reglab/statecodes huggingface dataset:
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.284 - Determination of financial condition—Hazardous to certificate holders—Commissioner's order—Hearing.

RCW 48.36A.284
Determination of financial condition—Hazardous to certificate holders—Commissioner's order—Hearing.
(1) For the purpose of making a determination of a society's financial condition, the commissioner may:
(a) Disregard any credit or amount receivable resulting from transactions with a reinsurer that is insolvent, impaired, or otherwise subject to a delinquency proceeding;
(b) Make appropriate adjustments to asset values attributable to investments in or transactions with parents, subsidiaries, or affiliates;
(c) Refuse to recognize the stated value of accounts receivable if the ability to collect receivables is highly speculative in view of the age of the account or the financial condition of the debtor; or
(d) Increase the society's liability in an amount equal to any contingent liability, pledge, or guarantee not otherwise included if there is a substantial risk that the society will be called upon to meet the obligation undertaken within the next twelve-month period.
(2) If the commissioner determines that the continued operation of the society authorized to transact business in this state may be hazardous to the certificate holders, then the commissioner may, in conjunction with or in lieu of a notice required or permitted by RCW 48.36A.272, issue an order requiring the society to:
(a) Reduce the total amount of present and potential liability for policy benefits by reinsurance;
(b) Reduce, suspend, or limit the volume of business being accepted or renewed;
(c) Reduce general insurance and commission expenses by specified methods;
(d) Increase the society's surplus;
(e) Suspend or limit the declaration and payment of refunds by a society to its members;
(f) File reports in a form acceptable to the commissioner concerning the market value of a society's assets;
(g) Limit or withdraw from certain investments or discontinue certain investment practices to the extent the commissioner deems necessary;
(h) Document the adequacy of premium rates in relation to the risks insured; or
(i) File, in addition to regular annual statements, interim financial reports on the form adopted by the national association of insurance commissioners or on a format promulgated by the commissioner.
(3) Any society subject to an order under subsection (2) of this section may make a written demand for a hearing, subject to the requirements of RCW 48.04.010, by specifying in what respects it is aggrieved and the grounds to be relied upon as basis for the relief to be demanded at the hearing.
[ 1996 c 236 § 9.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.286 - Rehabilitation, liquidation, or conservation of society—Same as insurance companies—Priority of distribution of claims.

RCW 48.36A.286
Rehabilitation, liquidation, or conservation of society—Same as insurance companies—Priority of distribution of claims.
(1) Any rehabilitation, liquidation, or conservation of a domestic fraternal benefit society is the same as the rehabilitation, liquidation, or conservation of an insurance company and shall be conducted under the supervision of the commissioner pursuant to the law governing the rehabilitation, liquidation, or conservation of insurance companies. The commissioner may apply for an order directing the commissioner to rehabilitate, liquidate, or conserve a domestic fraternal benefit society upon any one or more of the following grounds: That the domestic fraternal benefit society:
(a) Is insolvent; or
(b) Has ceased transacting insurance business for a period of one year; or
(c) Is insolvent and has commenced voluntary liquidation or dissolution, or attempts to commence or prosecute any action or proceeding to liquidate its business or affairs, or to dissolve its corporate charter, or to procure the appointment of a receiver, trustee, custodian, or sequestrator under any law except this code; or
(d) Any of the matters set forth in RCW 48.36A.310.
(2) The priority of the distribution of claims from a domestic fraternal benefit society's estate shall be as set forth in RCW 48.31.280.
[ 1996 c 236 § 10.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.290 - License required—Obtaining.

RCW 48.36A.290
License required—Obtaining.
(1) No foreign or alien society shall transact business in this state without a license issued by the commissioner. Any society desiring admission to this state shall comply substantially with the requirements and limitations of this chapter applicable to domestic societies and must have and continue to maintain unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340. A society may be licensed to transact business in this state upon filing with the commissioner:
(a) A duly certified copy of its articles of incorporation;
(b) A copy of its bylaws, certified by its secretary or corresponding officer;
(c) A power of attorney to the commissioner as prescribed in RCW 48.36A.410;
(d) A statement of its business under oath by its president and secretary, or corresponding officers, in a form prescribed by the commissioner, verified by an examination made by the supervising insurance official of its home state or other state, territory, province, or country, satisfactory to the commissioner;
(e) Certification from the proper official of its home state, territory, province, or country that the society is legally incorporated and licensed to transact business;
(f) Copies of its certificate forms; and
(g) Such other information as the commissioner may deem necessary; and upon a showing that its assets are invested in accordance with the provisions of this chapter.
(2) After June 30, 1997, a foreign or alien society which does not have unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340 may not issue any new policies or certificates until the society has unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340; however, a foreign or alien society may continue to issue new policies or certificates to members of the society who have an existing policy or certificate in force with the society on June 30, 1997. Once such a foreign or alien society obtains unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340, the society must continue to maintain unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340.
(3) After June 30, 1997, a foreign or alien society which had unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340 on December 31, 1996, must continue to maintain unimpaired surplus in the minimum amount of total capital and surplus required by RCW 48.05.340.
(4) The commissioner may, by rule, require foreign or alien fraternal societies to have and maintain a larger amount of surplus than the minimum amount of capital and surplus prescribed under RCW 48.05.340, based upon the type, volume, and nature of insurance business transacted, consistent with the principles of risk-based capital modified to recognize the special characteristics of fraternal benefit societies.
[ 1996 c 236 § 2; 1987 c 366 § 29.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.310 - Deficiencies, noncompliance by societies—Actions against license.

RCW 48.36A.310
Deficiencies, noncompliance by societies—Actions against license.
(1) The commissioner may refuse, suspend, or revoke a fraternal benefit society's license, if the society:
(a) Has exceeded its powers;
(b) Has failed to comply with any of the provisions of this chapter;
(c) Is not fulfilling its contracts in good faith;
(d) Is conducting its business fraudulently;
(e) Has a membership of less than four hundred after an existence of one year or more;
(f) Is found by the commissioner to be in such a condition that its further transaction of insurance in this state would be hazardous to certificate holders and the people in this state;
(g) Refuses to remove or discharge a trustee, director, or officer who has been convicted of any crime involving fraud, dishonesty, or like moral turpitude;
(h) Refuses to be examined, or if its trustees, directors, officers, employees, or representatives refuse to submit to examination or to produce its accounts, records, and files for examination by the commissioner when required, or refuse to perform any legal obligation relative to the examination;
(i) Fails to pay any final judgment rendered against it in this state upon any certificate, or undertaking issued by it, within thirty days after the judgment became final or within thirty days after time for taking an appeal has expired, or within thirty days after dismissal of an appeal before final determination, whichever date is the later;
(j) Is found by the commissioner, after investigation or upon receipt of reliable information, to be managed by persons, whether by its trustees, directors, officers, or by any other means, who are incompetent or untrustworthy or so lacking in fraternal benefit society managerial experience as to make a proposed operation hazardous to its members; or that there is good reason to believe it is affiliated directly or indirectly through ownership, control, or business relations, with any person or persons whose business operations are or have been found to be in violation of any law or rule, to the detriment of the members of the society or of the public, by bad faith or by manipulation of the assets, or of accounts, or of reinsurance of the society; or
(k) Does business through insurance producers or other representatives in this state or in any other state who are not properly licensed under applicable laws and rules.
(2) Nothing in this section shall prevent a society from continuing, in good faith, all contracts made in this state during the time the society was legally authorized to transact business herein.
[ 2008 c 217 § 45; 1996 c 236 § 3; 1987 c 366 § 31.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.320 - Requirements for injunction.

RCW 48.36A.320
Requirements for injunction.
No application or petition for injunction against any domestic, foreign, or alien society, or lodge thereof, shall be maintained in any court of this state unless made by the attorney general upon request of the commissioner.
[ 1987 c 366 § 32.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.330 - Insurance producers.

RCW 48.36A.330
Insurance producers.
(1) Insurance producers of societies shall be licensed in accordance with the applicable provisions of chapter 48.17 RCW regulating the licensing, revocation, suspension, or termination of licenses of resident and nonresident insurance producers.
(2) The following individuals shall not be deemed an insurance producer of a fraternal benefit society within the provisions of subsection (1) of this section:
(a) Any regular salaried officer or employee of a licensed society who devotes substantially all of their services to activities other than the solicitation of fraternal insurance contracts from the public, and who receives for the solicitation of such contracts no commission or other compensation directly dependent upon the amount of business obtained; or
(b) Any insurance producer or representative of a society who devotes, or intends to devote, less than fifty percent of their time to the solicitation and procurement of insurance contracts for such society: PROVIDED, That any person who in the preceding calendar year has solicited and procured life insurance contracts on behalf of any society in an amount of insurance in excess of fifty thousand dollars shall be conclusively presumed to be devoting, or intending to devote, fifty percent of the person's time to the solicitation or procurement of insurance contracts for such society.
[ 2008 c 217 § 46; 1987 c 366 § 33.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.340 - Unfair trade practices.

RCW 48.36A.340
Unfair trade practices.
(1) Except as provided in subsection (2) of this section, every society authorized to do business in this state shall be subject to the provisions of chapter 48.30 RCW relating to unfair trade practices.
(2) Nothing in chapter 48.30 RCW shall be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership, or be construed as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society.
[ 1987 c 366 § 34.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.350 - Service of process upon commissioner.

RCW 48.36A.350
Service of process upon commissioner.
(1) Every society authorized to do business in this state must appoint the commissioner as its attorney to receive service of, and upon whom must be served, all legal process issued against it in this state upon causes of action arising within this state. Service upon the commissioner as attorney constitutes service upon the society.
(2) With the appointment the society must designate the person to whom the commissioner must forward legal process so served upon him or her.
(3) The appointment of the commissioner as attorney is irrevocable, binds any successor in interest or to the assets or liabilities of the society, and remains in effect as long as there is in force in this state any contract made by the society or liabilities or duties arising therefrom.
(4) The service of process must be accomplished and processed in the manner prescribed under RCW 48.02.200.
[ 2011 c 47 § 11; 1987 c 366 § 35.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.360 - Penalties.

RCW 48.36A.360
Penalties.
(1) Any person who wilfully makes a false or fraudulent statement in or relating to an application for membership or for the purpose of obtaining money from or a benefit in any society, shall upon conviction be fined not less than one hundred dollars nor more than five hundred dollars or imprisonment in the county jail not less than thirty days nor more than three hundred sixty-four days, or both.
(2) Any person who wilfully makes a false or fraudulent statement in any verified report or declaration under oath required or authorized by this chapter, or of any material fact or thing contained in a sworn statement concerning the death or disability of an insured for the purpose of procuring payment of a benefit named in the certificate, shall be guilty of false swearing and shall be subject to the penalties under RCW 9A.72.040.
(3) Any person who solicits membership for, or in any manner assists in procuring membership in, any society not licensed to do business in this state shall be guilty of a misdemeanor and upon conviction be fined not less than fifty dollars nor more than two hundred dollars.
(4) Any person guilty of a wilful violation of, or neglect or refusal to comply with, the provisions of this chapter for which a penalty is not otherwise prescribed, shall upon conviction, be subject to a fine not exceeding two hundred dollars.
[ 2011 c 96 § 39; 1987 c 366 § 36.]
NOTES:
Findings—Intent—2011 c 96: See note following RCW 9A.20.021.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.380 - World War I societies.

RCW 48.36A.380
World War I societies.
Any corporation, society, order, or voluntary association operating as set forth in RCW 48.36A.010, 48.36A.020, and 48.36A.030, organized during the war in which the United States entered on April 6, 1917, with the purposes of assisting the government of the United States in maintaining and increasing the production of commodities essential for the prosecution of that war, and of developing loyalty to the United States, or whose membership is limited to veterans of that war, may be licensed under the provisions of this chapter and shall have all the privileges and shall be subject to all the provisions and regulations of this chapter, except that the provisions of this chapter requiring death benefits of at least one thousand dollars, medical examinations, and valuations of benefit certificates, shall not apply to such society, but the society may provide benefits in case of death or disability resulting solely from accidents in an amount not exceeding one thousand dollars and may also provide for death or funeral benefits, or both, not exceeding one hundred dollars each, and for sick or disability benefits not exceeding five hundred dollars to any one person, in any one year. Any corporation, society, order, or voluntary association organized under the provisions of this section shall file with the insurance commissioner a copy of all its rates and policy forms. Rates and policy forms must be approved by the insurance commissioner before becoming effective. All rates and forms approved by the commissioner shall be observed by the society until amended rates or forms shall have been filed with and approved by the insurance commissioner.
[ 1987 c 366 § 38.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.400 - Fraternal mutual life insurers.

RCW 48.36A.400
Fraternal mutual life insurers.
(1) A mutual life insurer which is affiliated with and insures exclusively members of a specified fraternal society, which society conducts its business and secures its membership on the lodge system, having ritualistic work and ceremonies, is herein designated as a fraternal mutual life insurer.
(2) Such an insurer shall be subject to the applicable provisions of this title governing mutual life insurers except only as to the provisions relative to annual meeting, taxes, fees, and licenses. Such an insurer shall pay for its annual license and filing its annual statement, the sum of ten dollars. Such an insurer shall pay the expense of examinations of it by the commissioner, upon statement furnished by the commissioner.
[ 1987 c 366 § 40.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.410 - Review of commissioner's decisions and findings.

RCW 48.36A.410
Review of commissioner's decisions and findings.
All decisions and findings of the commissioner made under the provisions of this chapter shall be subject to review as provided in chapter 34.05 RCW.
[ 1987 c 366 § 41.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.36A - Fraternal Benefit Societies. › 48.36A.901 - Effective date—1987 c 366.

RCW 48.36A.901
Effective date—1987 c 366.
This act shall take effect January 1, 1988.
[ 1987 c 366 § 45.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.010 - Purpose—Intent.

RCW 48.37.010
Purpose—Intent.
(1) The purpose of this chapter is to establish a framework for the commissioner's market conduct actions, including:
(a) Processes and systems for identifying, assessing, and prioritizing market conduct problems that have a substantial adverse impact on consumers, policyholders, and claimants;
(b) Market conduct actions by the commissioner to substantiate such market conduct problems and a means to remedy significant market conduct problems; and
(c) Procedures to communicate and coordinate market conduct actions among state insurance regulators to foster the most efficient and effective use of resources.
(2) It is the intent of the legislature that the market analysis or market conduct process utilize available technology in the least intrusive and most cost-efficient manner to develop a baseline understanding of the marketplace and to identify insurers or practices that deviate significantly from the norm or that pose a potential risk to the insurance consumer. It is also the intent of the legislature that this process include discretion for the commissioner to use market conduct examinations when the continuum of available market conduct actions have not sufficiently addressed issues concerning insurer activities in Washington, or when the continuum of available market conduct actions are not reasonably expected to address issues concerning insurer activities in Washington.
(3) It is further the intent of the legislature that the commissioner work with the national association of insurance commissioners toward development of an accreditation process for market conduct oversight and an effective process for domestic deference that creates protections for Washington consumers and efficient and effective regulation of the industry.
[ 2007 c 82 § 3.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.020 - Application.

RCW 48.37.020
Application.
This chapter applies to all entities regulated by this title, and to all persons or entities acting as or holding themselves out as insurers in this state, unless otherwise exempted from the provisions of this title.
[ 2007 c 82 § 4.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.050 - Protocols for market conduct actions—Rules—Report to the legislature.

RCW 48.37.050
Protocols for market conduct actions—Rules—Report to the legislature.
(1) Market conduct actions shall be taken as a result of market analysis and shall focus on the general business practices and compliance activities of insurers, rather than identifying obviously infrequent or unintentional random errors that do not cause significant consumer harm.
(2)(a) The commissioner is authorized to determine the frequency and timing of such market conduct actions. The timing shall depend upon the specific market conduct action to be initiated, unless extraordinary circumstances indicating a risk to consumers require immediate action.
(b) If the commissioner has information that more than one insurer is engaged in common practices that may violate statutes or rules, the commissioner may schedule and coordinate multiple examinations simultaneously.
(3) The insurer shall be given reasonable opportunity to resolve matters that arise as a result of a market analysis to the satisfaction of the commissioner before any additional market conduct actions are taken against the insurer.
(4) The commissioner shall adopt by rule, under chapter 34.05 RCW, procedures and documents that are substantially similar to the NAIC work products defined or referenced in this chapter. Market analysis, market conduct actions, and market conduct examinations shall be performed in accordance with the rule.
(5) At the beginning of the next legislative session after the adoption of the rules adopted under the authority of this section, the commissioner shall report to the appropriate policy committees of the legislature what rules were adopted; what statutory policies these rules were intended to implement; and such other matters as are indicated for the legislature's understanding of the role played by the NAIC in regulation of the insurance industry of Washington.
[ 2007 c 82 § 7.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.080 - Confidentiality.

RCW 48.37.080
Confidentiality.
(1) All data and documents, including but not limited to working papers, third-party models or products, complaint logs, and copies thereof, created, produced, or obtained by or disclosed to the commissioner, the commissioner's authorized representative, or an examiner appointed by the commissioner in the course of any market conduct actions or examinations made under this chapter, or in the course of market analysis by the commissioner of the market conditions of an insurer, or obtained by the NAIC as a result of any of the provisions of this chapter, to the extent the documents are in the possession of the commissioner or the NAIC, shall be confidential by law and privileged, shall not be subject to the provisions of chapter 42.56 RCW, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action.
(2) If the commissioner elects to issue a report of an examination, a preliminary or draft market conduct examination report is confidential and not subject to disclosure by the commissioner nor is it subject to subpoena or discovery. This subsection does not limit the commissioner's authority to use a preliminary or draft market conduct examination report and related information in furtherance of any legal or regulatory action, or to release it in accordance with the provisions of RCW 48.02.065.
(3) An insurance compliance self-evaluative audit document in the possession of the commissioner is confidential by law and privileged, and shall not be:
(a) Made public by the commissioner;
(b) Subject to the provisions of chapter 42.56 RCW;
(c) Subject to subpoena; and
(d) Subject to discovery and admissible in evidence in any private civil action.
(4) Neither the disclosure of any self-evaluative audit document to the commissioner or to the commissioner's designee nor the citation to this document in connection with an agency action shall constitute a waiver of any privilege that may otherwise apply.
[ 2007 c 82 § 10.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.090 - Market conduct oversight personnel.

RCW 48.37.090
Market conduct oversight personnel.
(1) Market conduct oversight personnel shall be qualified by education, experience, and, where applicable, professional designations. The commissioner may supplement the in-house market conduct oversight staff with qualified outside professional assistance if the commissioner determines that the assistance is necessary.
(2) Market conduct oversight personnel have a conflict of interest, either directly or indirectly, if they are affiliated with the management of, and have, within five years of any market conduct action, been employed by, or own a pecuniary interest in the insurer, subject to any examination under this chapter. This section shall not be construed to automatically preclude an individual from being:
(a) A policyholder or claimant under an insurance policy;
(b) A grantor of a mortgage or similar instrument on the individual's residence from a regulated entity, if done under customary terms and in the ordinary course of business;
(c) An investment owner in shares of regulated diversified investment companies; or
(d) A settlor or beneficiary of a "blind trust" into which any otherwise impermissible holdings have been placed.
[ 2007 c 82 § 11.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.100 - Immunity for the commissioner, market conduct oversight personnel, authorized representatives, and examiners.

RCW 48.37.100
Immunity for the commissioner, market conduct oversight personnel, authorized representatives, and examiners.
(1) No cause of action shall arise, nor shall any liability be imposed against the commissioner, the commissioner's authorized representatives, market conduct oversight personnel, or an examiner appointed by the commissioner for any statements made, or conduct performed in good faith while carrying out the provisions of this chapter.
(2) No cause of action shall arise, nor shall any liability be imposed against any person for the act of communicating or delivering information or data to the commissioner or the commissioner's authorized representative, market conduct oversight personnel, or examiner, under an examination made under this chapter, if the act of communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive.
(3) A person identified in subsection (1) of this section is entitled to an award of attorneys' fees and costs if he or she is the prevailing party in a civil cause of action for libel, slander, or any other relevant tort arising out of activities in carrying out the provisions of this chapter, and the party bringing the action was not substantially justified in doing so. For purposes of this section, a proceeding is "substantially justified" if it had a reasonable basis in law or fact at the time that it was initiated.
(4) If a claim is made or threatened as described in subsection (1) of this section, the commissioner shall provide or pay for the defense of himself or herself, the examiner or representative, and shall pay a judgment or settlement, until it is determined that the person did not act in good faith or did act with fraudulent intent or the intent to deceive.
(5) The immunity, indemnification, and other protections under this section are in addition to those now or hereafter existing under other law.
(6) This section does not abrogate or modify in any way any common law or statutory privilege or immunity, now or hereafter existing under this section or other law, enjoyed by any person identified in subsection (1) of this section.
[ 2007 c 82 § 12.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.110 - Fines and penalties.

RCW 48.37.110
Fines and penalties.
(1) Fines and penalties, applicable to the insurer as found in the Washington insurance code, levied as a result of a market conduct action or examination shall be consistent, reasonable, and justified.
(2) The commissioner shall take into consideration actions taken by insurers to maintain membership in, and comply with the standards of, best practices organizations, and the extent to which insurers maintain regulatory compliance programs to self-assess, self-report, and remediate problems detected, and may include those considerations in determining the appropriate fines or penalties levied in accordance with subsection (1) of this section.
(3) Commissioner enforcement actions shall not be based solely on violations identified in the insurer self-evaluative audit document, unless the commissioner confirms both that the violations occurred and that the insurer has not taken reasonable action based on the self-evaluative audit document to resolve and remediate the identified violations.
[ 2007 c 82 § 13.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.120 - Dispute resolution—Rules.

RCW 48.37.120
Dispute resolution—Rules.
(1) At any point in the market analysis, the insurer may request a review and resolution of issues by identifying the issues either orally or in writing to the market conduct oversight manager, or deputy insurance commissioner responsible for market conduct oversight. At each level, a response to the insurer shall be provided within five business days.
(2) At any point in the market conduct examination, the insurer may request a review and resolution of issues either orally or in writing to the market conduct oversight manager, or deputy insurance commissioner responsible for market conduct oversight. At each level, a response to the insurer shall be provided within five business days. This authorization for dispute resolution shall be secondary to the specific procedures set forth in RCW 48.37.060.
(3) After the deputy insurance commissioner responsible for market conduct oversight has responded to an insurer's issues, the insurer may request mediation of the issues. The insurance commissioner shall adopt by rule a process to govern mediation of insurer market conduct oversight issues. That rule shall:
(a) Provide for the selection by the commissioner of a panel of preapproved mediators;
(b) Require that insurers, upon notice of the start of a market analysis process or the start of a market conduct examination, identify from the preapproved list a mediator and an alternative mediator;
(c) Require the party requesting mediation to pay the costs of the mediator; and
(d) Provide for other rule provisions as are reasonably necessary for the efficient operation of a mediation process.
(4) At any point in the dispute resolution process contained in this section, the insurer may commence an adjudicative proceeding under chapters 48.04 and 34.05 RCW.
[ 2007 c 82 § 14.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.130 - Coordination with other state insurance regulators through the NAIC.

RCW 48.37.130
Coordination with other state insurance regulators through the NAIC.
(1) The commissioner shall share information and coordinate the commissioner's market analysis, market conduct actions, and examination efforts with other state insurance regulators. Such matters will be coordinated in accordance with guidelines adopted by the NAIC.
(2)(a) If a market conduct examination or action performed by another state insurance regulator results in a finding that an insurer should modify a specific practice or procedure, the commissioner shall, in lieu of conducting a market conduct action or examination, accept verification that the insurer made a similar modification in this state, unless the commissioner determines that the other state does not have laws substantially similar to those of this state, or does not have a market conduct oversight system that is comparable to the market conduct oversight system set forth in this chapter.
(b) The commissioner's determination under (a) of this subsection is discretionary with the commissioner and is not subject to appeal.
[ 2007 c 82 § 15.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.37 - Market Conduct Oversight. › 48.37.140 - Additional duties of the commissioner.

RCW 48.37.140
Additional duties of the commissioner.
(1) The commissioner shall designate a specific person or persons within the commissioner's office whose responsibilities shall include the receipt of information from employees of insurers and licensed entities concerning violations of laws or rules by their employers, as defined in this chapter. These persons shall be provided with proper training on the handling of such information. The information shall be confidential and not open to public inspection.
(2) At least once per year, or more frequently if deemed necessary, the commissioner shall make available in an appropriate manner to insurers and other entities subject to the scope of this title, information on new laws and regulations, enforcement actions, and other information the commissioner deems pertinent to ensure compliance with market conduct requirements.
[ 2007 c 82 § 16.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.012 - Minimum unrestricted net assets required.

RCW 48.38.012
Minimum unrestricted net assets required.
After June 30, 1998, an insurer or institution which does not have the minimum unrestricted net assets required by RCW 48.38.010(6) may not issue any new charitable gift annuities until the insurer or institution has and maintains the minimum unrestricted net assets required by RCW 48.38.010(6).
[ 1998 c 284 § 7.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.030 - Charitable annuity contract or policy form—Contents.

RCW 48.38.030
Charitable annuity contract or policy form—Contents.
Each charitable annuity contract or policy form must include the following information:
(1) The value of the property to be transferred;
(2) The amount of the annuity to be paid to the transferor or the transferor's nominee;
(3) The manner in which and the intervals at which payment is to be made;
(4) The age of the person during whose life payment is to be made; and
(5) The reasonable value as of the date of the agreement of the benefits created. This value may not exceed by more than fifteen percent the net single premium for the benefits, determined according to the standard of valuation set forth in RCW 48.38.020(3).
[ 2005 c 223 § 24; 1979 c 130 § 8.]
NOTES:
Severability—1979 c 130: See note following RCW 28B.10.485.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.040 - Certificate holder exempt from certain title provisions—Chapter 48.31 RCW applies.

RCW 48.38.040
Certificate holder exempt from certain title provisions—Chapter 48.31 RCW applies.
(1) An insurer or institution holding a certificate of exemption under this chapter shall be exempt from all other provisions of this title except as specifically enumerated in this chapter by reference.
(2) An insurer or institution holding a certificate of exemption under this chapter is subject to chapter 48.31 RCW.
[ 1998 c 284 § 3; 1979 c 130 § 9.]
NOTES:
Severability—1979 c 130: See note following RCW 28B.10.485.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.042 - Certificate holder—Variable annuity business prohibited.

RCW 48.38.042
Certificate holder—Variable annuity business prohibited.
An insurer or institution holding a certificate of exemption to issue charitable gift annuities under this chapter shall not transact or be authorized to transact a variable annuity business as described in chapter 48.18A RCW.
[ 1998 c 284 § 5.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.050 - Grounds for denial, revocation, or suspension of certificate of exemption—Fine may be levied.

RCW 48.38.050
Grounds for denial, revocation, or suspension of certificate of exemption—Fine may be levied.
(1) The insurance commissioner may refuse to grant, or may revoke or suspend, a certificate of exemption if the insurance commissioner finds that the insurer or institution does not meet the requirements of this chapter or if the insurance commissioner finds that the insurer or institution has violated RCW 48.01.030, any provisions of chapter 48.30 RCW, or this chapter, and any applicable provisions of Title 284 WAC, or is found by the insurance commissioner to be in such condition that its further issuance of charitable gift annuities would be hazardous to annuity contract holders and the people of this state.
(2) After hearing or with the consent of the insurer or institution and in addition to or in lieu of the suspension, revocation, or refusal to renew any certificate of exemption, the commissioner may levy a fine upon the insurer or institution in an amount not more than ten thousand dollars. The order levying such a fine shall specify the period within which the fine shall be fully paid and which period shall not be less than fifteen nor more than thirty days from the date of the order. Upon failure to pay such a fine when due the commissioner may revoke the certificate of exemption of the insurer or institution if not already revoked, and the fine shall be recovered in a civil action brought in behalf of the commissioner by the attorney general. Any fine so collected shall be paid by the commissioner to the state treasurer for the account of the general fund.
[ 2012 c 211 § 7; 1998 c 284 § 4; 1979 c 130 § 10.]
NOTES:
Severability—1979 c 130: See note following RCW 28B.10.485.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.060 - Hearings and appeals provisions inapplicable.

RCW 48.38.060
Hearings and appeals provisions inapplicable.
For purposes of this chapter, the provisions of chapter 48.04 RCW are applicable.
[ 1979 c 130 § 11.]
NOTES:
Severability—1979 c 130: See note following RCW 28B.10.485.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.38 - Charitable Gift Annuity Business. › 48.38.070 - Enforcement powers and duties.

RCW 48.38.070
Enforcement powers and duties.
For the purposes of this chapter, the insurance commissioner has the same powers and duties of enforcement as are provided in RCW 48.02.080.
[ 1979 c 130 § 12.]
NOTES:
Severability—1979 c 130: See note following RCW 28B.10.485.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.39 - Contracts Between Insurance Carriers, Health Care Providers, and Third-Party Payors. › 48.39.003 - Findings.

RCW 48.39.003
Findings.
The legislature finds that Washington state is a provider friendly state within which to practice medicine. As part of health care reform, Washington state endeavors to establish and operate a state-based health benefits exchange wherein insurance products will be offered for sale and add potentially three hundred thousand patients to commercial insurance, and to expand access to medicaid for potentially three hundred thousand new enrollees. Such a successful and new insurance market in Washington state will require the willing participation of all categories of health care providers. The legislature further finds that principles of fair contracting apply to all contracts between health care providers and health insurance carriers offering insurance within Washington state and that fair dealings and transparency in expectations should be present in interactions between all third-party payors and health care providers.
[ 2013 c 293 § 1.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.39 - Contracts Between Insurance Carriers, Health Care Providers, and Third-Party Payors. › 48.39.005 - Definitions.

RCW 48.39.005
Definitions.
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Health care provider" or "provider" has the same meaning as in RCW 48.43.005 and, for the purposes of this chapter, includes facilities licensed under chapter 70.41 RCW.
(2) "Material amendment" means an amendment to a contract between a payor and health care provider that would result in requiring a health care provider to participate in a health plan, product, or line of business with a lower fee schedule in order to continue to participate in a health plan, product, or line of business with a higher fee schedule. A material amendment does not include any of the following:
(a) A decrease in payment or compensation resulting from a change in a fee schedule published by the payor upon which the payment or compensation is based and the date of applicability is clearly identified in the contract, compensation addendum, or fee schedule notice;
(b) A decrease in payment or compensation that was anticipated under the terms of the contract, if the amount and date of applicability of the decrease is clearly identified in the contract; or
(c) Changes unrelated to compensation so long as reasonable notice of not less than sixty days is provided.
(3) "Payor" or "third-party payor" means carriers licensed under chapters 48.20, 48.21, 48.44, and 48.46 RCW, and *managed health care systems as defined in RCW 74.09.522.
[ 2013 c 293 § 2.]
NOTES:
Reviser's note: *(1) RCW 74.09.522 was amended by 2023 c 51 § 43, removing the definition of "managed health care system" and changing "managed health care system" to "managed care organization."
(2) The definitions in this section have been alphabetized pursuant to RCW 1.08.015(2)(k).
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.39 - Contracts Between Insurance Carriers, Health Care Providers, and Third-Party Payors. › 48.39.010 - Notice of material amendments to contract—Failure to comply.

RCW 48.39.010
Notice of material amendments to contract—Failure to comply.
(1) A third-party payor shall provide no less than sixty days' notice to the health care provider of any proposed material amendments to a health care provider's contract with the third-party payor.
(2) Any material amendment to a contract must be clearly defined in a notice to the provider from the third-party payor as being a material change to the contract before the provider's notice period begins. The notice must also inform the providers that they may choose to reject the terms of the proposed material amendment through written or electronic means at any time during the notice period and that such rejection may not affect the terms of the health care provider's existing contract with the third-party payor.
(3) A health care provider's rejection of the material amendment does not affect the terms of the health care provider's existing contract with the third-party payor.
(4) A failure to comply with the terms of subsections (1), (2), and (3) of this section shall void the effectiveness of the material amendment.
[ 2013 c 293 § 3.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.39 - Contracts Between Insurance Carriers, Health Care Providers, and Third-Party Payors. › 48.39.020 - Payor may require provider to extend payor's medicaid rates—Limitations.

RCW 48.39.020
Payor may require provider to extend payor's medicaid rates—Limitations.
A payor may require a health care provider to extend the payor's medicaid rates, or some percentage above the payor's medicaid rates, that govern a health benefit program administered by a public purchaser to a commercial plan or line of business offered by a payor that is not administered by a public purchaser only if the health care provider has expressly agreed in writing to the extension. For the purposes of this section, "administered by a public purchaser" does not include commercial coverage offered through the Washington health benefit exchange. Nothing in this section prohibits a payor from utilizing medicaid rates, or some percentage above medicaid rates, as a base when negotiating payment rates with a health care provider.
[ 2013 c 293 § 4.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.39 - Contracts Between Insurance Carriers, Health Care Providers, and Third-Party Payors. › 48.39.030 - Ambulatory surgical facilities—Payor survey requirements.

RCW 48.39.030
Ambulatory surgical facilities—Payor survey requirements.
If a payor that contracts with an ambulatory surgical facility licensed under chapter 70.230 RCW requires successful completion of a survey as part of the contract, the ambulatory surgical facility is deemed to have met survey requirements if it has successfully completed a survey performed pursuant to medicare certification or by an accrediting organization that has been determined by the secretary of the department of health to have substantially equivalent survey standards to those of the centers for medicare and medicaid services. The payor may not impose additional survey requirements on the ambulatory surgical facility.
[ 2016 c 146 § 5.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.41 - Health Insurance Coverage Access Act. › 48.41.020 - Intent.

RCW 48.41.020
Intent.
It is the purpose and intent of the legislature to provide access to health insurance coverage to all residents of Washington who are denied health insurance. It is the intent of the Washington state health insurance coverage access act to provide a mechanism to ensure the availability of comprehensive health insurance to persons unable to obtain such insurance coverage on either an individual or group basis directly under any health plan.
[ 2000 c 79 § 5; 1987 c 431 § 2.]
NOTES:
Effective date—Severability—2000 c 79: See notes following RCW 48.04.010.