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Wash. Rev. Code ch. 48.46 – Health maintenance organizations. | Midpage
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Revised Code of Washington
Title 48
Chapter 48.46
Wash. Rev. Code ch. 48.46
Health maintenance organizations.
48.46.010
Legislative declaration—Purpose.
48.46.012
Filings with secretary of state—Copy for commissioner.
48.46.020
Definitions.
48.46.023
Insurance producer—Definition—License required—Application, issuance, renewal, fees—Penalties involving license.
48.46.027
Registration, required—Issuance of securities—Penalty.
48.46.030
Eligibility requirements for certificate of registration—Application requirements, information—Provider compensation.
48.46.033
Unregistered activities—Acts committed in this state—Sanctions.
48.46.040
Certificate of registration—Issuance—Grounds for refusal—Name restrictions—Inspection and review of facilities.
48.46.045
Catastrophic health plans permitted.
48.46.060
Prepayment agreements—Standards for forms and documents—Grounds for disapproval—Cancellation or failure to renew—Filing of agreement forms.
48.46.062
Schedule of rates for individual agreements—Loss ratio—Definitions.
48.46.063
Calculation of premiums—Members of a purchasing pool—Adjusted community rating method—Definitions.
48.46.064
Calculation of premiums—Adjusted community rate—Definitions.
48.46.066
Health plan benefits for small employers—Coverage—Exemption from statutory requirements—Premium rates—Requirements for providing coverage for small employers.
48.46.068
Requirements for plans offered to small employers—Definitions.
48.46.070
Governing body.
48.46.080
Annual statement—Filings—Contents—Fee—Penalty for failure to file—Accuracy required.
48.46.090
Standard of services provided.
48.46.100
Grievance procedure.
48.46.110
Name restrictions—Discrimination—Recovery of costs of health care services participant not entitled to.
48.46.120
Examination of health maintenance organizations—Duties of organizations, powers of commissioner—Independent audit reports.
48.46.130
Investigation of violations—Hearing—Findings—Penalties—Order requiring compliance, etc.—Suspension or revocation of certificate, effect—Application to courts.
48.46.135
Fine in addition to or in lieu of suspension, revocation, or refusal.
48.46.140
Fees.
48.46.170
Effect of chapter as to other laws—Construction.
48.46.180
Duty of employer to inform and make available to employees option of enrolling in health maintenance organization.
48.46.190
Payroll deductions for capitation payments to health maintenance organizations.
48.46.200
Rules and regulations.
48.46.210
Compliance with federal funding requirements—Construction.
48.46.220
Review of administrative action.
48.46.225
Financial failure—Supervision of commissioner—Priority of distribution of assets.
48.46.235
Minimum net worth—Requirement to maintain—Determination of amount.
48.46.237
Minimum net worth—Domestic or foreign health maintenance organization.
48.46.240
Funded reserve requirements.
48.46.243
Contract—Participant liability.
48.46.245
Plan for handling insolvency—Commissioner's review.
48.46.247
Insolvency—Commissioner's duties—Participants' options—Allocation of coverage.
48.46.250
Coverage of dependent children—Newborn infants, congenital anomalies—Notification period.
48.46.260
Individual health maintenance agreement—Return within ten days of delivery—Refunds—Void from beginning.
48.46.270
Financial interests of health maintenance organization authorities, restricted—Exceptions, regulations.
48.46.272
Diabetes coverage—Definitions.
48.46.274
Prescribed, self-administered anticancer medication.
48.46.275
Mammograms—Insurance coverage. (Effective until June 30, 2027.)
48.46.277
Prostate cancer screening. (Effective until June 30, 2027.)
48.46.280
Reconstructive breast surgery.
48.46.285
Mastectomy, lumpectomy.
48.46.291
Mental health services—Health plans—Definition—Coverage required, when. (Effective until January 1, 2027.)
48.46.292
Mental health treatment—Waiver of preauthorization for persons involuntarily committed.
48.46.300
Future dividends or refunds, restricted—Issuance or sale of securities regulated.
48.46.310
Registration not endorsement.
48.46.320
Dependent children, termination of coverage, conditions.
48.46.325
Option to cover child under age twenty-six.
48.46.340
Return of agreement within ten days.
48.46.350
Chemical dependency treatment.
48.46.355
"Chemical dependency" defined.
48.46.360
Payment of cost of agreement directly to holder during labor dispute—Changes restricted—Notice to employee.
48.46.370
Coverage not denied for disability.
48.46.375
Benefits for prenatal diagnosis of congenital disorders—Agreements entered into or renewed on or after January 1, 1990.
48.46.380
Notice of reason for cancellation, denial, or refusal to renew agreement.
48.46.390
Providing information on cancellation or refusal—No liability for insurance commissioner or health maintenance organization.
48.46.400
False or misleading advertising prohibited.
48.46.410
Misrepresentations to induce termination or retention of agreement prohibited.
48.46.420
Penalty for violations.
48.46.430
Enforcement authority of commissioner.
48.46.440
Continuation option to be offered.
48.46.450
Conversion agreement to be offered—Exceptions, conditions.
48.46.460
Conversion agreement—Restrictions and requirements—Rules.
48.46.470
Endorsement of modifications.
48.46.480
Continuation of coverage of former family members.
48.46.490
Coverage for adopted children.
48.46.500
Cancellation of rider.
48.46.510
Phenylketonuria.
48.46.520
Neurodevelopmental therapies—Employer-sponsored group contracts.
48.46.530
Temporomandibular joint disorders—Insurance coverage.
48.46.535
Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.
48.46.540
Nonresident pharmacies.
48.46.565
Foot care services.
48.46.570
Denturist services.
48.46.575
Doctor of osteopathic medicine and surgery—Discrimination based on board certification is prohibited.
48.46.580
When injury caused by intoxication or use of narcotics.
48.46.600
Disclosure of certain material transactions—Report—Information is confidential.
48.46.605
Material acquisitions or dispositions.
48.46.610
Asset acquisitions—Asset dispositions.
48.46.615
Report of a material acquisition or disposition of assets—Information required.
48.46.620
Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
48.46.625
Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.
48.46.900
Liberal construction.
48.46.920
Short title.
48.46.930
Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.