Wash. Admin. Code § 284-46A-010
Definitions that apply to this chapter
Effective Nov 10, 2022WSR 22-21-042RCW 48.02.060, 48.19.035, 48.43.730, 48.43.731, 48.44.050, 48.46.200, and 48.200.900INSURANCE COMMISSIONER, OFFICE OF THE
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 48.43.730 and WAC 284-170-480; and
- (f) Medicare supplement forms required to be filed under chapter 48.66 RCW.
- (5) "Health care benefit manager contract" or "HCBM contract" means a contract that includes the services under RCW 48.200.020(4) and any amendments made to such contracts.
- (6) "Health maintenance organization" or "HMO" means the same as in RCW 48.46.020.
- (7) "NAIC" means the National Association of Insurance Commissioners.
(8) "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 48.43.730.
- (9) "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.
- (10) "Rate schedule" means the same as in WAC 284-43-6020.
- (11) "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.
- (12) "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, 48.19.035, 48.43.730, 48.43.731, 48.44.050, 48.46.200, and 48.200.900. WSR 22-21-042 (Matter R 2022-06), § 284-46A-010, filed 10/10/22, effective 11/10/22. 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.]