WASHINGTON STATUTES AND CODES

48.44.380 - Conversion contract -- Restrictions and requirements.

Conversion contract — Restrictions and requirements.

(1) A health care service contractor shall not require proof of insurability as a condition for issuance of the conversion contract.

     (2) A conversion contract may not contain an exclusion for preexisting conditions except to the extent that a waiting period for a preexisting condition has not been satisfied under the group contract.

     (3) A health care service contractor must offer at least three contract benefit plans that comply with the following:

     (a) A major medical plan with a five thousand dollar deductible and a lifetime benefit maximum of two hundred fifty thousand dollars per person;

     (b) A comprehensive medical plan with a five hundred dollar deductible and a lifetime benefit maximum of five hundred thousand dollars per person; and

     (c) A basic medical plan with a one thousand dollar deductible and a lifetime maximum of seventy-five thousand dollars per person.

     (4) The insurance commissioner may revise the deductibles and lifetime benefit amounts in subsection (3) of this section from time to time to reflect changing health care costs.

     (5) The insurance commissioner shall adopt rules to establish minimum benefit standards for conversion contracts.

     (6) The commissioner shall adopt rules to establish specific standards for conversion contract provisions. These rules may include but are not limited to:

     (a) Terms of renewability;

     (b) Nonduplication of coverage;

     (c) Benefit limitations, exceptions, and reductions; and

     (d) Definitions of terms.