reglab/housing_qa huggingface dataset:
WA Rev Code § 48.42.050 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.42 - Personal Coverage, General Authority.|48.42.050 - Notice to purchasers by uninsured production agency—Notice to production agency by administrator of coverage.

RCW 48.42.050 Notice to purchasers by uninsured production agency—Notice to production agency by administrator of coverage.Any production agency or administrator which advertises, sells, transacts, or administers the coverage in this state described in RCW 48.42.010 and which is required to submit to an examination by the insurance commissioner under RCW 48.42.030, shall, if the coverage is not fully insured or otherwise fully covered by an admitted life or disability insurer or health care service contractor or health maintenance organization agreement, advise every purchaser, prospective purchaser, and covered person of the lack of insurance or other coverage.Any administrator which advertises or administers the coverage in this state described in RCW 48.42.010 and which is subject to an examination by the insurance commissioner under RCW 48.42.030 shall advise any production agency of the elements of the coverage, including the amount of "stop-loss" insurance in effect.[ 1983 c 36 § 5.]
WA Rev Code § 48.42.090 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.42 - Personal Coverage, General Authority.|48.42.090 - Prenatal testing—Limitation on changes to coverage.

RCW 48.42.090 Prenatal testing—Limitation on changes to coverage.The carrier or provider of any group disability contract, health care services contract or health maintenance agreement shall not cancel, reduce, limit or otherwise alter or change the coverage provided solely on the basis of the result of any prenatal test.[ 1988 c 276 § 9.]
WA Rev Code § 48.43.001 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.001 - Intent.

RCW 48.43.001 Intent.It is the intent of the legislature to ensure that all enrollees in managed care settings have access to adequate information regarding health care services covered by health carriers' health plans, and provided by health care providers and health care facilities. It is only through such disclosure that Washington state citizens can be fully informed as to the extent of health insurance coverage, availability of health care service options, and necessary treatment. With such information, citizens are able to make knowledgeable decisions regarding their health care.[ 1996 c 312 § 1.]
WA Rev Code § 48.43.008 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.008 - Enrollment in employer-sponsored health plan—Person eligible for medical assistance.

RCW 48.43.008 Enrollment in employer-sponsored health plan—Person eligible for medical assistance.When the health care authority determines that it is cost-effective to enroll a person eligible for medical assistance under chapter 74.09 RCW in an employer-sponsored health plan, a carrier shall permit the enrollment of the person in the health plan for which he or she is otherwise eligible without regard to any open enrollment period restrictions.[ 2011 1st sp.s. c 15 § 77; 2007 c 259 § 24.]NOTES:Effective date—Findings—Intent—Report—Agency transfer—References to head of health care authority—Draft legislation—2011 1st sp.s. c 15: See notes following RCW 74.09.010.Severability—Subheadings not law—2007 c 259: See notes following RCW 41.05.033.
WA Rev Code § 48.43.009 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.009 - Health care sharing ministries.

RCW 48.43.009 Health care sharing ministries.Health care sharing ministries are not health carriers as defined in RCW 48.43.005 or insurers as defined in RCW 48.01.050. For purposes of this section, "health care sharing ministry" has the same meaning as in 26 U.S.C. Sec. 5000A.[ 2011 c 314 § 18.]
WA Rev Code § 48.43.012 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.012 - Health plans—Preexisting conditions—Rules.

RCW 48.43.012 Health plans—Preexisting conditions—Rules.(1) No carrier may reject an individual for an individual or group health benefit plan based upon preexisting conditions of the individual.(2) No carrier may deny, exclude, or otherwise limit coverage for an individual's preexisting health conditions including, but not limited to, preexisting condition exclusions or waiting periods.(3) No carrier may avoid the requirements of this section through the creation of a new rate classification or the modification of an existing rate classification. A new or changed rate classification will be deemed an attempt to avoid the provisions of this section if the new or changed classification would substantially discourage applications for coverage from individuals who are higher than average health risks. These provisions apply only to individuals who are Washington residents.(4) Unless preempted by federal law, the commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.[ 2019 c 33 § 2; 2011 c 315 § 3; 2001 c 196 § 6; 2000 c 79 § 19.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.Intent—2011 c 315: See note following RCW 48.43.005.Effective date—2001 c 196: See note following RCW 48.20.025.Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.
WA Rev Code § 48.43.01211 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.01211 - Health plans—Eligibility—Health status-related factors—Rules.

RCW 48.43.01211 Health plans—Eligibility—Health status-related factors—Rules.(1) A health carrier or health plan may not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual:(a) Health status;(b) Medical condition, including both physical and mental illnesses;(c) Claims experience;(d) Receipt of health care;(e) Medical history;(f) Genetic information;(g) Evidence of insurability, including conditions arising out of acts of domestic violence;(h) Disability; or(i) Any other health status-related factor determined appropriate by the commissioner.(2) Unless preempted by federal law, the commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.[ 2019 c 33 § 3.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.
WA Rev Code § 48.43.0122 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.0122 - Individual health benefit plans—Open enrollment and special enrollment periods—Rules—Enforcement.

RCW 48.43.0122 Individual health benefit plans—Open enrollment and special enrollment periods—Rules—Enforcement.(1) The commissioner shall adopt rules establishing and implementing requirements for the open enrollment periods and special enrollment periods that carriers must follow for individual health benefit plans.(2) The commissioner shall monitor the sale of individual health benefit plans and if a carrier refuses to sell guaranteed issue policies to persons in compliance with rules adopted by the commissioner pursuant to subsection (1) of this section, the commissioner may levy fines or suspend or revoke a certificate of authority as provided in chapter 48.05 RCW.[ 2019 c 33 § 11; 2011 c 315 § 4.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.Intent—2011 c 315: See note following RCW 48.43.005.
WA Rev Code § 48.43.0123 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.0123 - Health plans—Rescission of coverage—Rules.

RCW 48.43.0123 Health plans—Rescission of coverage—Rules.(1) A health plan or health carrier offering group or individual coverage may not rescind such coverage with respect to an enrollee once the enrollee is covered under the plan or coverage involved, except that this section does not apply to a covered person who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage. The plan or coverage may not be canceled except as permitted under RCW 48.43.035 or 48.43.038.(2) The commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.[ 2019 c 33 § 8.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.
WA Rev Code § 48.43.0124 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.0124 - Health plans—Cost sharing for essential health benefits—Rules.

RCW 48.43.0124 Health plans—Cost sharing for essential health benefits—Rules.(1) For plan years beginning in 2020, the cost sharing incurred under a health plan for the essential health benefits may not exceed the following amounts:(a) For self-only coverage:(i) The amount required under federal law for the calendar year; or(ii) If there are no cost-sharing requirements under federal law, eight thousand two hundred dollars increased by the premium adjustment percentage for the calendar year.(b) For coverage other than self-only coverage:(i) The amount required under federal law for the calendar year; or(ii) If there are no cost-sharing requirements under federal law, sixteen thousand four hundred dollars increased by the premium adjustment percentage for the calendar year.(2) Regardless of whether an enrollee is covered by a self-only plan or a plan that is other than self-only, the enrollee's cost sharing for the essential health benefits may not exceed the self-only annual limitation on cost sharing.(3) For purposes of this section, "the premium adjustment percentage for the calendar year" means the percentage, if any, by which the average per capita premium for health insurance in Washington for the preceding year, as estimated by the commissioner no later than April 1st of such preceding year, exceeds such average per capita premium for 2020 as determined by the commissioner.(4) Unless preempted by federal law, the commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.[ 2019 c 33 § 10.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.
WA Rev Code § 48.43.0125 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.0125 - Essential health benefits—Annual or lifetime dollar limits.

RCW 48.43.0125 Essential health benefits—Annual or lifetime dollar limits.A health carrier may not impose annual or lifetime dollar limits on an essential health benefit, other than those permitted as reference-based limitations under rules adopted by the commissioner.[ 2019 c 33 § 12.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.
WA Rev Code § 48.43.0127 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.0127 - Group health plans—Waiting period—Rules.

RCW 48.43.0127 Group health plans—Waiting period—Rules.(1) A group health plan and a health carrier offering group health coverage may not apply any waiting period that exceeds ninety days.(2) Unless preempted by federal law, the commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.[ 2019 c 33 § 14.]NOTES:Effective date—2019 c 33: See note following RCW 48.43.005.
WA Rev Code § 48.43.021 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.021 - Personally identifiable health information—Restrictions on release.

RCW 48.43.021 Personally identifiable health information—Restrictions on release.Except as otherwise required by statute or rule, a carrier and the Washington state health insurance pool, and persons acting at the direction of or on behalf of a carrier or the pool, who are in receipt of an enrollee's or applicant's personally identifiable health information included in the standard health questionnaire shall not disclose the identifiable health information unless such disclosure is explicitly authorized in writing by the person who is the subject of the information.[ 2000 c 79 § 22.]NOTES:Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.
WA Rev Code § 48.43.022 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.022 - Enrollee identification card—Social security number restriction.

RCW 48.43.022 Enrollee identification card—Social security number restriction.After December 31, 2005, a health carrier that issues a card identifying a person as an enrollee, and requires the person to present the card to providers for purposes of claims processing, may not display on the card an identification number that includes more than a four-digit portion of the person's complete social security number.[ 2004 c 115 § 1.]
WA Rev Code § 48.43.023 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.023 - Pharmacy identification cards—Rules.

RCW 48.43.023 Pharmacy identification cards—Rules.(1) A health carrier that provides coverage for prescription drugs provided on an outpatient basis and issues a card or other technology for claims processing, or an administrator of a health benefit plan including, but not limited to, third-party administrators for self-insured plans, pharmacy benefits managers, and state administered plans, shall issue to its enrollees a pharmacy identification card or other technology containing all information required for proper prescription drug claims adjudication.(2) Upon renewal of the health benefit plan, information on the pharmacy identification card or other technology shall be made current by the health carrier or other entity that issues the card.(3) Nothing in this section shall be construed to require any health carrier or administrator of a health benefit plan to issue a pharmacy identification card or other technology separate from another identification card issued to an enrollee under the health benefit plan if the identification card contains all of the information required under subsection (1) of this section.(4) This section applies to health benefit plans that are delivered, issued for delivery, or renewed on or after July 1, 2003. For the purposes of this section, renewal of a health benefit policy, contract, or plan occurs on each anniversary of the date on which coverage was first effective on the person or persons covered by the health benefit plan.(5) The insurance commissioner may adopt rules to implement chapter 106, Laws of 2001, taking into consideration any relevant standards developed by the national council for prescription drug programs and the requirements of the federal health insurance portability and accountability act of 1996.[ 2001 c 106 § 2.]NOTES:Intent—2001 c 106: "It is the intent of the legislature to improve care to patients by minimizing confusion, eliminating unnecessary paperwork, decreasing administrative burdens, and streamlining dispensing of prescription products paid for by third-party payors." [ 2001 c 106 § 1.]
WA Rev Code § 48.43.028 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.028 - Eligibility to purchase certain health benefit plans—Small employers and small groups.

RCW 48.43.028 Eligibility to purchase certain health benefit plans—Small employers and small groups.To the extent required of the federal health insurance portability and accountability act of 1996, the eligibility of an employer or group to purchase a health benefit plan set forth in RCW 48.21.045(1)(b), 48.44.023(1)(b), and 48.46.066(1)(b) must be extended to all small employers and small groups as defined in RCW 48.43.005.[ 2001 c 196 § 10.]NOTES:Effective date—2001 c 196: See note following RCW 48.20.025.
WA Rev Code § 48.43.041 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.041 - Individual health benefit plans—Mandatory benefits.

RCW 48.43.041 Individual health benefit plans—Mandatory benefits.(1) All individual health benefit plans, other than catastrophic health plans, offered or renewed on or after October 1, 2000, shall include benefits described in this section. Nothing in this section shall be construed to require a carrier to offer an individual health benefit plan.(a) Maternity services that include, with no enrollee cost-sharing requirements beyond those generally applicable cost-sharing requirements: Diagnosis of pregnancy; prenatal care; delivery; care for complications of pregnancy; physician services; hospital services; operating or other special procedure rooms; radiology and laboratory services; appropriate medications; anesthesia; and services required under RCW 48.43.115; and(b) Prescription drug benefits with at least a two thousand dollar benefit payable by the carrier annually.(2) If a carrier offers a health benefit plan that is not a catastrophic health plan to groups, and it chooses to offer a health benefit plan to individuals, it must offer at least one health benefit plan to individuals that is not a catastrophic health plan.[ 2000 c 79 § 26.]NOTES:Effective dates—2000 c 79 §§ 26, 38, and 39: "(1) Section 38 of this act takes effect July 1, 2000.(2) Section 39 of this act takes effect September 1, 2000.(3) *Section 26 of this act takes effect on the first day of the month following the expiration of a one hundred eighty-day period beginning on the effective date of section 25 of this act." [ 2000 c 79 § 50.]*Reviser's note: Section 26 of this act takes effect October 1, 2000.Severability—2000 c 79: See note following RCW 48.04.010.
WA Rev Code § 48.43.043 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.043 - Colorectal cancer examinations and laboratory tests—Required benefits or coverage.

RCW 48.43.043 Colorectal cancer examinations and laboratory tests—Required benefits or coverage.(1) Health plans issued or renewed on or after July 1, 2008, must provide benefits or coverage for colorectal cancer examinations and laboratory tests consistent with the guidelines or recommendations of the United States preventive services task force or the federal centers for disease control and prevention. Benefits or coverage must be provided:(a) For any of the colorectal screening examinations and tests in the selected guidelines or recommendations, at a frequency identified in such guidelines or recommendations, as deemed appropriate by the patient's physician after consultation with the patient; and(b) To a covered individual who is:(i) At least fifty years old; or(ii) Less than fifty years old and at high risk or very high risk for colorectal cancer according to such guidelines or recommendations.(2) To encourage colorectal cancer screenings, patients and health care providers must not be required to meet burdensome criteria or overcome significant obstacles to secure such coverage. An individual may not be required to pay an additional deductible or coinsurance for testing that is greater than an annual deductible or coinsurance established for similar benefits. If the health plan does not cover a similar benefit, a deductible or coinsurance may not be set at a level that materially diminishes the value of the colorectal cancer benefit required.(3)(a) A health carrier is not required under this section to provide for a referral to a nonparticipating health care provider, unless the carrier does not have an appropriate health care provider that is available and accessible to administer the screening exam and that is a participating health care provider with respect to such treatment.(b) If a health carrier refers an individual to a nonparticipating health care provider pursuant to this section, screening exam services or resulting treatment, if any, must be provided at no additional cost to the individual beyond what the individual would otherwise pay for services provided by a participating health care provider.[ 2007 c 23 § 1.]
WA Rev Code § 48.43.045 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.045 - Health plan requirements—Annual reports—Exemptions.

RCW 48.43.045 Health plan requirements—Annual reports—Exemptions.(1) Every health plan delivered, issued for delivery, or renewed by a health carrier on and after January 1, 1996, shall:(a) Permit every category of health care provider to provide health services or care included in the basic essential health benefits benchmark plan established by the commissioner consistent with RCW 48.43.715, to the extent that:(i) The provision of such health services or care is within the health care providers' permitted scope of practice;(ii) The providers agree to abide by standards related to:(A) Provision, utilization review, and cost containment of health services;(B) Management and administrative procedures; and(C) Provision of cost-effective and clinically efficacious health services; and(iii) The plan covers such services or care in the essential health benefits benchmark plan. The reference to the essential health benefits does not create a mandate to cover a service that is otherwise not a covered benefit.(b) Annually report the names and addresses of all officers, directors, or trustees of the health carrier during the preceding year, and the amount of wages, expense reimbursements, or other payments to such individuals, unless substantially similar information is filed with the commissioner or the national association of insurance commissioners. This requirement does not apply to a foreign or alien insurer regulated under chapter 48.20 or 48.21 RCW that files a supplemental compensation exhibit in its annual statement as required by law.(2) The requirements of subsection (1)(a) of this section do not apply to a licensed health care profession regulated under Title 18 RCW when the licensing statute for the profession states that such requirements do not apply.[ 2015 c 237 § 2; 2007 c 253 § 12; 2007 c 98 § 18; 2006 c 25 § 7; 1997 c 231 § 205; 1995 c 265 § 8.]NOTES:Effective date—Implementation—2007 c 253: See RCW 18.250.901 and 18.250.902.Effective dates—2007 c 98: See RCW 18.74.912.Short title—Part headings and captions not law—Severability—Effective dates—1997 c 231: See notes following RCW 48.43.005.Captions not law—Effective dates—Savings—Severability—1995 c 265: See notes following RCW 70.47.015.
WA Rev Code § 48.43.047 (2021)
2021 Revised Code of Washington|Title 48 - Insurance|Chapter 48.43 - Insurance Reform.|48.43.047 - Health plans—Minimum coverage for preventative services—No cost-sharing requirements.

RCW 48.43.047 Health plans—Minimum coverage for preventative services—No cost-sharing requirements.(1) A health plan issued on or after June 7, 2018, must, at a minimum, provide coverage for the same preventive services required to be covered under 42 U.S.C. Sec. 300gg-13 (2016) and any federal rules or guidance in effect on December 31, 2016, implementing 42 U.S.C. Sec. 300gg-13.(2) The health plan may not impose cost-sharing requirements for the preventive services required to be covered under subsection (1) of this section.(3) The insurance commissioner shall enforce this section consistent with federal rules, guidance, and case law in effect on December 31, 2016, applicable to 42 U.S.C. 300gg-13 (2016).[ 2018 c 14 § 1.]