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Chapter 284-51 WAC

Last Update: 9/15/11

STANDARDS FOR COORDINATION OF BENEFITS

WAC Sections

284-51-190 Purpose.
284-51-195 Definitions.
284-51-200 Use of model COB contract provision.
284-51-205 Rules for coordination of benefits.
284-51-210 Coordination procedures.
284-51-215 Time limit.
284-51-220 Facility of payment.
284-51-225 Right of recovery.
284-51-230 Procedure to be followed by secondary plan to calculate benefits and pay a claim.
284-51-235 Notice to covered persons.
284-51-240 Small claim waivers.
284-51-245 Miscellaneous provisions.
284-51-250 Applicability and scope -- Effective date for existing contracts.
284-51-255 Appendix A -- Model COB contract provisions.
284-51-260 Appendix B -- Consumer explanatory booklet.
DISPOSITIONS OF SECTIONS FORMERLY CODIFIED IN THIS CHAPTER
284-51-010 Purpose and scope. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-010, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-010, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060],48.21.200 , 48.44.050, and 48.46.200
284-51-015 Amount of reduction allowed. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-015, filed 10/3/94, effective 11/3/94.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200,48.44.050 , and 48.46.200
284-51-020 Required provisions for coordination of benefits. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-020, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-020, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-030 Benefits subject to coordination. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-030, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-030, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-040 "Plan" defined. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-040, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-040, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060],48.21.200 , 48.44.050, and 48.46.200
284-51-045 "Preventive care" defined. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-045, filed 10/3/94, effective 11/3/94.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200,48.44.050 , and 48.46.200
284-51-050 Allowable expense. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-050, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060 (3)(a),48.44.050 and 48.46.200. 91-18-026 (Order R 91-6), § 284-51-050, filed 8/23/91, effective 9/23/91. Statutory Authority: RCW 48.02.060, 48.44.050, and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-050, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-060 Claim determination period. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-060, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-060, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-070 Order of benefit determination. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-070, filed 6/18/81, effective 1/1/82.]  Repealed by 94-20-068 (Order R 94-15), filed 10/3/94, effective 11/3/94.  Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a).
284-51-075 Order of benefit determination. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-075, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 86-22-051 (Order R 86-6), § 284-51-075, filed 11/4/86, effective 1/1/87.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-080 Determination of length of coverage. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-080, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-090 Coordination procedures. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-090, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-100 Time limit. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-100, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-110 Small claim waivers. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-110, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-120 Facility of payment. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-120, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-120, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-130 Right of recovery. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-130, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-130, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060],48.21.200 , 48.44.050, and 48.46.200
284-51-140 Right to receive and release necessary information. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-140, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-140, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-150 Disclosure of coordination. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-150, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-150, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200
284-51-160 Conformity of contracts. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-160, filed 6/18/81, effective 1/1/82.]  Repealed by 94-20-068 (Order R 94-15), filed 10/3/94, effective 11/3/94.  Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a).
284-51-170 Effective date. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). 94-20-068 (Order R 94-15), § 284-51-170, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-170, filed 6/18/81, effective 1/1/82.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060],48.21.200 , 48.44.050, and 48.46.200
284-51-180 Appendix A, form for "effect on benefits" provision. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 81-14-001 (Order R 81-2), § 284-51-180, filed 6/18/81, effective 1/1/82.]  Repealed by 98-09-041 (Matter R 98-01), filed 4/14/98, effective 5/15/98. Statutory Authority: RCW 48.02.060, 48.17.150, 48.44.040, 48.46.200 and 48.44.050
284-51-185 Appendix B, form for "effect on benefits" provision. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. 86-22-051 (Order R 86-6), § 284-51-185, filed 11/4/86, effective 1/1/87.]  Repealed by 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060],48.21.200 , 48.44.050, and 48.46.200