reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-020 - Definitions

Current through Register Vol. 24-14, July 15, 2024
(1) "Actuary" means
				any person who is a fellow of the Casualty Actuarial Society and a member of
				the American Academy of Actuaries.
(2) "Assessment" means the moneys paid by the
				members to a joint self-insurance program.
(3) "Broker of record" means the insurance
				producer licensed in the state of Washington who, through a contractual
				agreement with the joint self-insurance program, procures insurance on behalf
				of the joint self-insurance program.
(4) "Case reserves" means the total of all
				claims and claims adjustment expenses for covered events which have occurred
				and have been reported to the joint self-insurance programs as of the date of
				the financial statement. Case reserves include an estimate for each reported
				claim based on the undiscounted jury verdict value of said claim.
(5) "Claim adjustment expense" means
				expenses, other than claim payments, incurred in the course of investigating
				and settling claims.
(6) "Claim"
				means a demand for payment for damages or policy benefit because of the
				occurrence of an event that includes, but is not limited to, the destruction or
				damage of property or reputation, bodily injury or death and alleged civil
				rights violations.
(7) "Claims
				auditor" means a person who has the following qualifications:
(a) A minimum of five years in claims
				management and investigative experience;
(b) A minimum of three years of experience in
				auditing the same manner of claims filed against the program being
				audited;
(c) Proof of professional
				liability insurance; and
(d)
				Provides a statement that the auditor is independent from the program being
				audited, its vendors, insurers, brokers, and third-party
				administrators.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02005 - Standards for operation-Membership

Current through Register Vol. 24-14, July 15, 2024
Membership in a joint self-insurance program requires the
				  execution of a foundation agreement. Only members may participate in
				  risk-sharing. Only members may participate in the self-insured retention layer,
				  and only members may participate in the joint purchase of insurance or
				  reinsurance. Further, each member shall agree to the following:
(1) Each member shall pay assessments and
				reassessments when required by the governing body of the program.
(2) Each member shall obtain approval to join
				the program from the governing body of the respective member.
(3) Each member shall become a signatory to
				the foundation agreement and subsequent amendments to the foundation agreement
				of the joint self-insurance program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02007 - Standards for operation-Providing services to nonmembers

Current through Register Vol. 24-14, July 15, 2024
(1) Nonmembers may
				purchase services through a contract or agreement. Nonmembers shall not
				participate in any coverages of the joint self-insurance program including the
				self-insured retention layer and the excess insurance or reinsurance layer.
				This section is not intended to preclude nonmembers purchasing services from
				becoming members of the joint self-insurance program, provided the nonmember
				meets the requirements of WAC 200-150-020(15) and (16)    and is eligible for
				membership as authorized by chapter 109, Laws of 2015.
(2) A program intending to provide services
				to nonmem-bers shall submit a written plan to the state risk manager for
				approval prior to providing services. The plan shall include, at a minimum, the
				services to be provided, the time frame for providing such services, the
				expected revenues and expenditures resulting from providing said services, and
				a written legal analysis of all potential federal and state tax liabilities
				created by providing services to nonmembers. The arrangement to provide such
				services shall be approved in writing by the state risk manager within sixty
				days of the joint self-insurance program's final plan submission.
(3) Every joint self-insurance program
				providing services as of the effective date of these regulations must submit a
				written plan meeting the requirements stated herein.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02009 - Standards for operation-Communication with members-Annual membership report

Current through Register Vol. 24-14, July 15, 2024
The joint self-insurance program shall make available to
				  each member a copy of the program's annual membership report. The annual
				  membership report shall include, at a minimum, financial information which
				  includes the comparative balance sheet and statement of revenues, expenses and
				  net assets. The reports shall be delivered to each member by electronic or
				  regular mail. Programs may meet the delivery requirement by publishing and
				  maintaining the membership report on the official web site of the program for a
				  minimum of three years from the date of publication.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02013 - Standards for operation-Notice of regular meetings of the governing body

Current through Register Vol. 24-14, July 15, 2024
Every joint self-insurance program shall provide every
				  member with a notice of the time and place of each regular meeting of the
				  governing body at least ten days prior to the meeting. The notice shall be
				  provided in electronic or paper form, and the time and location of each meeting
				  shall be included in such notice. The state risk manager shall be provided a
				  copy of all meeting notifications to members in the same form, manner and time
				  as provided to members. In addition to electronic or regular mail, programs
				  shall publish notification of regular meetings on the electronic web site of
				  the program accessible to the public.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02015 - Standards for operation-Special meetings-Notice to members

Current through Register Vol. 24-14, July 15, 2024
All joint self-insurance programs shall provide notice by
				  electronic mail to the state risk manager and every member of the joint
				  self-insurance program twenty-four hours in advance of every special
				  meeting.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02017 - Standards for operations-Meeting agendas-Meeting minutes

Current through Register Vol. 24-14, July 15, 2024
Every joint self-insurance program must provide the state
				  risk manager and every member with a preliminary agenda in advance of each
				  meeting of the governing body. The agenda shall be provided by electronic mail
				  and shall be posted on the web site of the program accessible to the public.
				  Meeting minutes, after approval, shall be posted on the web site of the program
				  accessible to the public.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02019 - Standards for operation-Notification of changes to bylaws or foundation agreement

Current through Register Vol. 24-14, July 15, 2024
Every joint self-insurance program shall provide
				  notification of the intent to change the bylaws or foundation agreement to each
				  member of the joint self-insurance program and the state risk manager by
				  regular or electronic mail at least thirty days in advance of the meeting
				  during which a vote on the proposed change will occur. Such notification shall
				  include a copy of proposed changes.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02021 - Standards for operation-Changes to foundation agreement

Current through Register Vol. 24-14, July 15, 2024
(1) Changes to the foundation agreement shall
				be by amendment and shall be approved by the governing body of each joint
				self-insurance program during a regular meeting of the governing
				body.
(2) Amendments to the
				foundation agreement shall be adopted by the governing body of each member and
				signed by an authorized representative of each member. The signed amendment,
				shall be submitted to, and retained by, the joint self-insurance program.
				Copies of the foundation agreement and subsequent amendments shall be published
				on the web site of the joint self-insurance program.
(3) Changes to any terms of the foundation
				agreement shall require amendment using the approval and adoption process
				described above.
(4) Each new
				member joining a joint self-insurance program after the formation of the
				program shall sign a copy of the most current foundation agreement and copies
				of all subsequent amendments to that agreement that have been adopted by the
				governing body of the joint self-insurance program. The joint self-insurance
				program shall retain the signed foundation agreements and amendments until
				termination of the program occurs.
(5) When a new foundation agreement is
				adopted by the governing body of the joint self-insurance program to replace
				the existing foundation agreement and incorporate amendments, the new
				foundation agreement shall be approved by the governing body of each member of
				the joint self-insurance program. The new foundation agreement shall be signed
				by an authorized representative of each member. The signed agreement shall be
				submitted to, and retained by, the joint self-insurance program until
				termination of the program occurs.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-02023 - Standards for operation-Elections of the governing body

Current through Register Vol. 24-14, July 15, 2024
The governing body of every joint self-insurance program
				  shall be elected by a majority of the members voting in the election. Elections
				  may be conducted during a regular meeting of the governing body or by mail-in
				  ballot or electronic ballot. If mail-in or electronic ballots are used, the
				  ballots are to be counted and secured until certified by the governing body at
				  the next regular meeting and recorded in the meeting minutes. Vacancies on the
				  governing board shall be filled according to program bylaws. Joint
				  self-insurance programs governed by a governing body which requires the
				  inclusion of a voting representative from each member entity in such governing
				  body are exempt from the requirements of this section.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-033 - Standards for management and operations-Individual rate setting-Nondiscrimination in joint program assessments

Current through Register Vol. 24-14, July 15, 2024
(1) Joint self-insurance program assessment
				formulas shall include all costs including rating for insured and self-insured
				layers of coverage. Assessment formulas shall be consistent and
				nondiscriminatory among all members.
(2) This provision shall not be construed to
				prohibit individual choice of coverage by members from several offered by the
				joint self-insurance program. The assessment formula, including the insured and
				self-insured components, shall be consistently applied to reflect the selection
				from among these choices.
(3) The
				assessment formula shall be available for review by the state risk
				manager.
(4) Joint self-insurance
				programs shall not sell equity, security, or shares in the joint self-insurance
				program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-034 - Standards for operations-Disclosures

Current through Register Vol. 24-14, July 15, 2024
(1) All joint self-insurance programs shall
				furnish to each new member joining a self-insurance program written statements
				which describe:
(a) Insurance coverages or
				benefits currently provided by the program, including any applicable
				restrictions, limitations, and exclusions;
(b) The method by which members'
				(re)assessments are determined;
(c)
				The procedure for filing a claim against the joint self-insurance
				program;
(d) The procedure for a
				member to request an adjudication of disputes or appeals arising from coverage,
				claim payment or denial, membership, and other issues; and
(e) General characteristics of the insurance
				coverage portion of the program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-036 - Standards for operations-Standards for solvency-Termination provisions

Current through Register Vol. 24-14, July 15, 2024
(1) Program
				terminations. All joint self-insurance programs shall maintain a written plan
				that provides for the partial or complete termination of the program and for
				liquidation of its assets upon termination of the program. The termination
				procedure shall include, but not be limited to, a provision for the settling of
				all its liabilities for unpaid claims and claim adjustment expenses.
(2) Member terminations. All joint
				self-insurance programs shall maintain a written plan that provides for the
				termination of membership of a member.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-037 - Standards for management and operations-Financial plans

Current through Register Vol. 24-14, July 15, 2024
(1) All joint self-insurance programs shall
				maintain a written plan for managing the financial resources of the program.
				The financial plan shall include:
(a) A
				procedure for accounting for moneys received, payments made and liabilities of
				the joint program which complies with generally accepted accounting
				principles;
(b) An investment
				policy approved by the governing body governing the investments of the
				program;
(c) The preparation of
				accurate and timely annual financial reports of the program; and
(d) The submission of audited financial
				statements to the state risk manager within one hundred twenty days of the
				program's fiscal year end which meet the requirements of the state risk manager
				as described in this chapter.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-038 - Standards for management-Standards for contracts-Third-party administrator contracts

Current through Register Vol. 24-14, July 15, 2024
Before contracting for third-party administrator
				  professional services, all joint self-insurance programs shall establish and
				  maintain written procedures for contracting with third-party administrators.
				  Entering a contract for services shall not relieve the governing body of the
				  joint self-insurance program of its ultimate governing, managerial and
				  financial responsibilities. The procedures shall, as a minimum:
(1) Provide a method of third-party
				administrator selection using a formal competitive solicitation
				process;
(2) Require a complete
				written description of the services to be provided, remuneration levels,
				contract period and expiration date providing for a contract term no greater
				than five years. The contract may include an additional one year extension to
				be exercised at the discretion of the joint self-insurance program;
(3) Provide for the confidentiality of the
				program's information, data and other intellectual property developed or shared
				during the course of the contract;
(4) Provide for the program's ownership of
				the information, data, and other intellectual property developed or shared
				during the course of the contract;
(5) Provide for the expressed authorization
				of the joint self-insurance program, consultants to the program, the state risk
				manager, or their designees, to enter the third-party administrator's premises
				to inspect and audit the records and performance of the third-party
				administrator which pertains to the program and to obtain such records
				electronically when audit travel costs can be eliminated or reduced;
(6) Require the compliance with all
				applicable local, state and federal laws;
(7) Establish a monitoring and acceptance
				procedure to determine compliance with third-party administrator contract
				requirements; and
(8) Establish
				indemnification provisions and set forth insurance requirements between the
				parties.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-050 - Standards for claims management-Claims administration

Current through Register Vol. 24-14, July 15, 2024
(1) All joint self-insurance programs shall
				adopt a written claims administration program which includes, as a minimum, the
				following procedures:
(a) Claims filing
				procedures and forms.
(b) Standards
				requiring case reserves for each claim be established in the amount of the jury
				verdict value.
(c) Standards
				requiring case reserves be reviewed every ninety days or when reasonably
				practicable and such review is documented in the claims diary.
(d) Standards requiring appropriate adjuster
				work loads.
(e) Standards requiring
				claims payment procedures include sufficient internal controls to ensure
				adequate review and approval by claims management staff.
(f) Standards requiring file documentation be
				complete and up-to-date.
(g)
				Standards requiring timely and appropriate claim resolution
				practices.
(h) Standards requiring
				opportunities for recoveries be reviewed and documented for each
				claim.
(i) Standards requiring
				compliance with Internal Revenue Service (IRS) rules for 1099MISC
				regulations.
(j) Standards
				requiring claims files be audited on the following categories: Staffing,
				caseloads, supervision, diary, coverage, reserves, promptness of contacts,
				field investigations, file documentation, settlements, litigation management
				and subrogation.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-060 - Standards for management and operations-State risk manager reports

Current through Register Vol. 24-14, July 15, 2024
(1) Every joint
				property and liability self-insurance program authorized to transact business
				in the state of Washington shall submit the annual report to the state risk
				manager.
(2) The annual report to
				the state risk manager shall require the following information to be submitted
				in electronic form:
(a) Audited annual
				financial statements;
(b) Actuarial
				reserve review report on which the net claims liabilities at fiscal year end
				reported in the audited financial statements are based;
(c) Copies of all insurance coverage
				documents;
(d) List of contracted
				consultants;
(e) Details of changes
				in articles of incorporation, bylaws or foundation agreement;
(f) Details of services provided by contract
				to nonmem-bers;
(g) List of members
				added or terminated.
Such reports shall be submitted to the state risk manager no
				  later than one hundred twenty days following the completion of the joint
				  program's fiscal year.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-065 - Standards for operations-Program changes-Notification to the state risk manager

Current through Register Vol. 24-14, July 15, 2024
(1) All joint
				self-insurance programs shall operate in the same form and manner stated in the
				program's original application approved by the state risk manager. Programs
				shall submit a written request and receive approval from the state risk manager
				prior to implementing the following proposed program changes:
(a) Elimination or reduction of stop loss
				insurance;
(b) Acceptance of any
				loans or lines of credit;
(c)
				Provision of services to nonmembers;
(d) Addition of members of other entity types
				than those included in original application approved by state risk
				manager.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-080 - Standards for management and operations-Conflict of interest

Current through Register Vol. 24-14, July 15, 2024
(1) Every joint
				self-insurance program shall require the claims auditor, the third-party
				administrator, the actuary, and the broker of record to contract separately
				with the joint self-insurance program. Each contract shall require that a
				written statement be submitted to the program on a form provided by the state
				risk manager providing assurance that no conflict of interest exists prior to
				acceptance of the contract by the joint self-insurance program.
(2) All joint self-insurance programs shall
				meet the following standards regarding restrictions on the financial interests
				of the program administrators:
(a) No member
				of the board of directors; trustee; administrator, including a third-party
				administrator; or any other person having responsibility for the management or
				administration of a joint self-insurance program or the investment or other
				handling of the program's money shall:
(i)
				Receive directly or indirectly or be pecuniarily interested in any fee,
				commission, compensation, or emolument arising out of any transaction to which
				the program is or is expected to be a party except for salary or other similar
				compensation regularly fixed and allowed for because of services regularly
				rendered to the program.
(ii)
				Receive compensation as a consultant to the program while also acting as a
				member of the board of directors, trustee, third-party administrator, or as an
				employee.
(iii) Have any direct or
				indirect pecuniary interest in any loan or investment of the program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-100 - Standards for operations-State risk manager-Expense and operating cost fees

Current through Register Vol. 24-14, July 15, 2024
(1) The state risk
				manager shall fix state risk manager fees to cover expenses and operating costs
				of the state risk manager's office in administering chapter 109, Laws of 2015.
				Such fees shall be levied against each joint property and liability
				self-insurance program regulated by chapter 109, Laws of 2015. Services covered
				by the state risk manager fees will include program reviews, monitoring and
				continuing oversight.
(2) The state
				risk manager fees shall be paid by each joint self-insurance program to the
				state of Washington, department of enterprise services within sixty days of the
				date of invoice. Any joint self-insurance program failing to remit its fee when
				due is subject to denial of permission to operate or to a cease and desist
				order until the fee is paid.
(3) A
				joint self-insurance program that has voluntarily or involuntarily terminated
				shall continue to pay an administrative fee until such time as all liabilities
				for unpaid claims and claim adjustment expenses and all administrative
				responsibilities of the joint self-insurance program have been
				satisfied.
(4) The state risk
				manager shall assess each prospective joint self-insurance program an initial
				investigation fee at a rate determined annually by the state risk
				manager.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-190 - Standards for operation-Multistate operations

Current through Register Vol. 24-14, July 15, 2024
Nonprofit joint self-insurance programs domiciled in this
				  state and operating in this state and other states must obtain any licenses,
				  permits and permissions to the extent required by a state prior to commencing
				  operations in that state.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-200 - Standards for operations-Appeals of fees

Current through Register Vol. 24-14, July 15, 2024
(1) A joint self-insurance program which
				disagrees with a fee for services issued to it by the state risk manager shall
				notify the state risk manager in writing within thirty days after receipt of
				the invoice. The writing shall include the self-insurance program's reasons for
				challenging the fee and any other information the self-insurance program deems
				pertinent.
(2) The state risk
				manager shall review any fee appealed by a joint self-insurance program,
				together with the reasons for the appeal. Within fourteen days of receipt of
				notification from the self-insurance program, the state risk manager shall
				respond in writing to the self-insurance program, either reaffirming the fee or
				modifying it, and stating the reasons for the decision.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-150 - Self-insurance requirements as to nonprofit corporations › Section 200-150-210 - Standards for operations-Appeals of cease and desist orders

Current through Register Vol. 24-14, July 15, 2024
Within ten days after a joint self-insurance program
				  covering property or liability risks has been served with a cease and desist
				  order under section 12(3), chapter 109, Laws of 2015, the entity may request an
				  administrative hearing. The hearing provided may be held in such a place as is
				  designated by the state risk manager and shall be conducted in accordance with
				  chapters
				  34.05 RCW and 10-08
				  WAC.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-010 - Preamble and authority

Current through Register Vol. 24-14, July 15, 2024
These rules governing self-insurance transactions are
				  adopted by the state risk manager to implement chapter 48.190 RCW relating to
				  the management and operations of joint public benefit hospital entity property
				  and liability self-insurance programs.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-020 - Definitions

Current through Register Vol. 24-14, July 15, 2024
(1) "Actuary" means
				any person who is a fellow of the Casualty Actuarial Society and a member of
				the American Academy of Actuaries.
(2) "Assessment" means the moneys paid by the
				members to a joint self-insurance program.
(3) "Broker of record" means the licensed
				insurance producer who, through a contractual agreement with the joint
				self-insurance program, procures insurance and/or reinsurance on behalf of the
				joint self-insurance program.
(4)
				"Case reserves" means the total of all claims and claims adjustment expenses
				for covered events which have occurred and have been reported to the joint and
				individual self-insurance programs as of the date of the financial statement.
				Case reserves include an estimate for each reported claim based on the
				undiscounted jury verdict value of said claim.
(5) "Claim adjustment expense" means
				expenses, other than claim payments, incurred in the course of investigating
				and settling claims.
(6) "Claim"
				means a demand for payment for damages or policy benefit because of the
				occurrence of an event that includes, but is not limited to, the destruction or
				damage of property or reputation, bodily injury or death and alleged civil
				rights violations.
(7) "Claims
				auditor" means a person who has the following qualifications:
(a) A minimum of five years in claims
				management and investigative experience;
(b) A minimum of three years of experience in
				auditing the same manner of claims filed against the program being
				audited;
(c) Proof of professional
				liability insurance; and
(d)
				Provides a statement that the auditor is independent from the program being
				audited, its vendors, insurers, brokers, and third-party
				administrators.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-030 - Standards for operation and management-Rules for joint hospital benefit entities self-insurance programs

Current through Register Vol. 24-14, July 15, 2024
The following rules apply exclusively to joint
				  self-insurance programs. Individual entity programs shall be exempt from these
				  requirements.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-040 - Standards for operation-Membership

Current through Register Vol. 24-14, July 15, 2024
Membership in a joint self-insurance program requires the
				  execution of a foundation agreement. Only members may participate in risk
				  sharing. Only members may participate in the self-insured retention layer, and
				  only members may participate in the joint purchase of insurance or reinsurance.
				  Further, each member shall agree to the following:
(1) Each member shall pay assessments when
				required by the governing body of the program.
(2) Each member shall obtain approval to join
				the program from the governing body of the respective member. The approval
				shall be by resolution or ordinance of the governing body as appropriate for
				the entity type.
(3) Each member
				shall become a signatory to the foundation agreement and subsequent amendments
				to the foundation agreement of the joint self-insurance program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-050 - Standards for operation-Providing services to nonmembers

Current through Register Vol. 24-14, July 15, 2024
(1) Nonmembers may purchase ongoing services
				through agreement or contract as permitted by the laws of this state and other
				states. Nonmembers shall not participate in any coverages of the joint
				self-insurance program including the self-insured retention layer and the
				excess insurance or reinsurance layer. This section is not intended to preclude
				nonmembers purchasing services from becoming members of the joint
				self-insurance program, provided the nonmember meets the requirements of WAC
				200-160-020(17) and is eligible for membership as authorized by chapter 48.190
				RCW.
(2) A program intending to
				provide ongoing services to nonmembers shall submit a written plan to the state
				risk manager for approval prior to providing services. The plan shall include,
				at a minimum, the services to be provided, the time frame for providing such
				services, the expected revenues and expenditures resulting from providing said
				services, and a written analysis of all potential federal and state tax
				liabilities created by providing services to nonmembers. The arrangement to
				provide ongoing services shall be approved in writing by the state risk manager
				within sixty days of the joint self-insurance program's final plan
				submission.
(3) Joint
				self-insurance programs may provide incidental or occasional services to
				nonmember public benefit hospitals at no charge when there is a monetary or
				nonmonetary benefit to members and nonmembers in providing the incidental or
				occasional services.
(4) Every
				joint self-insurance program providing ongoing services as of the effective
				date of these regulations must submit a written plan meeting the requirements
				stated herein.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-060 - Standards for operation-Communication with members-Annual membership report

Current through Register Vol. 24-14, July 15, 2024
The joint self-insurance program shall make available to each
				  member a copy of the program's annual membership report. The annual membership
				  report shall include, at a minimum, the audited annual financial statements.
				  The reports shall be delivered to each member by electronic or regular mail.
				  Programs may meet the delivery requirement by publishing and maintaining the
				  membership report on the official web site of the program for a minimum of
				  three years from the date of publication.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-070 - Standards for operations-Meetings

Current through Register Vol. 24-14, July 15, 2024
All joint self-insurance programs are required to comply
				  with all applicable laws and regulations pertaining to public meetings. All
				  joint self-insurance programs are required to comply with all additional
				  requirements for meeting notifications as described in this
				  chapter.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-080 - Standards for operation-Notice of regular meetings of the governing body

Current through Register Vol. 24-14, July 15, 2024
Every joint self-insurance program shall provide every
				  member with a notice of the time and place of each regular meeting of the
				  governing body at least ten days prior to the meeting. The notice shall be
				  provided in electronic or paper form, and the time and location of each meeting
				  shall be included in such notice. The state risk manager shall be provided a
				  copy of all meeting notifications to members in the same form, manner and time
				  as provided to members. In addition to electronic or regular mail, programs
				  shall publish notification of regular meetings on the web site of the program
				  accessible to the public. Notice of regular meetings shall be published at
				  least ten days in advance of regular meetings.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-090 - Standards for operation-Special meetings-Notice to members

Current through Register Vol. 24-14, July 15, 2024
All joint self-insurance programs shall provide notice by
				  electronic mail to the state risk manager and every member of the joint
				  self-insurance program twenty-four hours in advance of every special
				  meeting.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-100 - Standards for operations-Meeting agendas-Meeting minutes

Current through Register Vol. 24-14, July 15, 2024
Every joint self-insurance program must provide the state
				  risk manager and every member with a preliminary agenda in advance of each
				  meeting of the governing body. The agenda shall be provided by electronic mail
				  and shall be posted on the web site of the program accessible to the public.
				  Meeting minutes, after approval, shall be posted on the web site of the program
				  accessible to the public.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-110 - Standards for operation-Notification of changes to bylaws or foundation agreement

Current through Register Vol. 24-14, July 15, 2024
Every joint self-insurance program shall provide notification
				  of the intent to change the bylaws or foundation agreement to each member of
				  the joint self-insurance program and the state risk manager by regular or
				  electronic mail at least thirty days in advance of the meeting during which a
				  vote on the proposed change will occur. Such notification shall include a copy
				  of proposed changes.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-120 - Standards for operation-Changes to foundation agreement

Current through Register Vol. 24-14, July 15, 2024
(1) Changes to the foundation agreement shall
				be by amendment and shall be approved by the governing body of each joint
				self-insurance program during a regular meeting of the governing
				body.
(2) Amendments to the
				foundation agreement shall be adopted by ordinance or resolution of the
				governing board or council of each member and signed by an authorized
				representative of each member. The signed amendment and copy of the ordinance
				or resolution, as appropriate, shall be submitted to, and retained by, the
				joint self-insurance program. Copies of the foundation agreement and subsequent
				amendments shall be published on the web site of the joint self-insurance
				program.
(3) Changes to any terms
				of the foundation agreement shall require amendment using the approval and
				adoption process described in subsection (2) of this section.
(4) Each new member joining a joint
				self-insurance program after the formation of the program shall sign a copy of
				the most current foundation agreement and copies of all subsequent amendments
				to that agreement that have been adopted by the governing body of the joint
				self-insurance program. The joint self-insurance program shall retain the
				signed foundation agreements and amendments until termination of the program
				occurs.
(5) When a new foundation
				agreement is adopted by the governing body of the joint self-insurance program
				to replace the existing foundation agreement and incorporate amendments, the
				new foundation agreement shall be adopted by ordinance or resolution by the
				governing body of each member of the joint self-insurance program. The new
				foundation agreement shall be signed by an authorized representative of each
				member. The signed foundation agreement and a copy of the ordinance or
				resolution adopting the program shall be submitted to, and retained by, the
				joint self-insurance program until termination of the program occurs.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-130 - Standards for operation-Elections of the governing body

Current through Register Vol. 24-14, July 15, 2024
The governing body of every joint self-insurance program
				  shall be elected by a majority of the members voting in the election. Elections
				  may be conducted during a regular meeting of the governing body or by mail-in
				  ballot or electronic ballot. If mail-in or electronic ballots are used, the
				  ballots are to be counted and secured until certified by the governing body at
				  the same or the next regular meeting and recorded in the meeting minutes.
				  Vacancies on the governing board shall be filled according to program bylaws.
				  Joint self-insurance programs governed by a governing body which requires the
				  inclusion of a voting representative from each member entity in such governing
				  body are exempt from the requirements of this section.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-150 - Standards for management and operations-Individual rate setting-Nondiscrimination in joint program assessments

Current through Register Vol. 24-14, July 15, 2024
(1) Joint self-insurance program assessment
				formulas shall include all costs including rating for insured and self-insured
				layers of coverage. Assessment formulas shall be consistent and
				nondiscriminatory among all members.
(2) This provision shall not be construed to
				prohibit individual choice of coverage by members from several offered by the
				joint self-insurance program. The assessment formula, including the insured and
				self-insured components, shall be consistently applied to reflect the selection
				from among these choices.
(3) The
				assessment formula shall be available for review by the state risk
				manager.
(4) Joint self-insurance
				programs shall not sell equity, security, or shares in the joint self-insurance
				program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-160 - Standards for operations-Disclosures

Current through Register Vol. 24-14, July 15, 2024
(1) All joint self-insurance programs shall
				furnish to each new member joining a self-insurance program written statements
				which describe:
(a) Insurance coverages or
				benefits currently provided by the program, including any applicable
				restrictions, limitations, and exclusions;
(b) The method by which the member's annual
				contribution rates is determined;
(c) The procedure for filing a claim against
				the joint self-insurance program;
(d) The procedure for a member to request an
				adjudication of disputes or appeals arising from coverage, claim payment or
				denial, membership, and other issues; and
(e) General characteristics of the insurance
				coverage portion of the program.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-170 - Standards for operations-Standards for solvency-Termination provisions

Current through Register Vol. 24-14, July 15, 2024
(1) Program
				terminations. All joint self-insurance programs shall maintain a written plan
				that provides for the partial or complete termination of the program and for
				liquidation of its assets upon termination of the program. The termination
				procedure shall include, but not be limited to, a provision for the settling of
				all its liabilities for unpaid claims and claim adjustment expenses.
(2) Member terminations. All joint
				self-insurance programs shall maintain a written plan that provides for the
				termination of membership of a member.
Washington Administrative Code › Title 200 - Enterprise Services, Department of › RISK MANAGEMENT › Chapter 200-160 - SELF-INSURANCE REQUIREMENTS AS TO PUBLIC BENEFIT HOSPITAL ENTITIES JOINT SELF-INSURANCE PROGRAMS › Section 200-160-180 - Standards for management and operations-Financial plans

Current through Register Vol. 24-14, July 15, 2024
(1) All joint self-insurance programs shall
				maintain a written plan for managing the financial resources of the program.
				The financial plan shall include:
(a) A
				procedure for accounting for moneys received, payments made and liabilities of
				the joint program which complies with generally accepted accounting
				principles;
(b) An investment
				policy governing the investments of the program which conforms to the legal
				requirements applicable to local government members; and
(c) The submission of required documents and
				audited financial statements to the state risk manager within one hundred
				twenty days of the program's fiscal year end.