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WAC 284-46A-010

Definitions that apply to this chapter.

The definitions in this section apply throughout this chapter.
(1) "Complete filing" means a package of information containing forms, supporting information, documents and exhibits submitted to the commissioner electronically using the system for electronic rate and form filing (SERFF).
(2) "Date filed" means the date a complete filing has been received and accepted by the commissioner.
(3) "Filer" means:
(a) A person, organization or other entity that files forms or rates with the commissioner for an HMO; or
(b) A person employed by the HMO to file under this chapter.
(4) "Form" means a:
(a) "Contract" as defined in WAC 284-43-6020; and includes:
(i) Applications;
(ii) Certificates of coverage;
(iii) Disclosure forms;
(iv) Enrollment forms;
(v) Policy forms, including riders;
(vi) Termination notice forms;
(vii) Short form filing summary, as outlined in the SERFF filing instructions; and
(viii) All other forms that are part of the contract.
(b) "Contract form" as defined in WAC 284-43-6020;
(c) Network enrollment forms described in WAC 284-170-280(3);
(d) Prepayment agreements described in RCW 48.46.060;
(e) Participating provider agreements as required by RCW 48.46.243; and
(f) Medicare supplement forms required to be filed under chapter 48.66 RCW.
(5) "Health maintenance organization" or "HMO" means the same as in RCW 48.46.020.
(6) "NAIC" means the National Association of Insurance Commissioners.
(7) "Objection letter" means correspondence created in SERFF and sent by the commissioner to the filer that:
(a) Requests clarification, documentation or other information;
(b) Explains errors or omissions in the filing; or
(c) Disapproves a form under RCW 48.46.060 or 48.46.243.
(8) "Rate" or "rates" means all classification manuals, rate manuals, rating schedules, class rates, and rating rules that must be filed under RCW 48.46.060 or 48.66.035.
(9) "Rate schedule" means the same as in WAC 284-43-6020.
(10) "SERFF" means the system for electronic rate and form filing. SERFF is a proprietary NAIC computer-based application that allows insurers and other entities to create and submit rate, rule and form filings electronically to the commissioner.
(11) "Type of insurance" or "TOI" means a specific type of health care coverage listed in the Uniform Life, Accident and Health, Annuity and Credit Coding Matrix published by the NAIC and available at www.naic.org.
[Statutory Authority: RCW 48.02.060. WSR 16-14-106 (Matter No. R 2016-11), § 284-46A-010, filed 7/6/16, effective 8/6/16. Statutory Authority: RCW 48.02.060, 48.44.050, and 48.46.200. WSR 10-01-118 (Matter No. R 2009-04), § 284-46A-010, filed 12/17/09, effective 1/17/10.]
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