reglab/statecodes huggingface dataset:
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.011 - Insurance producer—Definition—License required—Application, issuance, renewal, fees—Penalties involving license.

RCW 48.44.011
Insurance producer—Definition—License required—Application, issuance, renewal, fees—Penalties involving license.
(1) Insurance producer, as used in this chapter, means any person appointed or authorized by a health care service contractor to solicit applications for health care service contracts on its behalf.
(2) No person shall act as or hold himself or herself out to be an appointed insurance producer of a health care service contractor unless licensed as a disability insurance producer by this state and appointed by the health care service contractor on whose behalf solicitations are to be made.
(3) Applications, appointments, and qualifications for licenses, the renewal thereof, the fees and issuance of a license, and the renewal thereof shall be in accordance with the provisions of chapter 48.17 RCW that are applicable to a disability insurance producer.
(4) The commissioner may revoke, suspend, or refuse to issue or renew any insurance producer's license, or levy a fine upon the licensee, in accordance with those provisions of chapter 48.17 RCW that are applicable to a disability insurance producer.
[ 2008 c 217 § 50; 1983 c 202 § 1; 1969 c 115 § 7.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.013 - Filings with secretary of state—Copy for commissioner.

RCW 48.44.013
Filings with secretary of state—Copy for commissioner.
Health care service contractors and limited health care service contractors shall send a copy specifically for the office of the insurance commissioner to the secretary of state of any corporate document required to be filed in the office of the secretary of state, including articles of incorporation and bylaws, and any amendments thereto. The copy specifically provided for the office of the insurance commissioner shall be in addition to the copies required by the secretary of state and shall clearly indicate on the copy that it is for delivery to the office of the insurance commissioner.
[ 1998 c 23 § 16.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.015 - Registration by health care service contractors required—Penalty.

RCW 48.44.015
Registration by health care service contractors required—Penalty.
(1) A person may not in this state, by mail or otherwise, act as or hold himself or herself out to be a health care service contractor, as defined in RCW 48.44.010 without first being registered with the commissioner.
(2) The issuance, sale, or offer for sale in this state of securities of its own issue by any health care service contractor domiciled in this state other than the memberships and bonds of a nonprofit corporation shall be subject to the provisions of chapter 48.06 RCW relating to obtaining solicitation permits the same as if health care service contractors were domestic insurers.
(3) Any person violating any provision of subsection (2) of this section is guilty of a gross misdemeanor and will, upon conviction, be fined not more than one thousand dollars or imprisoned for not more than six months, or both, for each violation.
[ 2003 c 250 § 7; 1983 c 202 § 2; 1969 c 115 § 6.]
NOTES:
Severability—2003 c 250: See note following RCW 48.01.080.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.016 - Unregistered activities—Acts committed in this state—Sanctions.

RCW 48.44.016
Unregistered activities—Acts committed in this state—Sanctions.
(1) As used in this section, "person" has the same meaning as in RCW 48.01.070.
(2) For the purpose of this section, an act is committed in this state if it is committed, in whole or in part, in the state of Washington, or affects persons or property within the state and relates to or involves a health care services contract.
(3) Any person who knowingly violates RCW 48.44.015(1) is guilty of a class B felony punishable under chapter 9A.20 RCW.
(4) Any criminal penalty imposed under this section is in addition to, and not in lieu of, any other civil or administrative penalty or sanction otherwise authorized under state law.
(5)(a) If the commissioner has cause to believe that any person has violated the provisions of RCW 48.44.015(1), the commissioner may:
(i) Issue and enforce a cease and desist order in accordance with the provisions of RCW 48.02.080; and/or
(ii) Assess a civil penalty of not more than twenty-five thousand dollars for each violation, after providing notice and an opportunity for a hearing in accordance with chapters 34.05 and 48.04 RCW.
(b) Upon failure to pay a civil penalty when due, the attorney general may bring a civil action on behalf of the commissioner to recover the unpaid penalty. Any amounts collected by the commissioner must be paid to the state treasurer for the account of the general fund.
[ 2003 c 250 § 8.]
NOTES:
Severability—2003 c 250: See note following RCW 48.01.080.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.024 - Requirements for plans offered to small employers—Definitions.

RCW 48.44.024
Requirements for plans offered to small employers—Definitions.
(1) A health care service contractor may not offer any health benefit plan to any small employer without complying with RCW 48.44.023(3).
(2) Employers purchasing health plans provided through associations or through member-governed groups formed specifically for the purpose of purchasing health care are not small employers and the plans are not subject to RCW 48.44.023(3).
(3) For purposes of this section, "health benefit plan," "health plan," and "small employer" mean the same as defined in RCW 48.43.005.
[ 2003 c 248 § 15; 1995 c 265 § 23.]
NOTES:
Captions not law—Effective dates—Savings—Severability—1995 c 265: See notes following RCW 70.47.015.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.026 - Payment for certain health care services.

RCW 48.44.026
Payment for certain health care services.
Checks in payment for claims pursuant to any health care service contract for health care services provided by persons licensed or regulated under chapters 18.25, 18.29, 18.30, 18.32, 18.53, 18.57, 18.64, 18.71, 18.73, 18.74, 18.83, or 18.79 RCW, as it applies to registered nurses and advanced registered nurse practitioners, where the provider is not a participating provider under a contract with the health care service contractor, shall be made out to both the provider and the enrolled participant with the provider as the first named payee, jointly, to require endorsement by each: PROVIDED, That payment shall be made in the single name of the enrolled participant if the enrolled participant as part of his or her claim furnishes evidence of prepayment to the health care service provider: AND PROVIDED FURTHER, That nothing in this section shall preclude a health care service contractor from voluntarily issuing payment in the single name of the provider.
[ 1999 c 130 § 1; 1994 sp.s. c 9 § 732; 1990 c 120 § 6; 1989 c 122 § 1; 1984 c 283 § 1; 1982 c 168 § 1.]
NOTES:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.033 - Financial failure—Supervision of commissioner—Priority of distribution of assets.

RCW 48.44.033
Financial failure—Supervision of commissioner—Priority of distribution of assets.
(1) Any rehabilitation, liquidation, or conservation of a health care service contractor shall be deemed to be 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 health care service contractor upon any one or more grounds set out in RCW 48.31.030, 48.31.050, and 48.31.080.
(2) For purpose of determining the priority of distribution of general assets, claims of enrolled participants and enrolled participants' beneficiaries shall have the same priority as established by RCW 48.31.280 for policyholders and beneficiaries of insureds of insurance companies. If an enrolled participant is liable to any provider for services provided pursuant to and covered by the health care plan, that liability shall have the status of an enrolled participant claim for distribution of general assets.
(3) Any provider who is obligated by statute or agreement to hold enrolled participants harmless from liability for services provided pursuant to and covered by a health care plan shall have a priority of distribution of the general assets immediately following that of enrolled participants and enrolled participants' beneficiaries as described herein, and immediately preceding the priority of distribution described in chapter 48.31 RCW.
[ 1990 c 120 § 2.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.039 - Minimum net worth—Domestic or foreign health care service contractor.

RCW 48.44.039
Minimum net worth—Domestic or foreign health care service contractor.
(1) For purposes of this section:
(a) "Domestic health care service contractor" means a health care service contractor formed under the laws of this state; and
(b) "Foreign health care service contractor" means a health care service contractor formed under the laws of the United States, of a state or territory of the United States other than this state, or of the District of Columbia.
(2) If the minimum net worth of a domestic health care service contractor falls below the minimum net worth required by this chapter, the commissioner shall at once ascertain the amount of the deficiency and serve notice upon the domestic health care service contractor to cure the deficiency within ninety days after that service of notice.
(3) If the deficiency is not cured, and proof thereof filed with the commissioner within the ninety-day period, the domestic health care service contractor shall be declared insolvent and shall be proceeded against as authorized by this code, or the commissioner shall, consistent with chapters 48.04 and 34.05 RCW, suspend or revoke the registration of the domestic health care service contractor as being hazardous to its subscribers and the people in this state.
(4) If the deficiency is not cured the domestic health care service contractor shall not issue or deliver any individual or group contract after the expiration of the ninety-day period.
(5) If the minimum net worth of a foreign health care service contractor falls below the minimum net worth required by this chapter, the commissioner shall, consistent with chapters 48.04 and 34.05 RCW, suspend or revoke the foreign health care service contractor's registration as being hazardous to its subscribers or the people in this state.
[ 1997 c 212 § 3.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.040 - Registration with commissioner—Fee.

RCW 48.44.040
Registration with commissioner—Fee.
Every health care service contractor who or which enters into agreements which require prepayment for health care services shall register with the insurance commissioner on forms to be prescribed and provided by him or her. Such registrants shall state their name, address, type of organization, area of operation, type or types of health care services provided, and such other information as may reasonably be required by the insurance commissioner and shall file with such registration a copy of all contracts being offered and a schedule of all rates charged. No registrant shall change any rates, modify any contract, or offer any new contract, until he or she has filed a copy of the changed rate schedule, modified contract, or new contract with the insurance commissioner. The insurance commissioner shall charge a fee of ten dollars for the filing of each original registration statement and may require each registrant to file a current reregistration statement annually thereafter.
[ 2009 c 549 § 7145; 1947 c 268 § 4; Rem. Supp. 1947 § 6131-13.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.050 - Rules and regulations.

RCW 48.44.050
Rules and regulations.
The insurance commissioner shall make reasonable regulations in aid of the administration of this chapter which may include, but shall not be limited to regulations concerning the maintenance of adequate insurance, bonds, or cash deposits, information required of registrants, and methods of expediting speedy and fair payments to claimants.
[ 1947 c 268 § 5; Rem. Supp. 1947 § 6131-14.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.055 - Plan for handling insolvency—Commissioner's review.

RCW 48.44.055
Plan for handling insolvency—Commissioner's review.
Each health care service contractor shall have a plan for handling insolvency that allows for continuation of benefits for the duration of the contract period for which premiums have been paid and continuation of benefits to members who are confined on the date of insolvency in an inpatient facility until their discharge or expiration of benefits. The commissioner shall approve such a plan if it includes:
(1) Insurance to cover the expenses to be paid for continued benefits after insolvency;
(2) Provisions in provider contracts that obligate the provider to provide services for the duration of the period after the health care service contractor's insolvency for which premium payment has been made and until the enrolled participants are discharged from inpatient facilities;
(3) Use of insolvency reserves established under RCW 48.44.030;
(4) Acceptable letters of credit or approved surety bonds; or
(5) Any other arrangements the commissioner and the organization mutually agree are appropriate to assure that the benefits are continued.
[ 1990 c 120 § 11.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.060 - Penalty.

RCW 48.44.060
Penalty.
Except as otherwise provided in this chapter, any person who violates any of the provisions of this chapter is guilty of a gross misdemeanor.
[ 2003 c 250 § 9; 1947 c 268 § 6; Rem. Supp. 1947 § 6131-15.]
NOTES:
Severability—2003 c 250: See note following RCW 48.01.080.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.080 - Master lists of contractor's participating providers—Filing with commissioner—Notice of termination or participation.

RCW 48.44.080
Master lists of contractor's participating providers—Filing with commissioner—Notice of termination or participation.
Every health care service contractor shall file with its annual statement with the insurance commissioner a master list of the participating providers with whom or with which such health care service contractor has executed contracts of participation, certifying that each such participating provider has executed such contract of participation. The health care service contractor shall on the first day of each month notify the insurance commissioner in writing in case of the termination of any such contract, and of any participating provider who has entered into a participating contract during the preceding month.
[ 1990 c 120 § 10; 1986 c 223 § 4; 1965 c 87 § 3; 1961 c 197 § 5.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.090 - Refusal to register corporate, etc., contractor if name confusing with existing contractor or insurance company.

RCW 48.44.090
Refusal to register corporate, etc., contractor if name confusing with existing contractor or insurance company.
The insurance commissioner shall refuse to accept the registration of any corporation, cooperative group, or association seeking to act as a health care service contractor if, in his or her discretion, the insurance commissioner deems that the name of the corporation, cooperative group, or association would be confused with the name of an existing registered health care service contractor or authorized insurance company.
[ 2009 c 549 § 7146; 1961 c 197 § 6.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.100 - Filing inaccurate financial statement prohibited.

RCW 48.44.100
Filing inaccurate financial statement prohibited.
No person shall knowingly file with any public official or knowingly make, publish, or disseminate any financial statement of a health care service contractor which does not accurately state the health care service contractor's financial condition.
[ 1961 c 197 § 7.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.110 - False representation, advertising.

RCW 48.44.110
False representation, advertising.
No person shall knowingly make, publish, or disseminate any false, deceptive, or misleading representation or advertising in the conduct of the business of a health care service contractor, or relative to the business of a health care service contractor or to any person engaged therein.
[ 1961 c 197 § 8.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.120 - Misrepresentations of contract terms, benefits, etc.

RCW 48.44.120
Misrepresentations of contract terms, benefits, etc.
No person shall knowingly make, issue, or circulate, or cause to be made, issued, or circulated, a misrepresentation of the terms of any contract, or the benefits or advantages promised thereby, or use the name or title of any contract or class of contract misrepresenting the nature thereof.
[ 1961 c 197 § 9.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.130 - Future dividends or refunds—When permissible.

RCW 48.44.130
Future dividends or refunds—When permissible.
No health care service contractor nor any individual acting on behalf thereof shall guarantee or agree to the payment of future dividends or future refunds of unused charges or savings in any specific or approximate amounts or percentages in respect to any contract being offered to the public, except in a group contract containing an experience refund provision.
[ 1961 c 197 § 10.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.140 - Misleading comparisons to terminate or retain contract.

RCW 48.44.140
Misleading comparisons to terminate or retain contract.
No health care service contractor nor any person representing a health care service contractor shall by misrepresentation or misleading comparisons induce or attempt to induce any member of any health care service contractor to terminate or retain a contract or membership.
[ 1961 c 197 § 11.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.145 - Examination of contractors—Duties of contractor, powers of commissioner—Independent audit reports.

RCW 48.44.145
Examination of contractors—Duties of contractor, powers of commissioner—Independent audit reports.
(1) The commissioner may make an examination of the operations of any health care service contractor as often as he or she deems necessary in order to carry out the purposes of this chapter.
(2) Every health care service contractor shall submit its books and records relating to its operation for financial condition and market conduct examinations and in every way facilitate them. For the purpose of examinations, the commissioner may issue subpoenas, administer oaths, and examine the officers and principals of the health care service contractor.
(3) The commissioner may elect to accept and rely on audit reports made by an independent certified public accountant for the health care service contractor in the course of that part of the commissioner's examination covering the same general subject matter as the audit. The commissioner may incorporate the audit report in his or her report of the examination.
(4) Whenever any health care service contractor applies for initial admission, the commissioner may make, or cause to be made, an examination of the applicant's business and affairs. Whenever such an examination is made, all of the provisions of chapter 48.03 RCW not inconsistent with this chapter shall be applicable. In lieu of making an examination himself or herself the commissioner may, in the case of a foreign health care service contractor, accept an examination report of the applicant by the regulatory official in its state of domicile.
[ 2009 c 549 § 7147; 1986 c 296 § 8; 1983 c 63 § 1; 1969 c 115 § 12.]
NOTES:
Severability—Effective date—1986 c 296: See notes following RCW 48.14.020.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.150 - Certificate of registration not an endorsement—Display in solicitation prohibited.

RCW 48.44.150
Certificate of registration not an endorsement—Display in solicitation prohibited.
The granting of a certificate of registration to a health care service contractor is permissive only, and shall not constitute an endorsement by the insurance commissioner of any person or thing related to the health care service contractor, and no person shall advertise or display a certificate of registration for use as an inducement in any solicitation.
[ 1961 c 197 § 12.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.164 - Notice of suspension, revocation, or refusal to be given contractor—Authority of insurance producers.

RCW 48.44.164
Notice of suspension, revocation, or refusal to be given contractor—Authority of insurance producers.
Upon the suspension, revocation or refusal of a health care service contractor's registration, the commissioner shall give notice thereof to such contractor and shall likewise suspend, revoke, or refuse the authority of its appointed insurance producers to represent it in this state and give notice thereof to the appointed insurance producers.
[ 2008 c 217 § 52; 1969 c 115 § 10.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.166 - Fine in addition to or in lieu of suspension, revocation, or refusal.

RCW 48.44.166
Fine in addition to or in lieu of suspension, revocation, or refusal.
After hearing or upon stipulation by the registrant and in addition to or in lieu of the suspension, revocation or refusal to renew any registration of a health care service contractor the commissioner may levy a fine against the party involved for each offense in an amount not less than fifty dollars and not more than ten thousand dollars. The order levying such 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 such order. Upon failure to pay any such fine when due the commissioner shall revoke the registration of the registrant, 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.
[ 1983 c 202 § 4; 1969 c 115 § 11.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.170 - Hearings and appeals.

RCW 48.44.170
Hearings and appeals.
For the purposes of this chapter, the insurance commissioner shall be subject to and may avail himself or herself of the provisions of chapter 48.04 RCW, which relate to hearings and appeals.
[ 2009 c 549 § 7149; 1961 c 197 § 14.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.180 - Enforcement.

RCW 48.44.180
Enforcement.
For the purposes of this chapter, the insurance commissioner shall have the same powers and duties of enforcement as are provided in RCW 48.02.080.
[ 1961 c 197 § 15.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.200 - Individual health care service plan contracts—Coverage of dependent child with developmental or physical disability.

RCW 48.44.200
Individual health care service plan contracts—Coverage of dependent child with developmental or physical disability.
An individual health care service plan contract, delivered or issued for delivery in this state more than one hundred twenty days after August 11, 1969, which provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the contract shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (1) incapable of self-sustaining employment by reason of developmental or physical disability and (2) chiefly dependent upon the subscriber for support and maintenance, provided proof of such incapacity and dependency is furnished to the health care service plan corporation by the subscriber within thirty-one days of the child's attainment of the limiting age and subsequently as may be required by the corporation but not more frequently than annually after the two year period following the child's attainment of the limiting age.
[ 2020 c 274 § 35; 1977 ex.s. c 80 § 33; 1969 ex.s. c 128 § 1.]
NOTES:
Purpose—Intent—Severability—1977 ex.s. c 80: See notes following RCW 4.16.190.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.210 - Group health care service plan contracts—Coverage of dependent child with developmental or physical disability.

RCW 48.44.210
Group health care service plan contracts—Coverage of dependent child with developmental or physical disability.
A group health care service plan contract, delivered or issued for delivery in this state more than one hundred twenty days after August 11, 1969, which provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the contract shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (1) incapable of self-sustaining employment by reason of developmental or physical disability and (2) chiefly dependent upon the employee or member for support and maintenance, provided proof of such incapacity and dependency is furnished to the health care service plan corporation by the employee or member within thirty-one days of the child's attainment of the limiting age and subsequently as may be required by the corporation, but not more frequently than annually after the two year period following the child's attainment of the limiting age.
[ 2020 c 274 § 36; 1977 ex.s. c 80 § 34; 1969 ex.s. c 128 § 2.]
NOTES:
Purpose—Intent—Severability—1977 ex.s. c 80: See notes following RCW 4.16.190.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.212 - Coverage of dependent children to include newborn infants and congenital anomalies from moment of birth—Notification period.

RCW 48.44.212
Coverage of dependent children to include newborn infants and congenital anomalies from moment of birth—Notification period.
(1) Any health care service plan contract under this chapter delivered or issued for delivery in this state more than one hundred twenty days after February 16, 1974, which provides coverage for dependent children of the insured or covered group member, shall provide coverage for newborn infants of the insured or covered group member from and after the moment of birth. Coverage provided in accord with this section shall include, but not be limited to, coverage for congenital anomalies of such infant children from the moment of birth.
(2) If payment of an additional premium is required to provide coverage for a child, the contract may require that notification of birth of a newly born child and payment of the required premium must be furnished to the contractor. The notification period shall be no less than sixty days from the date of birth. This subsection applies to policies issued or renewed on or after January 1, 1984.
[ 1984 c 4 § 1; 1983 c 202 § 5; 1974 ex.s. c 139 § 3.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.215 - Option to cover child under age twenty-six.

RCW 48.44.215
Option to cover child under age twenty-six.
(1) Each individual health care service plan contract that is not grandfathered and that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six.
(2) Each group health care service plan contract that is not grandfathered and that provides coverage for a participating member's child must offer each participating member the option of covering any child under the age of twenty-six.
(3) Each grandfathered health care service plan that provides coverage for a subscriber's child must offer the option of covering any child under the age of twenty-six unless the child is eligible to enroll in an eligible health plan sponsored by the child's employer or the child's spouse's employer.
(4) As used in this section, "grandfathered" has the same meaning as "grandfathered health plan" in RCW 48.43.005.
[ 2012 c 211 § 18; 2011 c 314 § 6; 2007 c 259 § 21.]
NOTES:
Effective date—2007 c 259 §§ 18-22: See note following RCW 41.05.095.
Subheadings not law—2007 c 259: See note following RCW 7.70.060.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.220 - Discrimination prohibited.

RCW 48.44.220
Discrimination prohibited.
No health care service contractor shall deny coverage to any person solely on account of race, religion, national origin, or the presence of any disability. Nothing in this section shall be construed as limiting a health care service contractor's authority to deny or otherwise limit coverage to a person when the person because of a medical condition does not meet the essential eligibility requirements established by the health care service contractor for purposes of determining coverage for any person.
No health care service contractor shall refuse to provide reimbursement or indemnity to any person for covered health care services for reasons that the health care services were provided by a holder of a license under chapter 18.22 RCW.
[ 2020 c 274 § 37; 1983 c 154 § 4; 1979 c 127 § 1; 1969 c 115 § 4.]
NOTES:
Severability—1983 c 154: See note following RCW 48.44.299.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.225 - Podiatric physicians and surgeons not excluded.

RCW 48.44.225
Podiatric physicians and surgeons not excluded.
A health care service contractor which provides foot care services shall not exclude any individual doctor who is licensed to perform podiatric health care services from being a participant for reason that the doctor is licensed under chapter 18.22 RCW. Rejections of requests by doctors to be participants must be in writing stating the cause for the rejection.
[ 1983 c 154 § 5.]
NOTES:
Severability—1983 c 154: See note following RCW 48.44.299.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.230 - Individual health service plan contract—Return within ten days of delivery—Refunds—Void from beginning—Notice required.

RCW 48.44.230
Individual health service plan contract—Return within ten days of delivery—Refunds—Void from beginning—Notice required.
Every subscriber of an individual health care service plan contract issued after September 1, 1973, may return the contract to the health care service contractor or the insurance producer through whom it was purchased within ten days of its delivery to the subscriber if, after examination of the contract, he or she is not satisfied with it for any reason, and the health care service contractor shall refund promptly any fee paid for such contract. Upon such return of the contract it shall be void from the beginning and the parties shall be in the same position as if no policy had been issued. Notice of the substance of this section shall be printed on the face of each such contract or be attached thereto. An additional ten percent penalty shall be added to any premium refund due which is not paid within thirty days of return of the policy to the insurer or insurance producer.
[ 2008 c 217 § 53; 1983 1st ex.s. c 32 § 11; 1973 1st ex.s. c 65 § 4.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.240 - Chemical dependency benefits—Provisions of group contracts delivered or renewed after January 1, 1988.

RCW 48.44.240
Chemical dependency benefits—Provisions of group contracts delivered or renewed after January 1, 1988.
Each group contract for health care services that is delivered or issued for delivery or renewed, on or after January 1, 1988, must contain provisions providing benefits for the treatment of chemical dependency rendered to covered persons by a provider that is an "approved substance use disorder treatment program" under *RCW 70.96A.020(2).
[ 2018 c 201 § 8012; 2005 c 223 § 25; 1990 1st ex.s. c 3 § 12; 1987 c 458 § 16; 1975 1st ex.s. c 266 § 14; 1974 ex.s. c 119 § 4.]
NOTES:
*Reviser's note: RCW 70.96A.020 was repealed by 2016 sp.s. c 29 § 301.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Effective date—Severability—1987 c 458: See notes following RCW 48.21.160.
Severability—1975 1st ex.s. c 266: See note following RCW 48.01.010.
Legislative declaration—1974 ex.s. c 119: See RCW 48.21.160.
Chemical dependency benefits, rules: RCW 48.21.197.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.241 - Chemical dependency benefits—RCW 48.21.160 through 48.21.190, 48.44.240 inapplicable, when.

RCW 48.44.241
Chemical dependency benefits—RCW 48.21.160 through 48.21.190, 48.44.240 inapplicable, when.
See RCW 48.21.190.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.245 - "Chemical dependency" defined.

RCW 48.44.245
"Chemical dependency" defined.
For the purposes of RCW 48.44.240, "chemical dependency" means an illness characterized by a physiological or psychological dependency, or both, on a controlled substance regulated under chapter 69.50 RCW and/or alcoholic beverages. It is further characterized by a frequent or intense pattern of pathological use to the extent the user exhibits a loss of self-control over the amount and circumstances of use; develops symptoms of tolerance or physiological and/or psychological withdrawal if use of the controlled substance or alcoholic beverage is reduced or discontinued; and the user's health is substantially impaired or endangered or his or her social or economic function is substantially disrupted.
[ 1987 c 458 § 17.]
NOTES:
Effective date—Severability—1987 c 458: See notes following RCW 48.21.160.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.250 - Payment of premium by employee in event of suspension of compensation due to labor dispute.

RCW 48.44.250
Payment of premium by employee in event of suspension of compensation due to labor dispute.
Any employee whose compensation includes a health care services contract providing health care services expenses, the premiums for which are paid in full or in part by an employer including the state of Washington, its political subdivisions, or municipal corporations, or paid by payroll deduction, may pay the premiums as they become due directly to the contract holder whenever the employee's compensation is suspended or terminated directly or indirectly as the result of a strike, lockout, or other labor dispute, for a period not exceeding six months and at the rate and coverages as the health care services contract provides. During that period of time such contract may not be altered or changed. Nothing in this section shall be deemed to impair the right of the health care service contractor to make normal decreases or increases of the premium rate upon expiration and renewal of the contract, in accordance with the provisions of the contract. Thereafter, if such health care services coverage is no longer available, then the employee shall be given the opportunity to purchase an individual health care services contract at a rate consistent with rates filed by the health care service contractor with the commissioner. When the employee's compensation is so suspended or terminated, the employee shall be notified immediately by the contract holder in writing, by mail addressed to the address last of record with the contract holder, that the employee may pay the premiums to the contract holder as they become due as provided in this section.
Payment of the premiums must be made when due or the coverage may be terminated by the health care service contractor.
The provisions of any health care services contract contrary to provisions of this section are void and unenforceable after May 29, 1975.
[ 1982 c 149 § 1; 1975 1st ex.s. c 117 § 3.]
NOTES:
Severability—1975 1st ex.s. c 117: See note following RCW 48.21.075.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.260 - Notice of reason for cancellation, denial, or refusal to renew contract.

RCW 48.44.260
Notice of reason for cancellation, denial, or refusal to renew contract.
Every authorized health care service contractor, upon canceling, denying, or refusing to renew any individual health care service contract, shall, upon written request, directly notify in writing the applicant or subscriber, as the case may be, of the reasons for the action by the health care service contractor. Any benefits, terms, rates, or conditions of such a contract which are restricted, excluded, modified, increased, or reduced shall, upon written request, be set forth in writing and supplied to the subscriber. The written communications required by this section shall be phrased in simple language which is readily understandable to a person of average intelligence, education, and reading ability.
[ 1993 c 492 § 290; 1979 c 133 § 3.]
NOTES:
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.270 - Immunity from libel or slander.

RCW 48.44.270
Immunity from libel or slander.
With respect to health care service contracts as defined in RCW 48.44.260, there shall be no liability on the part of, and no cause of action of any nature shall arise against, the insurance commissioner, the commissioner's agents, or members of the commissioner's staff, or against any health care service contractor, its authorized representative, its agents, its employees, furnishing to the health care service contractor information as to reasons for cancellation or refusal to issue or renew, for libel or slander on the basis of any statement made by any of them in any written notice of cancellation or refusal to issue or renew, or in any other communications, oral or written, specifying the reasons for cancellation or refusal to issue or renew or the providing of information pertaining thereto, or for statements made or evidence submitted in any hearing conducted in connection therewith.
[ 1979 c 133 § 4.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.290 - Registered nurses or advanced registered nurses.

RCW 48.44.290
Registered nurses or advanced registered nurses.
Notwithstanding any provision of this chapter, for any health care service contract thereunder which is entered into or renewed after July 26, 1981, benefits shall not be denied under such contract for any health care service performed by a holder of a license for registered nursing practice or advanced registered nursing practice issued pursuant to chapter 18.79 RCW if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a holder of a license issued pursuant to chapter 18.71 RCW: PROVIDED, HOWEVER, That no provision of chapter 18.71 RCW shall be asserted to deny benefits under this section.
The provisions of this section are intended to be remedial and procedural to the extent that they do not impair the obligation of any existing contract.
[ 1994 sp.s. c 9 § 733; 1986 c 223 § 6; 1981 c 175 § 1.]
NOTES:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.299 - Legislative finding.

RCW 48.44.299
Legislative finding.
The legislature finds and declares that there is a paramount concern that the right of the people to obtain access to health care in all its facets is being impaired by prepaid agreements which provide benefits, reimbursement, or indemnity by health care service contractors, whether for profit or for nonprofit, which do not provide parity of reimbursement among licensed health care providers performing the same health care services. It is further the intent of the legislature not to mandate the providing of any health care benefit, but rather to require parity of reimbursement for the same health care services performed by all licensees who perform such services within the scope of their respective licenses thereby assuring the people of the state access to health care services of their choice.
[ 1983 c 154 § 1.]
NOTES:
Severability—1983 c 154: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1983 c 154 § 6.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.300 - Podiatric medicine and surgery—Benefits not to be denied.

RCW 48.44.300
Podiatric medicine and surgery—Benefits not to be denied.
Benefits shall not be denied under a contract for any health care service performed by a holder of a license issued under chapter 18.22 RCW if (1) the service performed was within the lawful scope of the person's license, and (2) the contract would have provided benefits if the service had been performed by a holder of a license issued under chapter 18.71 RCW. There shall not be imposed upon one class of doctors providing health care services as defined by this chapter any requirement that is not imposed upon all other doctors providing the same or similar health care services within the scope of their license.
The provisions of this section are intended to be procedural to the extent that they do not impair the obligation of any existing contract.
[ 1986 c 223 § 7; 1983 c 154 § 2.]
NOTES:
Severability—1983 c 154: See note following RCW 48.44.299.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.305 - When injury caused by intoxication or use of narcotics.

RCW 48.44.305
When injury caused by intoxication or use of narcotics.
A health care service contractor may not deny coverage for the treatment of an injury solely because the injury was sustained as a consequence of the enrolled participant's being intoxicated or under the influence of a narcotic.
[ 2004 c 112 § 4.]
NOTES:
Finding—Application—2004 c 112: See notes following RCW 48.20.385.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.309 - Legislative finding.

RCW 48.44.309
Legislative finding.
The legislature finds and declares that there is a paramount concern that the right of the people to obtain access to health care in all its facets is being impaired. The legislature further finds that there is a heavy reliance by the public upon prepaid health care service agreements and insurance, whether profit or nonprofit, as the only effective manner in which the large majority of the people can obtain access to quality health care. Further, the legislature finds that health care service agreements may be anticompetitive because of the exclusion of other licensed forms of health care and that because of the high costs of health care, there is a need for competition to reduce these costs. It is, therefore, declared to be in the public interest that these contracts as a form of insurance be regulated under the police power of the state to assure that all the people have the greatest access to health care services.
[ 1983 c 286 § 1.]
NOTES:
Severability—1983 c 286: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1983 c 286 § 5.]
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.310 - Chiropractic care, coverage required, exceptions.

RCW 48.44.310
Chiropractic care, coverage required, exceptions.
(1) Each group contract for comprehensive health care service which is entered into, or renewed, on or after September 8, 1983, between a health care service contractor and the person or persons to receive such care shall offer coverage for chiropractic care on the same basis as any other care.
(2) A patient of a chiropractor shall not be denied benefits under a contract because the practitioner is not licensed under chapter 18.57 or 18.71 RCW.
(3) This section shall not apply to a group contract for comprehensive health care services entered into in accordance with a collective bargaining agreement between management and labor representatives. Benefits for chiropractic care shall be offered by the employer in good faith on the same basis as any other care as a subject for collective bargaining for group contracts for health care services.
[ 1986 c 223 § 8; 1983 c 286 § 2.]
NOTES:
Severability—1983 c 286: See note following RCW 48.44.309.
2023 Revised Code of Washington › Title 48 - Insurance › Chapter 48.44 - Health Care Services. › 48.44.323 - Prescribed, self-administered anticancer medication.

RCW 48.44.323
Prescribed, self-administered anticancer medication.
(1) Each health plan issued or renewed on or after January 1, 2012, that provides coverage for cancer chemotherapy treatment must provide coverage for prescribed, self-administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis at least comparable to cancer chemotherapy medications administered by a health care provider or facility as defined in *RCW 48.43.005 (25) and (26).
(2) Nothing in this section may be interpreted to prohibit a health plan from administering a formulary or preferred drug list, requiring prior authorization, or imposing other appropriate utilization controls in approving coverage for any chemotherapy.
[ 2020 c 18 § 21; 2011 c 159 § 5.]
NOTES:
*Reviser's note: RCW 48.43.005 was alphabetized pursuant to RCW 1.08.015(2)(k), changing subsections (25) and (26) to subsections (27) and (28).
Explanatory statement—2020 c 18: See note following RCW 43.79A.040.
Findings—2011 c 159: See note following RCW 41.05.175.