Chapter 48.44 RCW

HEALTH CARE SERVICES

Sections
Definitions.
Insurance producerDefinitionLicense requiredApplication, issuance, renewal, feesPenalties involving license.
Filings with secretary of stateCopy for commissioner.
Registration by health care service contractors requiredPenalty.
Unregistered activitiesActs committed in this stateSanctions.
Schedule of rates for individual contractsLoss ratioDefinitions.
Contracts for servicesExamination of contract forms by commissionerGrounds for disapprovalLiability of participant.
Calculation of premiumsMembers of a purchasing poolAdjusted community rating methodDefinitions.
Calculation of premiumsAdjusted community rateDefinitions.
Health plan benefits for small employersCoverageExemption from statutory requirementsPremium ratesRequirements for providing coverage for small employers.
Requirements for plans offered to small employersDefinitions.
Payment for certain health care services.
Underwriting of indemnity by insurance policy, bond, securities, or cash deposit.
Financial failureSupervision of commissionerPriority of distribution of assets.
Limited health care serviceUncovered expendituresMinimum net worth requirements.
Minimum net worthRequirement to maintainDetermination of amount.
Minimum net worthDomestic or foreign health care service contractor.
Registration with commissionerFee.
Rules and regulations.
Plan for handling insolvencyCommissioner's review.
InsolvencyCommissioner's dutiesParticipants' optionsAllocation of coverage.
Penalty.
Master lists of contractor's participating providersFiling with commissionerNotice of termination or participation.
Refusal to register corporate, etc., contractor if name confusing with existing contractor or insurance company.
Annual financial statementFilingsContentsFeePenalty for failure to file.
Filing inaccurate financial statement prohibited.
False representation, advertising.
Misrepresentations of contract terms, benefits, etc.
Future dividends or refundsWhen permissible.
Misleading comparisons to terminate or retain contract.
Examination of contractorsDuties of contractor, powers of commissionerIndependent audit reports.
Certificate of registration not an endorsementDisplay in solicitation prohibited.
Revocation, suspension, refusal of registrationHearingCease and desist orders, injunctive actionGrounds.
Notice of suspension, revocation, or refusal to be given contractorAuthority of insurance producers.
Fine in addition to or in lieu of suspension, revocation, or refusal.
Hearings and appeals.
Enforcement.
Individual health care service plan contractsCoverage of dependent child not to terminate because of developmental disability or physical handicap.
Group health care service plan contractsCoverage of dependent child not to terminate because of developmental disability or physical handicap.
Coverage of dependent children to include newborn infants and congenital anomalies from moment of birthNotification period.
Option to cover child under age twenty-six.
Discrimination prohibited.
Podiatric physicians and surgeons not excluded.
Individual health service plan contractReturn within ten days of deliveryRefundsVoid from beginningNotice required.
Chemical dependency benefitsProvisions of group contracts delivered or renewed after January 1, 1988.
Chemical dependency benefitsRCW 48.21.160 through 48.21.190, 48.44.240 inapplicable, when.
"Chemical dependency" defined.
Payment of premium by employee in event of suspension of compensation due to labor dispute.
Notice of reason for cancellation, denial, or refusal to renew contract.
Immunity from libel or slander.
Registered nurses or advanced registered nurses.
Legislative finding.
Podiatric medicine and surgeryBenefits not to be denied.
When injury caused by intoxication or use of narcotics.
Legislative finding.
Chiropractic care, coverage required, exceptions.
Diabetes coverageDefinitions.
Home health care, hospice care, optional coverage requiredStandards, limitations, restrictionsRulesMedicare supplemental contracts excluded.
Prescribed, self-administered anticancer medication.
MammogramsInsurance coverage.
Prostate cancer screening.
Reconstructive breast surgery.
Mastectomy, lumpectomy.
Mental health servicesHealth plansDefinitionCoverage required, when.
Mental health treatmentWaiver of preauthorization for persons involuntarily committed.
Benefits for prenatal diagnosis of congenital disordersContracts entered into or renewed on or after January 1, 1990.
Financial interests of health care service contractors, restrictedExceptions, regulations.
Continuation option to be offered.
Conversion contract to be offeredExceptions, conditions.
Conversion contractRestrictions and requirementsRules.
Modification of basis of agreement, endorsement required.
Continuance provisions for former family members.
Coverage for adopted children.
Cancellation of rider.
Phenylketonuria.
Neurodevelopmental therapiesEmployer-sponsored group contracts.
Temporomandibular joint disordersInsurance coverage.
PrescriptionsPreapproval of individual claimsSubsequent rejection prohibitedWritten record required.
Nonresident pharmacies.
Dental services that are not subject to contract or provider agreement.
Denturist services.
Disclosure of certain material transactionsReportInformation is confidential.
Material acquisitions or dispositions.
Asset acquisitionsAsset dispositions.
Report of a material acquisition or disposition of assetsInformation required.
Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreementsInformation required.
ConstructionChapter applicable to state registered domestic partnerships2009 c 521.
NOTES:
Insurance producers appointed by health care service contractors, additional regulations applicable: RCW 48.17.065.
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