H-2156              _______________________________________________

                                           SUBSTITUTE HOUSE BILL NO. 777

                        _______________________________________________

State of Washington                              50th Legislature                              1987 Regular Session

By House Committee on Financial Institutions & Insurance (originally sponsored by Representatives Lux, Zellinsky, Dellwo, Nutley, Day, Meyers, Chandler, Leonard, Locke, K. Wilson, Taylor, Lewis, Cole, Rasmussen, Sprenkle, Madsen, May, Rayburn and Jesernig)

Read first time 2/27/87 and passed to Committee on Rules.

AN ACT Relating to insurance; and amending RCW 48.84.040.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

        Sec. 1.  Section 4, chapter 170, Laws of 1986 and RCW 48.84.040 are each amended to read as follows:

          No long-term care insurance policy or benefit contract may:

          (1) Use riders, waivers, endorsements, or any similar method to limit or reduce coverage or benefits;

          (2) Indemnify against losses resulting from sickness on a different basis than losses resulting from accidents;

          (3) Be canceled, nonrenewed, or segregated at the time of rerating solely on the grounds of the age or the deterioration of the mental or physical health of the covered person;

          (4) Exclude or limit coverage for preexisting conditions for a period of more than one year prior to the effective date of the policy or contract or more than six months after the effective date of the policy or contract;

          (5) Differentiate benefit amounts on the basis of the type or level of nursing home care provided;

          (6) Contain a provision establishing any new waiting period in the event an existing policy or contract is converted to a new or other form within the same company;

(7) Contain a provision that conditions the availability or amount of policy or contract benefits upon the insured's or beneficiary's admission and stay in a hospital for a period of time greater than three days.  No policy or contract issued or renewed on or after January 1, 1989, may contain a provision that conditions the availability or amount of policy or contract benefits upon the insured's or beneficiary's admission and stay in a hospital unless the insurer, contractor, or health maintenance organization proves to the commissioner's satisfaction that such a provision is actuarially necessary and that alternative methods of controlling benefit utilization are unavailable, impractical, or would result in significant increase in cost to the insured or beneficiary.  In no case may the commissioner approve of a hospitalization requirement greater than three days.