reglab/housing_qa huggingface dataset:
WA Rev Code § 48.83.090 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.090 - Denial of claims—Written explanation.

RCW 48.83.090 Denial of claims—Written explanation.All long-term care denials must be made within thirty days after receipt of a written request made by a policyholder or certificate holder, or his or her representative. All denials of long-term care claims by the issuer must provide a written explanation of the reasons for the denial and make available to the policyholder or certificate holder all information directly related to the denial.[ 2013 c 8 § 1; 2008 c 145 § 10.]
WA Rev Code § 48.83.100 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.100 - Rescission of policy or certificate.

RCW 48.83.100 Rescission of policy or certificate.(1) An issuer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim if:(a) A policy or certificate has been in force for less than six months and upon a showing of misrepresentation that is material to the acceptance for coverage; or(b) A policy or certificate that has been in force for at least six months but less than two years, upon a showing of misrepresentation that is both material to the acceptance for coverage and that pertains to the condition for which benefits are sought.(2) After a policy or certificate has been in force for two years it is not contestable upon the grounds of misrepresentation alone. Such a policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health.(3) An issuer's payments for benefits under a long-term care insurance policy or certificate may not be recovered by the issuer if the policy or certificate is rescinded.(4) This section does not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care that are governed by RCW 48.23.050 the state's life insurance incontestability clause. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care.[ 2008 c 145 § 11.]
WA Rev Code § 48.83.110 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.110 - Inflation protection features—Rules.

RCW 48.83.110 Inflation protection features—Rules.(1) The commissioner must establish minimum standards for inflation protection features.(2) An issuer must comply with the rules adopted by the commissioner that establish minimum standards for inflation protection features.[ 2008 c 145 § 12.]
WA Rev Code § 48.83.120 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.120 - Nonforfeiture benefit option—Offer required—Rules.

RCW 48.83.120 Nonforfeiture benefit option—Offer required—Rules.(1) Except as provided by this section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that includes a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. If a policyholder or certificate holder declines the nonforfeiture benefit, the issuer must provide a contingent benefit upon lapse that is available for a specified period of time following a substantial increase in premium rates.(2) If a group long-term care insurance policy is issued, the offer required in subsection (1) of this section must be made to the group policyholder. However, if the policy is issued as group long-term care insurance as defined in RCW 48.83.020(6)(d) other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificate holder.(3) The commissioner must adopt rules specifying the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies and certificates, the standards for nonforfeiture benefits, and the rules regarding contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse will be available and the substantial premium rate increase that triggers a contingent benefit upon lapse.[ 2008 c 145 § 13.]
WA Rev Code § 48.83.140 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.140 - Determining whether coverage is appropriate—Suitability standards—Information protected—Rules.

RCW 48.83.140 Determining whether coverage is appropriate—Suitability standards—Information protected—Rules.Issuers and their agents, if any, must determine whether issuing long-term care insurance coverage to a particular person is appropriate, except in the case of a life insurance policy that accelerates benefits for long-term care. (1) An issuer must:(a) Develop and use suitability standards to determine whether the purchase or replacement of long-term care coverage is appropriate for the needs of the applicant or insured;(b) Train its agents in the use of the issuer's suitability standards; and(c) Maintain a copy of its suitability standards and make the standards available for inspection, upon request.(2) The following must be considered when determining whether the applicant meets the issuer's suitability standards:(a) The ability of the applicant to pay for the proposed coverage and any other relevant financial information related to the purchase of or payment for coverage;(b) The applicant's goals and needs with respect to long-term care and the advantages and disadvantages of long-term care coverage to meet those goals or needs; and(c) The values, benefits, and costs of the applicant's existing health or long-term care coverage, if any, when compared to the values, benefits, and costs of the recommended purchase or replacement.(3) The sale or transfer of any suitability information provided to the issuer or agent by the applicant to any other person or business entity is prohibited.(4)(a) The commissioner shall adopt, by rule, forms of consumer-friendly personal worksheets that issuers and their agents must use for applications for long-term care coverage.(b) The commissioner may require each issuer to file its current forms of suitability standards and personal worksheets with the commissioner.[ 2008 c 145 § 15.]
WA Rev Code § 48.83.150 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.150 - Prohibited practices.

RCW 48.83.150 Prohibited practices.A person engaged in the issuance or solicitation of long-term care coverage shall not engage in unfair methods of competition or unfair or deceptive acts or practices, as such methods, acts, or practices are defined in chapter 48.30 RCW, or as defined by the commissioner.[ 2008 c 145 § 16.]
WA Rev Code § 48.83.160 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.160 - Violations—Fine.

RCW 48.83.160 Violations—Fine.An issuer or an insurance producer who violates a law or rule relating to the regulation of long-term care insurance or its marketing shall be subject to a fine of up to three times the amount of the commission paid for each policy involved in the violation or up to ten thousand dollars, whichever is greater.[ 2008 c 145 § 17.]
WA Rev Code § 48.83.170 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.170 - Rules, generally.

RCW 48.83.170 Rules, generally.(1) The commissioner must adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. The commissioner must adopt rules establishing loss ratio standards for long-term care insurance policies. The commissioner must adopt rules to promote premium adequacy and to protect policyholders in the event of proposed substantial rate increases, and to establish minimum standards for producer education, marketing practices, producer compensation, producer testing, penalties, and reporting practices for long-term care insurance.(2) The commissioner must adopt rules establishing standards protecting patient privacy rights, rights to receive confidential health care services, and standards for an issuer's timely review of a claim denial upon request of a covered person.(3) The commissioner must adopt by rule prompt payment requirements for long-term care insurance. The rules must include a definition of a "claim" and a definition of "clean claim." In adopting the rules the commissioner must consider the prompt payment requirements in long-term care insurance model acts developed by the national association of insurance commissioners.(4) The commissioner may adopt reasonable rules to effectuate any provision of this chapter in accordance with the requirements of chapter 34.05 RCW.[ 2013 c 8 § 2; 2008 c 145 § 18.]
WA Rev Code § 48.83.901 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.83 - Long-Term Care Insurance Coverage—Standards.|48.83.901 - Effective date—2008 c 145.

RCW 48.83.901 Effective date—2008 c 145.This act takes effect January 1, 2009.[ 2008 c 145 § 24.]
WA Rev Code § 48.84.010 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.010 - General provisions, intent.

RCW 48.84.010 General provisions, intent.This chapter may be known and cited as the "long-term care insurance act" and is intended to govern the content and sale of long-term care insurance and long-term care benefit contracts issued before January 1, 2009, as defined in this chapter. This chapter shall be liberally construed to promote the public interest in protecting purchasers of long-term care insurance from unfair or deceptive sales, marketing, and advertising practices. The provisions of this chapter shall apply in addition to other requirements of Title 48 RCW.[ 2008 c 145 § 19; 1986 c 170 § 1.]NOTES:Effective date—2008 c 145: See RCW 48.83.901.
WA Rev Code § 48.84.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.020 - Definitions.

RCW 48.84.020 Definitions.Unless the context requires otherwise, the definitions in this section apply throughout this chapter.(1) "Long-term care insurance" or "long-term care benefit contract" means any insurance policy or benefit contract primarily advertised, marketed, offered, or designed to provide coverage or services for either institutional or community-based convalescent, custodial, chronic, or terminally ill care. Such terms do not include and this chapter shall not apply to policies or contracts governed by chapter 48.66 RCW and continuing care retirement communities.(2) "Loss ratio" means the incurred claims plus or minus the increase or decrease in reserves as a percentage of the earned premiums, or the projected incurred claims plus or minus the increase or decrease in projected reserves as a percentage of projected earned premiums, as defined by the commissioner.(3) "Preexisting condition" means a covered person's medical condition that caused that person to have received medical advice or treatment during the specified time period before the effective date of coverage.(4) "Medicare" means Title XVIII of the United States social security act, or its successor program.(5) "Medicaid" means Title XIX of the United States social security act, or its successor program.(6) "Nursing home" means a nursing home as defined in RCW 18.51.010.[ 1986 c 170 § 2.]
WA Rev Code § 48.84.030 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.030 - Rules—Benefits-premiums ratio, coverage limitations.

RCW 48.84.030 Rules—Benefits-premiums ratio, coverage limitations.(1) The commissioner shall adopt rules requiring reasonable benefits in relation to the premium or price charged for long-term care policies and contracts which rules may include but are not limited to the establishment of minimum loss ratios.(2) In addition, the commissioner may adopt rules establishing standards for long-term care coverage benefit limitations, exclusions, exceptions, and reductions and for policy or contract renewability.[ 1986 c 170 § 3.]
WA Rev Code § 48.84.040 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.040 - Policies and contracts—Prohibited provisions.

RCW 48.84.040 Policies and contracts—Prohibited provisions.No long-term care insurance policy or benefit contract may:(1) Use riders, waivers, endorsements, or any similar method to limit or reduce coverage or benefits;(2) Indemnify against losses resulting from sickness on a different basis than losses resulting from accidents;(3) Be canceled, nonrenewed, or segregated at the time of rerating solely on the grounds of the age or the deterioration of the mental or physical health of the covered person;(4) Exclude or limit coverage for preexisting conditions for a period of more than one year prior to the effective date of the policy or contract or more than six months after the effective date of the policy or contract;(5) Differentiate benefit amounts on the basis of the type or level of nursing home care provided;(6) Contain a provision establishing any new waiting period in the event an existing policy or contract is converted to a new or other form within the same company.[ 1986 c 170 § 4.]
WA Rev Code § 48.84.050 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.050 - Disclosure rules—Required provisions in policy or contract.

RCW 48.84.050 Disclosure rules—Required provisions in policy or contract.(1) The commissioner shall adopt rules requiring disclosure to consumers of the level, type, and amount of benefits provided and the limitations, exclusions, and exceptions contained in a long-term care insurance policy or contract. In adopting such rules the commissioner shall require an understandable disclosure to consumers of any cost for services that the consumer will be responsible for in utilizing benefits covered under the policy or contract.(2) Each long-term care insurance policy or contract shall include a provision, prominently displayed on the first page of the policy or contract, stating in substance that the person to whom the policy or contract is sold shall be permitted to return the policy or contract within thirty days of its delivery. In the case of policies or contracts solicited and sold by mail, the person may return the policy or contract within sixty days. Once the policy or contract has been returned, the person may have the premium refunded if, after examination of the policy or contract, the person is not satisfied with it for any reason. An additional ten percent penalty shall be added to any premium refund due which is not paid within thirty days of return of the policy or contract to the insurer or insurance producer. If a person, pursuant to such notice, returns the policy or contract to the insurer at its branch or home office, or to the insurance producer from whom the policy or contract was purchased, the policy or contract shall be void from its inception, and the parties shall be in the same position as if no policy or contract had been issued.(3) No later than January 1, 2010, or when the insurer has used all of its existing paper long-term care insurance policy forms which were in its possession on July 1, 2009, whichever is earlier, the notice required by subsection (2) of this section shall use the term insurance producer in place of agent.[ 2008 c 217 § 67; 1986 c 170 § 5.]NOTES:Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
WA Rev Code § 48.84.060 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.060 - Prohibited practices.

RCW 48.84.060 Prohibited practices.No insurance producer or other representative of an insurer, contractor, or other organization selling or offering long-term care insurance policies or benefit contracts may: (1) Complete the medical history portion of any form or application for the purchase of such policy or contract; (2) knowingly sell a long-term care policy or contract to any person who is receiving medicaid; or (3) use or engage in any unfair or deceptive act or practice in the advertising, sale, or marketing of long-term care policies or contracts.[ 2008 c 217 § 68; 1986 c 170 § 6.]NOTES:Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
WA Rev Code § 48.84.070 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.070 - Separation of data regarding certain policies.

RCW 48.84.070 Separation of data regarding certain policies.Commencing with reports for accounting periods beginning on or after January 1, 1988, all insurers, fraternal benefit societies, health care services contractors, and health maintenance organizations shall, for reporting and recordkeeping purposes, separate data concerning long-term care insurance policies and contracts from data concerning other insurance policies and contracts.[ 1986 c 170 § 7.]
WA Rev Code § 48.84.910 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.84 - Long-Term Care Insurance Act.|48.84.910 - Effective date, application—1986 c 170.

RCW 48.84.910 Effective date, application—1986 c 170.RCW 48.84.060 shall take effect on November 1, 1986, and the commissioner shall adopt all rules necessary to implement RCW 48.84.060 by its effective date including rules prohibiting particular unfair or deceptive acts and practices in the advertising, sale, and marketing of long-term care policies and contracts. The commissioner shall adopt all rules necessary to implement the remaining sections of this chapter by July 1, 1987, and the remaining sections of this chapter shall apply to policies and contracts issued on or after January 1, 1988.[ 1986 c 170 § 10.]
WA Rev Code § 48.85.010 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.85 - Washington Long-Term Care Partnership.|48.85.010 - Washington long-term care partnership program—Generally.

RCW 48.85.010 Washington long-term care partnership program—Generally.The department of social and health services shall, in conjunction with the office of the insurance commissioner, coordinate a long-term care insurance program entitled the Washington long-term care partnership, whereby private insurance and medicaid funds shall be used to finance long-term care. For individuals purchasing a long-term care insurance policy or contract governed by chapter 48.84 or 48.83 RCW and meeting the criteria prescribed in this chapter, and any other terms as specified by the office of the insurance commissioner and the department of social and health services, this program shall allow for the exclusion of some or all of the individual's assets in determination of medicaid eligibility as approved by the centers for medicare and medicaid services.[ 2012 c 211 § 9; 2008 c 145 § 21; 1995 1st sp.s. c 18 § 76; 1993 c 492 § 458.]NOTES:Effective date—2008 c 145: See RCW 48.83.901.Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
WA Rev Code § 48.85.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.85 - Washington Long-Term Care Partnership.|48.85.020 - Protection of assets—Federal approval—Rules.

RCW 48.85.020 Protection of assets—Federal approval—Rules.The department of social and health services shall seek approval from the centers for medicare and medicaid services to allow the protection of an individual's assets as provided in this chapter. The department shall adopt all rules necessary to implement the Washington long-term care partnership program, which rules shall permit the exclusion of all or some of an individual's assets in a manner specified by the department in a determination of medicaid eligibility to the extent that private long-term care insurance provides payment or benefits for services.[ 2012 c 211 § 10; 1995 1st sp.s. c 18 § 77; 1993 c 492 § 459.]NOTES:Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
WA Rev Code § 48.85.030 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.85 - Washington Long-Term Care Partnership.|48.85.030 - Insurance policy criteria—Rules.

RCW 48.85.030 Insurance policy criteria—Rules.(1) The insurance commissioner shall adopt rules defining the criteria that qualified long-term care partnership insurance policies must meet to satisfy the requirements of this chapter. The rules shall incorporate any requirements set forth by chapter 48.83 RCW and the deficit reduction act of 2005 for qualified long-term care partnership insurance policies purchased for the purposes of this chapter.(2) Insurers offering long-term care policies for the purposes of this chapter shall demonstrate to the satisfaction of the insurance commissioner that they:(a) Have procedures to provide notice to each purchaser of the long-term care consumer education program;(b) Have procedures that provide for the keeping of individual policy records and procedures for the explanation of coverage and benefits identifying those payments or services available under the policy that meet the purposes of this chapter;(c) Agree to provide the insurance commissioner any required annual report containing information derived from the long-term care partnership long-term care insurance uniform data set as specified by the office of the insurance commissioner.[ 2011 c 47 § 12; 1995 1st sp.s. c 18 § 78; 1993 c 492 § 460.]NOTES:Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
WA Rev Code § 48.85.040 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.85 - Washington Long-Term Care Partnership.|48.85.040 - Consumer education program.

RCW 48.85.040 Consumer education program.The insurance commissioner shall, with the cooperation of the department of social and health services and members of the long-term care insurance industry, develop a consumer education program designed to educate consumers as to the need for long-term care, methods for financing long-term care, the availability of long-term care insurance, and the availability and eligibility requirements of the asset protection program provided under this chapter.[ 1995 1st sp.s. c 18 § 79; 1993 c 492 § 461.]NOTES:Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
WA Rev Code § 48.85.900 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.85 - Washington Long-Term Care Partnership.|48.85.900 - Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492.

RCW 48.85.900 Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492.See RCW 43.72.910 through 43.72.915.