STATE STATUTES & CODES

WASHINGTON STATUTES AND CODES

48.43 - Insurance reform.

• 48.43.001 - Intent.
• 48.43.005 - Definitions.
• 48.43.008 - Enrollment in employer-sponsored health plan -- Person eligible for medical assistance.
• 48.43.012 - Individual health benefit plans -- Preexisting conditions.
• 48.43.0121 - Commissioner's authority to review certain rates.
• 48.43.015 - Health benefit plans -- Preexisting conditions.
• 48.43.017 - Organ transplant benefit waiting periods -- Prior creditable coverage.
• 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.
• 48.43.043 - Colorectal cancer examinations and laboratory tests -- Required benefits or coverage.
• 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 -- Requirement
• 48.43.083 - Chiropractor services -- Participating provider agreement -- Health carrier reimbursement.
• 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.
• 48.43.190 - Payment of chiropractic services -- Parity.
• 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.
• 48.43.290 - Coverage for prescribed durable medical equipment and mobility enhancing equipment -- Sales and use taxes -- Definitions.
• 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.
• 48.43.517 - Enrollment of child participating in medical assistance program -- Employer-sponsored health plan.
• 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.
• 48.43.650 - Fixed payment insurance products -- Commissioner's annual report.
• 48.43.670 - Plan or contract renewal -- Modification of wellness program.
• 48.43.680 - Lifetime limit on transplants -- Definition.
• 48.43.690 - Assessments under RCW 70.290.040 considered medical expenses.
• 48.43.901 - Captions not law -- 1996 c 312.
• 48.43.902 - Effective date -- 1996 c 312.
• 48.43.903 - Severability -- 1998 c 241.
• 48.43.904 - Construction -- Chapter applicable to state registered domestic partnerships -- 2009 c 521.

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