Chapter 48.46 RCW

HEALTH MAINTENANCE ORGANIZATIONS

Sections

48.46.010Legislative declarationPurpose.
48.46.012Filings with secretary of stateCopy for commissioner.
48.46.020Definitions.
48.46.023Insurance producerDefinitionLicense requiredApplication, issuance, renewal, feesPenalties involving license.
48.46.027Registration, requiredIssuance of securitiesPenalty.
48.46.030Eligibility requirements for certificate of registrationApplication requirements, informationProvider compensation.
48.46.033Unregistered activitiesActs committed in this stateSanctions.
48.46.040Certificate of registrationIssuanceGrounds for refusalName restrictionsInspection and review of facilities.
48.46.045Catastrophic health plans permitted.
48.46.060Prepayment agreementsStandards for forms and documentsGrounds for disapprovalCancellation or failure to renewFiling of agreement forms.
48.46.062Schedule of rates for individual agreementsLoss ratioDefinitions.
48.46.063Calculation of premiumsMembers of a purchasing poolAdjusted community rating methodDefinitions.
48.46.064Calculation of premiumsAdjusted community rateDefinitions.
48.46.066Health plan benefits for small employersCoverageExemption from statutory requirementsPremium ratesRequirements for providing coverage for small employers.
48.46.068Requirements for plans offered to small employersDefinitions.
48.46.070Governing body.
48.46.080Annual statementFilingsContentsFeePenalty for failure to fileAccuracy required.
48.46.090Standard of services provided.
48.46.100Grievance procedure.
48.46.110Name restrictionsDiscriminationRecovery of costs of health care services participant not entitled to.
48.46.120Examination of health maintenance organizationsDuties of organizations, powers of commissionerIndependent audit reports.
48.46.130Investigation of violationsHearingFindingsPenaltiesOrder requiring compliance, etc.Suspension or revocation of certificate, effectApplication to courts.
48.46.135Fine in addition to or in lieu of suspension, revocation, or refusal.
48.46.140Fees.
48.46.170Effect of chapter as to other lawsConstruction.
48.46.180Duty of employer to inform and make available to employees option of enrolling in health maintenance organization.
48.46.190Payroll deductions for capitation payments to health maintenance organizations.
48.46.200Rules and regulations.
48.46.210Compliance with federal funding requirementsConstruction.
48.46.220Review of administrative action.
48.46.225Financial failureSupervision of commissionerPriority of distribution of assets.
48.46.235Minimum net worthRequirement to maintainDetermination of amount.
48.46.237Minimum net worthDomestic or foreign health maintenance organization.
48.46.240Funded reserve requirements.
48.46.243ContractParticipant liability.
48.46.245Plan for handling insolvencyCommissioner's review.
48.46.247InsolvencyCommissioner's dutiesParticipants' optionsAllocation of coverage.
48.46.250Coverage of dependent childrenNewborn infants, congenital anomaliesNotification period.
48.46.260Individual health maintenance agreementReturn within ten days of deliveryRefundsVoid from beginning.
48.46.270Financial interests of health maintenance organization authorities, restrictedExceptions, regulations.
48.46.272Diabetes coverageDefinitions.
48.46.274Prescribed, self-administered anticancer medication.
48.46.275MammogramsInsurance coverage.
48.46.277Prostate cancer screening.
48.46.280Reconstructive breast surgery.
48.46.285Mastectomy, lumpectomy.
48.46.291Mental health servicesHealth plansDefinitionCoverage required, when.
48.46.292Mental health treatmentWaiver of preauthorization for persons involuntarily committed.
48.46.300Future dividends or refunds, restrictedIssuance or sale of securities regulated.
48.46.310Registration not endorsement.
48.46.320Dependent children, termination of coverage, conditions.
48.46.325Option to cover child under age twenty-six.
48.46.340Return of agreement within ten days.
48.46.350Chemical dependency treatment.
48.46.355"Chemical dependency" defined.
48.46.360Payment of cost of agreement directly to holder during labor disputeChanges restrictedNotice to employee.
48.46.370Coverage not denied for handicap.
48.46.375Benefits for prenatal diagnosis of congenital disordersAgreements entered into or renewed on or after January 1, 1990.
48.46.380Notice of reason for cancellation, denial, or refusal to renew agreement.
48.46.390Providing information on cancellation or refusalNo liability for insurance commissioner or health maintenance organization.
48.46.400False or misleading advertising prohibited.
48.46.410Misrepresentations to induce termination or retention of agreement prohibited.
48.46.420Penalty for violations.
48.46.430Enforcement authority of commissioner.
48.46.440Continuation option to be offered.
48.46.450Conversion agreement to be offeredExceptions, conditions.
48.46.460Conversion agreementRestrictions and requirementsRules.
48.46.470Endorsement of modifications.
48.46.480Continuation of coverage of former family members.
48.46.490Coverage for adopted children.
48.46.500Cancellation of rider.
48.46.510Phenylketonuria.
48.46.520Neurodevelopmental therapiesEmployer-sponsored group contracts.
48.46.530Temporomandibular joint disordersInsurance coverage.
48.46.535PrescriptionsPreapproval of individual claimsSubsequent rejection prohibitedWritten record required.
48.46.540Nonresident pharmacies.
48.46.565Foot care services.
48.46.570Denturist services.
48.46.575Doctor of osteopathic medicine and surgeryDiscrimination based on board certification is prohibited.
48.46.580When injury caused by intoxication or use of narcotics.
48.46.600Disclosure of certain material transactionsReportInformation is confidential.
48.46.605Material acquisitions or dispositions.
48.46.610Asset acquisitionsAsset dispositions.
48.46.615Report of a material acquisition or disposition of assetsInformation required.
48.46.620Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
48.46.625Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreementsInformation required.
48.46.900Liberal construction.
48.46.920Short title.
48.46.930ConstructionChapter applicable to state registered domestic partnerships2009 c 521.

NOTES:

Insurance producers appointed by health maintenance organizations, additional regulations applicable: RCW 48.17.065.
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