer the agreement holder an option to include an agreement provision granting a person who becomes ineligible for coverage under the group agreement, the right to continue the group benefits for a period of time and at a rate agreed upon. The agreement provision shall provide that when such coverage terminates the covered person may convert to an agreement as provided in RCW 48.46.450.[ 1984 c 190 § 8.]NOTES:Legislative intent—Severability—1984 c 190: See notes following RCW 48.21.250.Application—1984 c 190 §§ 2, 5, and 8: See note following RCW 48.21.250.
WA Rev Code § 48.46.450 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.450 - Conversion agreement to be offered—Exceptions, conditions.

RCW 48.46.450 Conversion agreement to be offered—Exceptions, conditions.(1) Except as otherwise provided by this section, any group health maintenance agreement that provides benefits for hospital or medical care must contain a provision granting a person covered by the group agreement the right to obtain a conversion agreement from the health maintenance organization upon termination of the person's eligibility for coverage under the group agreement.(2) A health maintenance organization need not offer a conversion agreement to:(a) A person whose coverage under the group agreement ended when the person's employment or membership was terminated for misconduct: PROVIDED, That when a person's employment or membership is terminated for misconduct, a conversion policy shall be offered to the spouse and/or dependents of the terminated employee or member. The policy shall include in the conversion provisions the same conversion rights and conditions which are available to employees or members and their spouses and/or dependents who are terminated for reasons other than misconduct;(b) A person who is eligible for federal medicare coverage; or(c) A person who is covered under another group plan, policy, contract, or agreement providing benefits for hospital or medical care.(3) To obtain the conversion agreement, a person must submit a written application and the first premium payment for the conversion agreement not later than thirty-one days after the date the person's eligibility for group coverage terminates or thirty-one days after the date the person received notice of termination of coverage, whichever is later. The conversion agreement shall become effective without lapse of coverage, immediately following termination of coverage under the group agreement.(4) If a health maintenance organization or group agreement holder does not renew, cancels, or otherwise terminates the group agreement, the health maintenance organization must offer a conversion agreement to any person who was covered under the terminated agreement unless the person is eligible to obtain group benefits for hospital or medical care within thirty-one days after such nonrenewal, cancellation, or termination of the group agreement or thirty-one days after the date the person received notice of termination of coverage, whichever is later.(5) The health maintenance organization shall determine the premium for the conversion agreement in accordance with the organization's table of premium rates applicable to the age and class of risk of each person to be covered under the agreement and the type and amount of benefits provided.[ 2010 c 110 § 3; 1984 c 190 § 9.]NOTES:Application—2010 c 110: See note following RCW 48.21.260.Legislative intent—Severability—1984 c 190: See notes following RCW 48.21.250.
WA Rev Code § 48.46.460 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.460 - Conversion agreement—Restrictions and requirements—Rules.

RCW 48.46.460 Conversion agreement—Restrictions and requirements—Rules.(1) A health maintenance organization must offer a conversion agreement for comprehensive health care services and shall not require proof of insurability as a condition for issuance of the conversion agreement.(2) A conversion agreement may not contain an exclusion for preexisting conditions for an applicant.(3) A conversion agreement need not provide benefits identical to those provided under the group agreement. The conversion agreement may contain provisions requiring the person covered by the conversion agreement to pay reasonable deductibles and copayments, except for preventive service benefits as defined in 45 C.F.R. 147.130 (2010), implementing sections 2701 through 2763, 2791, and 2792 of the public health service act (42 U.S.C. 300gg through 300gg-63, 300gg-91, and 300gg-92), as amended.(4) The insurance commissioner shall adopt rules to establish minimum benefit standards for conversion agreements.(5) The commissioner shall adopt rules to establish specific standards for conversion agreement 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.[ 2019 c 33 § 6; 2011 c 314 § 9; 1984 c 190 § 10.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.Legislative intent—Severability—1984 c 190: See notes following RCW 48.21.250.
WA Rev Code § 48.46.470 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.470 - Endorsement of modifications.

RCW 48.46.470 Endorsement of modifications.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.[ 1985 c 320 § 7.]
WA Rev Code § 48.46.480 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.480 - Continuation of coverage of former family members.

RCW 48.46.480 Continuation of coverage of former family members.Every health care service agreement issued, amended, or renewed after January 1, 1986, 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 maintenance agreement without a physical examination, statement of health, or other proof of insurability.[ 1985 c 320 § 8.]
WA Rev Code § 48.46.490 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.490 - Coverage for adopted children.

RCW 48.46.490 Coverage for adopted children.(1) Any health maintenance agreement under this chapter which provides coverage for dependent children, as defined in the agreement of the enrolled participant, shall cover adoptive children placed with the enrolled participant on the same basis as other dependents, as provided in RCW 48.01.180.(2) If payment of an additional premium is required to provide coverage for a child, the agreement may require that notification of placement of a child for adoption and payment of the required premium must be furnished to the health maintenance organization. The notification period shall be no less than sixty days from the date of placement.[ 1986 c 140 § 5.]NOTES:Effective date, application—Severability—1986 c 140: See notes following RCW 48.01.180.
WA Rev Code § 48.46.500 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.46 - Health Maintenance Organizations.|48.46.500 - Cancellation of rider.

RCW 48.46.500 Cancellation of rider.Upon application by an enrollee, a rider shall be canceled if at least five years after its issuance, no health care services have been received by the enrollee 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 enrollee from that condition, such agreement not to be unreasonably withheld. The option of the enrollee 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 § 4.]