The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
- (1) "Advance premium tax credit" means the premium assistance amount determined in accordance with the affordable care act.
- (2) "Affordable care act" means the federal patient protection and affordable care act, P.L. 111-148, as amended by the federal health care and education reconciliation act of 2010, P.L. 111-152, or federal regulations or guidance issued under the affordable care act.
- (3) "Authority" means the Washington state health care authority.
(4) "COFA citizen" means a person who is a citizen of:
- (a) The Republic of the Marshall Islands;
- (b) The Federated States of Micronesia; or
- (c) The Republic of Palau.
- (5) "Health benefit exchange" or "exchange" means the Washington health benefit exchange established in chapter 43.71 RCW.
- (6) "Income" means the modified adjusted gross income attributed to an individual for purposes of determining his or her eligibility for advance premium tax credits.
- (7) "In-network provider" means a health care provider or group of providers that directly contracts with an insurer to provide health benefits covered by a health benefit plan offered by an insurer.
- (8) "Open enrollment period" means the period during which a person may enroll in a qualified health plan.
- (9) "Out-of-pocket costs" means copayments, coinsurance, deductibles, and other cost-sharing requirements imposed under a qualified health plan for services, pharmaceuticals, devices, and other health benefits that are covered by the plan and rendered by in-network providers.
- (10) "Premium cost" means an individual's premium for a qualified health plan less the amount of the individual's advance premium tax credit.
- (11) "Qualified health plan" means a health benefit plan sold through the health benefit exchange.
- (12) "Resident" means a person who is domiciled in this state.
- (13) "Special enrollment period" means a period during which a person who has not done so during the open enrollment period may enroll in a qualified health plan through the exchange if the person meets specified requirements.
[ 2018 c 161 s 2.]