Washington Chapter 48.43 RCW: Insurance reform (formerly certified health plans)
RCW Sections
- 48.43.001 Intent.
- 48.43.005 Definitions.
- 48.43.012 Individual health benefit plans -- Preexisting conditions.
- 48.43.015 Health benefit plans -- Preexisting conditions.
- 48.43.018 Requirement to complete the standard health questionnaire -- Exemptions -- Results.
- 48.43.021 Personally identifiable health information -- Restrictions on release.
- 48.43.022 Enrollee identification card -- Social security number restriction.
- 48.43.023 Pharmacy identification cards--Rules.
- 48.43.025 Group health benefit plans -- Preexisting conditions.
- 48.43.028 Eligibility to purchase certain health benefit plans -- Small employers and small groups.
- 48.43.035 Group health benefit plans -- Guaranteed issue and continuity of coverage -- Exceptions -- Group of one.
- 48.43.038 Individual health plans -- Guarantee of continuity of coverage--Exceptions.
- 48.43.041 Individual health benefit plans -- Mandatory benefits.
- 48.43.045 Health plan requirements -- Annual reports -- Exemptions.
- 48.43.049 Health carrier data -- Information from annual statement -- Format prescribed by commissioner -- Public availability.
- 48.43.055 Procedures for review and adjudication of health care provider complaints -- Requirements.
- 48.43.065 Right of individuals to receive services -- Right of providers, carriers, and facilities to refuse to participate in or pay for services for reason of conscience or religion -- Requirements.
- 48.43.085 Health carrier may not prohibit its enrollees from contracting for services outside the health care plan.
- 48.43.087 Contracting for services at enrollee's expense -- Mental health care practitioner -- Conditions -- Exception.
- 48.43.091 Health carrier coverage of outpatient mental health services -- Requirements.
- 48.43.093 Health carrier coverage of emergency medical services -- Requirements -- Conditions.
- 48.43.097 Filing of financial statements -- Every health carrier.
- 48.43.105 Preparation of documents that compare health carriers -- Immunity -- Due diligence.
- 48.43.115 Maternity services -- Intent -- Definitions -- Patient preference -- Clinical sovereignty of provider -- Notice to policyholders -- Application.
- 48.43.125 Coverage at a long-term care facility following hospitalization -- Definition.
- 48.43.180 Denturist services.
- 48.43.185 General anesthesia services for dental procedures.
- 48.43.200 Disclosure of certain material transactions -- Report -- Information is confidential.
- 48.43.205 Material acquisitions or dispositions.
- 48.43.210 Asset acquisitions -- Asset dispositions.
- 48.43.215 Report of a material acquisition or disposition of assets -- Information required.
- 48.43.220 Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
- 48.43.225 Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements -- Information required.
- 48.43.300 Definitions.
- 48.43.305 Report of RBC levels -- Distribution of report -- Formula for determination -- Commissioner may make adjustments.
- 48.43.310 Company action level event -- Required RBC plan -- Commissioner's review -- Notification -- Challenge by carrier.
- 48.43.315 Regulatory action level event -- Required RBC plan -- Commissioner's review -- Notification -- Challenge by carrier.
- 48.43.320 Authorized control level event -- Commissioner's options.
- 48.43.325 Mandatory control level event -- Commissioner's duty -- Regulatory control.
- 48.43.330 Carrier's right to hearing -- Request by carrier -- Date set by commissioner.
- 48.43.335 Confidentiality of RBC reports and plans -- Use of certain comparisons prohibited -- Certain information intended solely for use by commissioner.
- 48.43.340 Powers or duties of commissioner not limited -- Rules.
- 48.43.345 Foreign or alien carriers -- Required RBC report -- Commissioner may require RBC plan -- Mandatory control level event.
- 48.43.350 No liability or cause of action against commissioner or department.
- 48.43.355 Notice by commissioner to carrier -- When effective.
- 48.43.360 Initial RBC reports -- Calculation of initial RBC levels -- Subsequent reports.
- 48.43.366 Self-funded multiple employer welfare arrangements.
- 48.43.370 RBC standards not applicable to certain carriers.
- 48.43.500 Intent -- Purpose -- 2000 c 5.
- 48.43.505 Requirement to protect enrollee's right to privacy or confidential services -- Rules.
- 48.43.510 Carrier required to disclose health plan information -- Marketing and advertising restrictions -- Rules.
- 48.43.515 Access to appropriate health services -- Enrollee options -- Rules.
- 48.43.520 Requirement to maintain a documented utilization review program description and written utilization review criteria -- Rules.
- 48.43.525 Prohibition against retrospective denial of health plan coverage -- Rules.
- 48.43.530 Requirement for carriers to have a comprehensive grievance process -- Carrier's duties -- Procedures -- Appeals -- Rules.
- 48.43.535 Independent review of health care disputes -- System for using certified independent review organizations -- Rules.
- 48.43.540 Requirement to designate a licensed medical director -- Exemption.
- 48.43.545 Standard of care -- Liability -- Causes of action -- Defense -- Exception.
- 48.43.550 Delegation of duties -- Carrier accountability.
- 48.43.600 Overpayment recovery -- Carrier.
- 48.43.605 Overpayment recovery -- Health care provider.
- 48.43.901 Captions not law -- 1996 c 312.
- 48.43.902 Effective date -- 1996 c 312.
- 48.43.903 Severability -- 1998 c 241.