Except as provided in subsection (3) of this section, a comprehensive medical plan shall have an annual deductible amount of five hundred dollars per person and shall provide at least the following benefits:
- (1) A lifetime maximum amount of benefits of five hundred thousand dollars per person.
(2) Payment of at least eighty percent of the usual and customary charges for the following:
- (a) Daily hospital room and board expenses not less than the semi-private room rate nor less than one hundred eighty days per calendar or contract year.
- (b) Ancillary hospital expenses.
- (c) Surgeons' fees.
- (d) Assistant surgeons' fees.
- (e) Anesthesiologists' and anesthetists' fees.
- (f) Inpatient and outpatient physician services.
- (3) A health maintenance organization's comprehensive medical plan may provide for no deductible amount or a deductible in any amount not exceeding five hundred dollars.
[Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 85-03-035 (Order R 85-1), § 284-52-060, filed 1/10/85; WSR 84-19-055 (Order R 84-4), § 284-52-060, filed 9/19/84.]