Revised Code of Washington
2023 Archive

Chapter 48.46 RCW
HEALTH MAINTENANCE ORGANIZATIONS
PDF of Chapter Digest
PDF of Complete Chapter
Sections
48.46.010Legislative declaration—Purpose.
48.46.012Filings with secretary of state—Copy for commissioner.
48.46.020Definitions.
48.46.023Insurance producer—Definition—License required—Application, issuance, renewal, fees—Penalties involving license.
48.46.027Registration, required—Issuance of securities—Penalty.
48.46.030Eligibility requirements for certificate of registration—Application requirements, information—Provider compensation.
48.46.033Unregistered activities—Acts committed in this state—Sanctions.
48.46.040Certificate of registration—Issuance—Grounds for refusal—Name restrictions—Inspection and review of facilities.
48.46.045Catastrophic health plans permitted.
48.46.060Prepayment agreements—Standards for forms and documents—Grounds for disapproval—Cancellation or failure to renew—Filing of agreement forms.
48.46.062Schedule of rates for individual agreements—Loss ratio—Definitions.
48.46.063Calculation of premiums—Members of a purchasing pool—Adjusted community rating method—Definitions.
48.46.064Calculation of premiums—Adjusted community rate—Definitions.
48.46.066Health plan benefits for small employers—Coverage—Exemption from statutory requirements—Premium rates—Requirements for providing coverage for small employers.
48.46.068Requirements for plans offered to small employers—Definitions.
48.46.070Governing body.
48.46.080Annual statement—Filings—Contents—Fee—Penalty for failure to file—Accuracy required.
48.46.090Standard of services provided.
48.46.100Grievance procedure.
48.46.110Name restrictions—Discrimination—Recovery of costs of health care services participant not entitled to.
48.46.120Examination of health maintenance organizations—Duties of organizations, powers of commissioner—Independent audit reports.
48.46.130Investigation of violations—Hearing—Findings—Penalties—Order requiring compliance, etc.—Suspension or revocation of certificate, effect—Application to courts.
48.46.135Fine in addition to or in lieu of suspension, revocation, or refusal.
48.46.140Fees.
48.46.170Effect of chapter as to other laws—Construction.
48.46.180Duty of employer to inform and make available to employees option of enrolling in health maintenance organization.
48.46.190Payroll deductions for capitation payments to health maintenance organizations.
48.46.200Rules and regulations.
48.46.210Compliance with federal funding requirements—Construction.
48.46.220Review of administrative action.
48.46.225Financial failure—Supervision of commissioner—Priority of distribution of assets.
48.46.235Minimum net worth—Requirement to maintain—Determination of amount.
48.46.237Minimum net worth—Domestic or foreign health maintenance organization.
48.46.240Funded reserve requirements.
48.46.243Contract—Participant liability.
48.46.245Plan for handling insolvency—Commissioner's review.
48.46.247Insolvency—Commissioner's duties—Participants' options—Allocation of coverage.
48.46.250Coverage of dependent children—Newborn infants, congenital anomalies—Notification period.
48.46.260Individual health maintenance agreement—Return within ten days of delivery—Refunds—Void from beginning.
48.46.270Financial interests of health maintenance organization authorities, restricted—Exceptions, regulations.
48.46.272Diabetes coverage—Definitions.
48.46.274Prescribed, self-administered anticancer medication.
48.46.275Mammograms—Insurance coverage.
48.46.277Prostate cancer screening.
48.46.280Reconstructive breast surgery.
48.46.285Mastectomy, lumpectomy.
48.46.291Mental health services—Health plans—Definition—Coverage required, when.
48.46.292Mental health treatment—Waiver of preauthorization for persons involuntarily committed.
48.46.300Future dividends or refunds, restricted—Issuance or sale of securities regulated.
48.46.310Registration not endorsement.
48.46.320Dependent children, termination of coverage, conditions.
48.46.325Option to cover child under age twenty-six.
48.46.340Return of agreement within ten days.
48.46.350Chemical dependency treatment.
48.46.355"Chemical dependency" defined.
48.46.360Payment of cost of agreement directly to holder during labor dispute—Changes restricted—Notice to employee.
48.46.370Coverage not denied for disability.
48.46.375Benefits for prenatal diagnosis of congenital disorders—Agreements entered into or renewed on or after January 1, 1990.
48.46.380Notice of reason for cancellation, denial, or refusal to renew agreement.
48.46.390Providing information on cancellation or refusal—No liability for insurance commissioner or health maintenance organization.
48.46.400False or misleading advertising prohibited.
48.46.410Misrepresentations to induce termination or retention of agreement prohibited.
48.46.420Penalty for violations.
48.46.430Enforcement authority of commissioner.
48.46.440Continuation option to be offered.
48.46.450Conversion agreement to be offered—Exceptions, conditions.
48.46.460Conversion agreement—Restrictions and requirements—Rules.
48.46.470Endorsement of modifications.
48.46.480Continuation of coverage of former family members.
48.46.490Coverage for adopted children.
48.46.500Cancellation of rider.
48.46.510Phenylketonuria.
48.46.520Neurodevelopmental therapies—Employer-sponsored group contracts.
48.46.530Temporomandibular joint disorders—Insurance coverage.
48.46.535Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.
48.46.540Nonresident pharmacies.
48.46.565Foot care services.
48.46.570Denturist services.
48.46.575Doctor of osteopathic medicine and surgery—Discrimination based on board certification is prohibited.
48.46.580When injury caused by intoxication or use of narcotics.
48.46.600Disclosure of certain material transactions—Report—Information is confidential.
48.46.605Material acquisitions or dispositions.
48.46.610Asset acquisitions—Asset dispositions.
48.46.615Report of a material acquisition or disposition of assets—Information required.
48.46.620Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
48.46.625Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.
48.46.900Liberal construction.
48.46.920Short title.
48.46.930Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.
NOTES:
Insurance producers appointed by health maintenance organizations, additional regulations applicable: RCW 48.17.065.