reglab/housing_qa huggingface dataset:
WA Rev Code § 48.41.050 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.050 - Operation plan—Contents.

RCW 48.41.050 Operation plan—Contents.The plan of operation submitted by the board to the commissioner shall:(1) Establish procedures for the handling and accounting of assets and moneys of the pool;(2) Establish regular times and places for meetings of the board of directors;(3) Establish procedures for records to be kept of all financial transactions and for an annual fiscal reporting to the commissioner;(4) Contain additional provisions necessary and proper for the execution of the powers and duties of the pool;(5) Establish procedures for the collection of assessments from all members to provide for claims paid under the plan and for administrative expenses incurred or estimated to be incurred during the period for which the assessment is made;(6) Establish the amount of assessment pursuant to RCW 48.41.060, which shall occur after March 1st of each calendar year, and which shall be due and payable within thirty days of the receipt of the assessment notice;(7) Select an administrator in accordance with RCW 48.41.080; (8) Develop and implement a program to publicize the existence of the plan, the eligibility requirements and procedures for enrollment, and to maintain public awareness of the plan; and(9) Establish procedures under which applicants and participants may have grievances reviewed by an impartial body and reported to the board.[ 1987 c 431 § 5.]
WA Rev Code § 48.41.070 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.070 - Examination and report.

RCW 48.41.070 Examination and report.The pool shall be subject to examination by the commissioner as provided under chapter 48.03 RCW. The board of directors shall submit to the commissioner, not later than one hundred twenty days after the end of each accounting year, a financial report for the year in a form approved by the commissioner.[ 1998 c 245 § 98; 1989 c 121 § 4; 1987 c 431 § 7.]
WA Rev Code § 48.41.080 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.080 - Pool administrator—Selection, term, duties, pay.

RCW 48.41.080 Pool administrator—Selection, term, duties, pay.The board shall select an administrator through a competitive bidding process to administer the pool.(1) The board shall evaluate bids based upon criteria established by the board, which shall include:(a) The administrator's proven ability to handle health coverage;(b) The efficiency of the administrator's claim-paying procedures;(c) An estimate of the total charges for administering the plan; and(d) The administrator's ability to administer the pool in a cost-effective manner.(2) The administrator shall serve for a period of three years subject to removal for cause. At least six months prior to the expiration of each three-year period of service by the administrator, the board shall invite all interested parties, including the current administrator, to submit bids to serve as the administrator for the succeeding three-year period. Selection of the administrator for this succeeding period shall be made at least three months prior to the end of the current three-year period, unless at the time required for submission of bids pursuant to this subsection to the pool will be discontinued before the end of the succeeding thirty-six month period.(3) The administrator shall perform such duties as may be assigned by the board including:(a) Administering eligibility and administrative claim payment functions relating to the pool;(b) Establishing a premium billing procedure for collection of premiums from covered persons. Billings shall be made on a periodic basis as determined by the board, which shall not be more frequent than a monthly billing;(c) Performing all necessary functions to assure timely payment of benefits to covered persons under the pool including:(i) Making available information relating to the proper manner of submitting a claim for benefits to the pool, and distributing forms upon which submission shall be made;(ii) Taking steps necessary to offer and administer managed care benefit plans; and(iii) Evaluating the eligibility of each claim for payment by the pool;(d) Submission of regular reports to the board regarding the operation of the pool. The frequency, content, and form of the report shall be as determined by the board;(e) Following the close of each accounting year, determination of net paid and earned premiums, the expense of administration, and the paid and incurred losses for the year and reporting this information to the board and the commissioner on a form as prescribed by the commissioner.(4) The administrator shall be paid as provided in the contract between the board and the administrator for its expenses incurred in the performance of its services.[ 2011 c 314 § 14; 2000 c 79 § 10; 1997 c 231 § 212; 1989 c 121 § 5; 1987 c 431 § 8.]NOTES:Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.Short title—Part headings and captions not law—Severability—Effective dates—1997 c 231: See notes following RCW 48.43.005.
WA Rev Code § 48.41.120 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.120 - Comprehensive pool policy—Deductibles—Coinsurance—Carryover.

RCW 48.41.120 Comprehensive pool policy—Deductibles—Coinsurance—Carryover.(1) Subject to the limitation provided in subsection (3) of this section, the comprehensive pool policy offered under RCW 48.41.110(4) shall impose a deductible as provided in this subsection. Deductibles of five hundred dollars and one thousand dollars on a per person per calendar year basis shall initially be offered. The board may authorize deductibles in other amounts. The deductible shall be applied to the first five hundred dollars, one thousand dollars, or other authorized amount of eligible expenses incurred by the covered person.(2) Subject to the limitations provided in subsection (3) of this section, a mandatory coinsurance requirement shall be imposed at a rate not to exceed twenty percent of eligible expenses in excess of the mandatory deductible and which supports the efficient delivery of high quality health care services for the medical conditions of pool enrollees.(3) The maximum aggregate out-of-pocket payments for eligible expenses by the insured in the form of deductibles and coinsurance under the comprehensive pool policy offered under RCW 48.41.110(4) shall not exceed in a calendar year:(a) One thousand five hundred dollars per individual, or three thousand dollars per family, per calendar year for the five hundred dollar deductible policy;(b) Two thousand five hundred dollars per individual, or five thousand dollars per family per calendar year for the one thousand dollar deductible policy; or(c) An amount authorized by the board for any other deductible policy.(4) Except for those enrolled in a high deductible health plan qualified under federal law for use with a health savings account, eligible expenses incurred by a covered person in the last three months of a calendar year, and applied toward a deductible, shall also be applied toward the deductible amount in the next calendar year.(5) The board may modify cost-sharing as an incentive for enrollees to participate in care management services and other cost-effective programs and policies.[ 2007 c 259 § 31; 2000 c 79 § 14; 1989 c 121 § 8; 1987 c 431 § 12.]NOTES:Severability—Subheadings not law—2007 c 259: See notes following RCW 41.05.033.Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.
WA Rev Code § 48.41.130 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.130 - Policy forms—Approval required.

RCW 48.41.130 Policy forms—Approval required.All policy forms issued by the pool shall conform in substance to prototype forms developed by the pool, and shall in all other respects conform to the requirements of this chapter, and shall be filed with and approved by the commissioner before they are issued.[ 2000 c 79 § 15; 1997 c 231 § 215; 1987 c 431 § 13.]NOTES:Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.Short title—Part headings and captions not law—Severability—Effective dates—1997 c 231: See notes following RCW 48.43.005.
WA Rev Code § 48.41.140 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.140 - Coverage for children, dependents.

RCW 48.41.140 Coverage for children, dependents.(1) Coverage shall provide that health insurance benefits are applicable to children of the person in whose name the policy is issued including adopted and newly born natural children. Coverage shall also include necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. If payment of a specific premium is required to provide coverage for the child, the policy may require that notification of the birth or adoption of a child and payment of the required premium must be furnished to the pool within thirty-one days after the date of birth or adoption in order to have the coverage continued beyond the thirty-one day period. For purposes of this subsection, a child is deemed to be adopted, and benefits are payable, when the child is physically placed for purposes of adoption under the laws of this state with the person in whose name the policy is issued; and, when the person in whose name the policy is issued assumes financial responsibility for the medical expenses of the child. For purposes of this subsection, "newly born" means, and benefits are payable, from the moment of birth.(2) A pool policy shall provide that coverage of a dependent person shall terminate when the person becomes twenty-six years of age: PROVIDED, That coverage of such person shall not terminate at age twenty-six while he or she is and continues to be both (a) incapable of self-sustaining employment by reason of developmental or physical disability and (b) chiefly dependent upon the person in whose name the policy is issued for support and maintenance, provided proof of such incapacity and dependency is furnished to the pool by the policyholder within thirty-one days of the dependent's attainment of age twenty-six and subsequently as may be required by the pool but not more frequently than annually after the two-year period following the dependent's attainment of age twenty-six.[ 2020 c 274 § 34; 2011 c 314 § 16; 2000 c 79 § 16; 1987 c 431 § 14.]NOTES:Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.
WA Rev Code § 48.41.150 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.150 - Medical supplement policy.

RCW 48.41.150 Medical supplement policy.(1) The board shall offer a medical supplement policy for persons receiving medicare parts A and B. The supplement policy shall provide benefits of one hundred percent of the deductible and copayment required under medicare and eighty percent of the charges for covered services under this chapter that are not paid by medicare. The coverage shall include a limitation of one thousand dollars per person on total annual out-of-pocket expenses for the covered services.(2) If federal law is adopted that addresses this subject, the board shall offer a policy that is consistent with that federal law.[ 1989 c 121 § 9; 1987 c 431 § 15.]
WA Rev Code § 48.41.170 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.170 - Required rule making.

RCW 48.41.170 Required rule making.The commissioner shall adopt rules pursuant to chapter 34.05 RCW that:(1) Provide for disclosure by the member of the availability of insurance coverage from the pool; and(2) Implement this chapter.[ 1987 c 431 § 17.]
WA Rev Code § 48.41.190 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.190 - Civil and criminal immunity.

RCW 48.41.190 Civil and criminal immunity.The pool, members of the pool, board directors of the pool, officers of the pool, employees of the pool, the commissioner, the commissioner's representatives, and the commissioner's employees shall not be civilly or criminally liable and shall not have any penalty or cause of action of any nature arise against them for any action taken or not taken, including any discretionary decision or failure to make a discretionary decision, when the action or inaction is done in good faith and in the performance of the powers and duties under this chapter. Nothing in this section prohibits legal actions against the pool to enforce the pool's statutory or contractual duties or obligations.[ 2007 c 259 § 33; 1989 c 121 § 10; 1987 c 431 § 19.]NOTES:Severability—Subheadings not law—2007 c 259: See notes following RCW 41.05.033.
WA Rev Code § 48.41.210 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.210 - Last payor of benefits.

RCW 48.41.210 Last payor of benefits.It is the express intent of this chapter that the pool be the last payor of benefits whenever any other benefit is available.(1) Benefits otherwise payable under pool coverage shall be reduced by all amounts paid or payable through any other health insurance, or health benefit plans, including but not limited to self-insured plans and by all hospital and medical expense benefits paid or payable under any worker's compensation coverage, automobile medical payment or liability insurance whether provided on the basis of fault or nonfault, and by any hospital or medical benefits paid or payable under or provided pursuant to any state or federal law or program.(2) The administrator or the pool shall have a cause of action against an eligible person for the recovery of the amount of benefits paid which are not for covered expenses. Benefits due from the pool may be reduced or refused as a set-off against any amount recoverable under this subsection.[ 1987 c 431 § 21.]
WA Rev Code § 48.41.240 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.240 - Review of populations needing coverage through pool—Analysis and recommendations—Report.

RCW 48.41.240 Review of populations needing coverage through pool—Analysis and recommendations—Report.(1) The board shall review populations that may need ongoing access to coverage through the pool, with specific attention to those persons who may be excluded from or may receive inadequate coverage beginning January 1, 2014, such as persons with end-stage renal disease or HIV/AIDS, or persons not eligible for coverage in the exchange.(2) If the review under subsection (1) of this section indicates a continued need for coverage through the pool after December 31, 2013, the board shall submit recommendations regarding any modifications to pool eligibility requirements for new and ongoing enrollment after December 31, 2013. The recommendations must address any needed modifications to the standard health questionnaire or other eligibility screening tool that could be used in a manner consistent with federal law to determine eligibility for enrollment in the pool.(3) The board shall complete an analysis of current pool assessment requirements in relation to assessments that will fund the reinsurance program and recommend changes to pool assessments or any credits against assessments that may be considered for the reinsurance program. The analysis shall recommend whether the categories of members paying assessments should be adjusted to make the assessment fair and equitable among all payers.(4) The board shall report its recommendations to the governor and the legislature by December 1, 2012.(5) The board shall revisit the study of eligibility completed in 2012 with another review of the populations that may need ongoing access to coverage through the pool, to be submitted to the governor and legislature by November 1, 2015. The eligibility study shall include the nonmedicare populations scheduled to lose coverage and medicare populations, and consider whether the enrollees have access to comprehensive coverage alternatives that include appropriate pharmacy coverage. The study shall include recommendations to address any barriers in eligibility that remain in accessing other coverage such as medicare supplemental coverage or comprehensive pharmacy coverage, as well as suggestions for financing changes and recommendations on a future expiration of the pool.[ 2013 c 279 § 5; 2012 c 87 § 17.]NOTES:Finding—Intent—2013 c 279: See note following RCW 48.41.060.Spiritual care services—2012 c 87: See RCW 43.71.901.
WA Rev Code § 48.41.250 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.250 - Administration of risk management functions—Contract with commissioner authorized—Recommendations—Report to legislature.

RCW 48.41.250 Administration of risk management functions—Contract with commissioner authorized—Recommendations—Report to legislature.(1) The pool is authorized to contract with the commissioner to administer risk management functions if necessary, consistent with RCW 48.43.720, and consistent with P.L. 111-148 of 2010, as amended. Prior to entering into a contract, the pool may conduct preoperational and planning activities related to these programs, including defining and implementing an appropriate legal structure or structures to administer and coordinate the reinsurance or risk adjustment programs.(2) The reasonable costs incurred by the pool for preoperational and planning activities related to the reinsurance program may be reimbursed from federal funds or from the additional contributions authorized under RCW 48.43.720 to pay the administrative costs of the reinsurance program.(3) If the pool contracts to administer and coordinate the reinsurance or risk adjustment program, the board must submit recommendations to the legislature with suggestions for additional consumer representatives or other representative members to the board.(4) The pool shall report on these activities to the appropriate committees of the senate and house of representatives by December 15, 2012, and December 15, 2013.[ 2012 c 87 § 18.]NOTES:Effective date—2012 c 87 §§ 4, 16, 18, and 19-23: See note following RCW 43.71.030.Spiritual care services—2012 c 87: See RCW 43.71.901.
WA Rev Code § 48.41.900 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.900 - Federal supremacy.

RCW 48.41.900 Federal supremacy.If any part of this chapter is found to be in conflict with federal requirements which are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this chapter is hereby declared to be inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and such finding or determination shall not affect the operation of the remainder of this chapter in its application to the agencies concerned. The rules under this chapter shall meet federal requirements which are a necessary condition to the receipt of federal funds by the state.[ 1987 c 431 § 22.]
WA Rev Code § 48.41.920 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.41 - Health Insurance Coverage Access Act.|48.41.920 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.

RCW 48.41.920 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 § 124.]
WA Rev Code § 48.42.010 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.42 - Personal Coverage, General Authority.|48.42.010 - Personal coverage, authority of commissioner—Definition.

RCW 48.42.010 Personal coverage, authority of commissioner—Definition.(1) Notwithstanding any other provision of law, and except as provided in this chapter, any person or other entity which provides coverage in this state for life insurance, annuities, loss of time, medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether the coverage is by direct payment, reimbursement, the providing of services, or otherwise, shall be subject to the authority of the state insurance commissioner, unless the person or other entity shows that while providing the services it is subject to the jurisdiction and regulation of another agency of this state, any subdivisions thereof, or the federal government.(2) "Another agency of this state, any subdivision thereof, or the federal government" does not include the Washington health benefit exchange under chapter 43.71 RCW or P.L. 111-148 of 2010, as amended.[ 2012 c 87 § 10; 1985 c 264 § 15; 1983 c 36 § 1.]NOTES:Spiritual care services—2012 c 87: See RCW 43.71.901.
WA Rev Code § 48.42.020 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.42 - Personal Coverage, General Authority.|48.42.020 - Showing regulation by other agency, how done—Definition.

RCW 48.42.020 Showing regulation by other agency, how done—Definition.(1) A person or entity may show that it is subject to the jurisdiction and regulation of another agency of this state, any subdivision thereof, or the federal government, by providing to the insurance commissioner the appropriate certificate, license, or other document issued by the other governmental agency which permits or qualifies it to provide the coverage as defined in RCW 48.42.010.(2) "Another agency of this state, any subdivision thereof, or the federal government" does not include the Washington health benefit exchange under chapter 43.71 RCW or P.L. 111-148 of 2010, as amended.[ 2012 c 87 § 11; 1983 c 36 § 2.]NOTES:Spiritual care services—2012 c 87: See RCW 43.71.901.
WA Rev Code § 48.42.030 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.42 - Personal Coverage, General Authority.|48.42.030 - Examination by commissioner—When required, scope of.

RCW 48.42.030 Examination by commissioner—When required, scope of.Any person or entity which is unable to show under RCW 48.42.020 that it is subject to the jurisdiction and regulation of another agency of this state, any subdivision thereof, or the federal government, shall submit to an examination by the insurance commissioner to determine the organization and solvency of the person or the entity, and to determine whether or not such person or entity complies with the applicable provisions of this title.[ 1983 c 36 § 3.]
WA Rev Code § 48.42.040 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.42 - Personal Coverage, General Authority.|48.42.040 - Application of this title to otherwise unregulated entities.

RCW 48.42.040 Application of this title to otherwise unregulated entities.Any person or entity unable to show that it is subject to the jurisdiction and regulation of another agency of this state, any subdivision thereof, or the federal government, shall be subject to all appropriate provisions of this title regarding the conduct of its business including, but not limited to, RCW 48.43.300 through 48.43.370.[ 1998 c 241 § 16; 1983 c 36 § 4.]