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284-43-5000  <<  284-43-5020 >>   284-43-5060

PDFWAC 284-43-5020

Recognizing the exercise of conscience by purchasers of basic health plan services and ensuring access for all enrollees to such services.

(1) All carriers required pursuant to law to offer and file with the commissioner a plan providing benefits identical to the basic health plan services (the model plan) shall file for such plan a full description of the process it will use to recognize an organization or individual's exercise of conscience based on a religious belief or conscientious objection to the purchase of coverage for a specific service. This process may not affect a nonobjecting enrollee's access to coverage for those services.
(2) A religiously sponsored carrier who elects, for reasons of religious belief, not to participate in the provision of certain services otherwise included in the model plan, shall file for such plan a description of the process by which enrollees will have timely access to all services in the model plan.
(3) The commissioner will not disapprove processes that meet the following criteria:
(a) Enrollee access to all basic health plan services is not impaired in any way;
(b) The process meets notification requirements specified in RCW 48.43.065; and
(c) The process relies on sound actuarial principles to distribute risk.
[WSR 16-01-081, recodified as § 284-43-5020, filed 12/14/15, effective 12/14/15. Statutory Authority: RCW 48.02.060, 48.20.450, 48.20.460, 48.30.010, 48.44.020, 48.44.050, 48.44.080, 48.46.030, 48.46.060(2), 48.46.200 and 48.46.243. WSR 98-04-005 (Matter No. R 97-3), § 284-43-800, filed 1/22/98, effective 2/22/98.]