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Chapter 48.46 RCW

HEALTH MAINTENANCE ORGANIZATIONS

Sections

HTMLPDF 48.46.010Legislative declaration—Purpose.
HTMLPDF 48.46.012Filings with secretary of state—Copy for commissioner.
HTMLPDF 48.46.020Definitions.
HTMLPDF 48.46.023Insurance producer—Definition—License required—Application, issuance, renewal, fees—Penalties involving license.
HTMLPDF 48.46.027Registration, required—Issuance of securities—Penalty.
HTMLPDF 48.46.030Eligibility requirements for certificate of registration—Application requirements, information—Provider compensation.
HTMLPDF 48.46.033Unregistered activities—Acts committed in this state—Sanctions.
HTMLPDF 48.46.040Certificate of registration—Issuance—Grounds for refusal—Name restrictions—Inspection and review of facilities.
HTMLPDF 48.46.045Catastrophic health plans permitted.
HTMLPDF 48.46.060Prepayment agreements—Standards for forms and documents—Grounds for disapproval—Cancellation or failure to renew—Filing of agreement forms.
HTMLPDF 48.46.062Schedule of rates for individual agreements—Loss ratio—Definitions.
HTMLPDF 48.46.063Calculation of premiums—Members of a purchasing pool—Adjusted community rating method—Definitions.
HTMLPDF 48.46.064Calculation of premiums—Adjusted community rate—Definitions.
HTMLPDF 48.46.066Health plan benefits for small employers—Coverage—Exemption from statutory requirements—Premium rates—Requirements for providing coverage for small employers.
HTMLPDF 48.46.068Requirements for plans offered to small employers—Definitions.
HTMLPDF 48.46.070Governing body.
HTMLPDF 48.46.080Annual statement—Filings—Contents—Fee—Penalty for failure to file—Accuracy required.
HTMLPDF 48.46.090Standard of services provided.
HTMLPDF 48.46.100Grievance procedure.
HTMLPDF 48.46.110Name restrictions—Discrimination—Recovery of costs of health care services participant not entitled to.
HTMLPDF 48.46.120Examination of health maintenance organizations—Duties of organizations, powers of commissioner—Independent audit reports.
HTMLPDF 48.46.130Investigation of violations—Hearing—Findings—Penalties—Order requiring compliance, etc.—Suspension or revocation of certificate, effect—Application to courts.
HTMLPDF 48.46.135Fine in addition to or in lieu of suspension, revocation, or refusal.
HTMLPDF 48.46.140Fees.
HTMLPDF 48.46.170Effect of chapter as to other laws—Construction.
HTMLPDF 48.46.180Duty of employer to inform and make available to employees option of enrolling in health maintenance organization.
HTMLPDF 48.46.190Payroll deductions for capitation payments to health maintenance organizations.
HTMLPDF 48.46.200Rules and regulations.
HTMLPDF 48.46.210Compliance with federal funding requirements—Construction.
HTMLPDF 48.46.220Review of administrative action.
HTMLPDF 48.46.225Financial failure—Supervision of commissioner—Priority of distribution of assets.
HTMLPDF 48.46.235Minimum net worth—Requirement to maintain—Determination of amount.
HTMLPDF 48.46.237Minimum net worth—Domestic or foreign health maintenance organization.
HTMLPDF 48.46.240Funded reserve requirements.
HTMLPDF 48.46.243Contract—Participant liability.
HTMLPDF 48.46.245Plan for handling insolvency—Commissioner's review.
HTMLPDF 48.46.247Insolvency—Commissioner's duties—Participants' options—Allocation of coverage.
HTMLPDF 48.46.250Coverage of dependent children—Newborn infants, congenital anomalies—Notification period.
HTMLPDF 48.46.260Individual health maintenance agreement—Return within ten days of delivery—Refunds—Void from beginning.
HTMLPDF 48.46.270Financial interests of health maintenance organization authorities, restricted—Exceptions, regulations.
HTMLPDF 48.46.272Diabetes coverage—Definitions.
HTMLPDF 48.46.274Prescribed, self-administered anticancer medication.
HTMLPDF 48.46.275Mammograms—Insurance coverage.
HTMLPDF 48.46.277Prostate cancer screening.
HTMLPDF 48.46.280Reconstructive breast surgery.
HTMLPDF 48.46.285Mastectomy, lumpectomy.
HTMLPDF 48.46.291Mental health services—Health plans—Definition—Coverage required, when.
HTMLPDF 48.46.292Mental health treatment—Waiver of preauthorization for persons involuntarily committed.
HTMLPDF 48.46.300Future dividends or refunds, restricted—Issuance or sale of securities regulated.
HTMLPDF 48.46.310Registration not endorsement.
HTMLPDF 48.46.320Dependent children, termination of coverage, conditions.
HTMLPDF 48.46.325Option to cover child under age twenty-six.
HTMLPDF 48.46.340Return of agreement within ten days.
HTMLPDF 48.46.350Chemical dependency treatment.
HTMLPDF 48.46.355"Chemical dependency" defined.
HTMLPDF 48.46.360Payment of cost of agreement directly to holder during labor dispute—Changes restricted—Notice to employee.
HTMLPDF 48.46.370Coverage not denied for disability.
HTMLPDF 48.46.375Benefits for prenatal diagnosis of congenital disorders—Agreements entered into or renewed on or after January 1, 1990.
HTMLPDF 48.46.380Notice of reason for cancellation, denial, or refusal to renew agreement.
HTMLPDF 48.46.390Providing information on cancellation or refusal—No liability for insurance commissioner or health maintenance organization.
HTMLPDF 48.46.400False or misleading advertising prohibited.
HTMLPDF 48.46.410Misrepresentations to induce termination or retention of agreement prohibited.
HTMLPDF 48.46.420Penalty for violations.
HTMLPDF 48.46.430Enforcement authority of commissioner.
HTMLPDF 48.46.440Continuation option to be offered.
HTMLPDF 48.46.450Conversion agreement to be offered—Exceptions, conditions.
HTMLPDF 48.46.460Conversion agreement—Restrictions and requirements—Rules.
HTMLPDF 48.46.470Endorsement of modifications.
HTMLPDF 48.46.480Continuation of coverage of former family members.
HTMLPDF 48.46.490Coverage for adopted children.
HTMLPDF 48.46.500Cancellation of rider.
HTMLPDF 48.46.510Phenylketonuria.
HTMLPDF 48.46.520Neurodevelopmental therapies—Employer-sponsored group contracts.
HTMLPDF 48.46.530Temporomandibular joint disorders—Insurance coverage.
HTMLPDF 48.46.535Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.
HTMLPDF 48.46.540Nonresident pharmacies.
HTMLPDF 48.46.565Foot care services.
HTMLPDF 48.46.570Denturist services.
HTMLPDF 48.46.575Doctor of osteopathic medicine and surgery—Discrimination based on board certification is prohibited.
HTMLPDF 48.46.580When injury caused by intoxication or use of narcotics.
HTMLPDF 48.46.600Disclosure of certain material transactions—Report—Information is confidential.
HTMLPDF 48.46.605Material acquisitions or dispositions.
HTMLPDF 48.46.610Asset acquisitions—Asset dispositions.
HTMLPDF 48.46.615Report of a material acquisition or disposition of assets—Information required.
HTMLPDF 48.46.620Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
HTMLPDF 48.46.625Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.
HTMLPDF 48.46.900Liberal construction.
HTMLPDF 48.46.920Short title.
HTMLPDF 48.46.930Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.

NOTES:

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