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284-52-050  <<  284-52-060 >>   284-52-070

PDFWAC 284-52-060

Comprehensive medical plan.

Except as provided in subsection (3) of this section, a comprehensive medical plan shall have an annual deductible amount of five hundred dollars per person and shall provide at least the following benefits:
(1) A lifetime maximum amount of benefits of five hundred thousand dollars per person.
(2) Payment of at least eighty percent of the usual and customary charges for the following:
(a) Daily hospital room and board expenses not less than the semi-private room rate nor less than one hundred eighty days per calendar or contract year.
(b) Ancillary hospital expenses.
(c) Surgeons' fees.
(d) Assistant surgeons' fees.
(e) Anesthesiologists' and anesthetists' fees.
(f) Inpatient and outpatient physician services.
(3) A health maintenance organization's comprehensive medical plan may provide for no deductible amount or a deductible in any amount not exceeding five hundred dollars.
[Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 85-03-035 (Order R 85-1), § 284-52-060, filed 1/10/85; WSR 84-19-055 (Order R 84-4), § 284-52-060, filed 9/19/84.]
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