| Passed by the Senate March 4, 2013 YEAS 49 ________________________________________ President of the Senate Passed by the House April 3, 2013 YEAS 97 ________________________________________ Speaker of the House of Representatives | I, Hunter G. Goodman, Secretary of the Senate of the State of Washington, do hereby certify that the attached is SENATE BILL 5216 as passed by the Senate and the House of Representatives on the dates hereon set forth. ________________________________________ Secretary | |
| Approved ________________________________________ Governor of the State of Washington | Secretary of State State of Washington |
| State of Washington | 63rd Legislature | 2013 Regular Session |
Read first time 01/23/13. Referred to Committee on Health Care .
AN ACT Relating to long-term care insurance; and amending RCW 48.83.090 and 48.83.170.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 RCW 48.83.090 and 2008 c 145 s 10 are each amended to read
as follows:
All long-term care denials must be made within ((sixty)) thirty
days after receipt of a written request made by a policyholder or
certificate holder, or his or her representative. All denials of long-term care claims by the issuer must provide a written explanation of
the reasons for the denial and make available to the policyholder or
certificate holder all information directly related to the denial.
Sec. 2 RCW 48.83.170 and 2008 c 145 s 18 are each amended to read
as follows:
(1) The commissioner must adopt rules that include standards for
full and fair disclosure setting forth the manner, content, and
required disclosures for the sale of long-term care insurance policies,
terms of renewability, initial and subsequent conditions of
eligibility, nonduplication of coverage provisions, coverage of
dependents, preexisting conditions, termination of insurance,
continuation or conversion, probationary periods, limitations,
exceptions, reductions, elimination periods, requirements for
replacement, recurrent conditions, and definitions of terms. The
commissioner must adopt rules establishing loss ratio standards for
long-term care insurance policies. The commissioner must adopt rules
to promote premium adequacy and to protect policyholders in the event
of proposed substantial rate increases, and to establish minimum
standards for producer education, marketing practices, producer
compensation, producer testing, penalties, and reporting practices for
long-term care insurance.
(2) The commissioner ((shall)) must adopt rules establishing
standards protecting patient privacy rights, rights to receive
confidential health care services, and standards for an issuer's timely
review of a claim denial upon request of a covered person.
(3) The commissioner must adopt by rule prompt payment requirements
for long-term care insurance. The rules must include a definition of
a "claim" and a definition of "clean claim." In adopting the rules the
commissioner must consider the prompt payment requirements in long-term
care insurance model acts developed by the national association of
insurance commissioners.
(4) The commissioner may adopt reasonable rules to effectuate any
provision of this chapter in accordance with the requirements of
chapter 34.05 RCW.