WASHINGTON ADMINISTRATIVE CODE ARCHIVE

Washington Administrative Code
2023 Archive

Chapter 284-51 WAC

Last Update: 7/6/16

STANDARDS FOR COORDINATION OF BENEFITS

PDF of Chapter Digest


WAC Sections
284-51-190	Purpose.
284-51-195	Definitions.
284-51-200	Use of model COB contract provision.
284-51-205	Rules for coordination of benefits.
284-51-210	Coordination procedures.
284-51-215	Time limit.
284-51-220	Facility of payment.
284-51-225	Right of recovery.
284-51-230	Procedure to be followed by secondary plan to calculate benefits and pay a claim.
284-51-235	Notice to covered persons.
284-51-240	Small claim waivers.
284-51-245	Miscellaneous provisions.
284-51-250	Applicability and scope—Effective date for existing contracts.
284-51-255	Appendix A—Model COB contract provisions.
284-51-260	Appendix B—Consumer explanatory booklet.

DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE


284-51-010	Purpose and scope. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-010, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-010, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-015	Amount of reduction allowed. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-015, filed 10/3/94, effective 11/3/94.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-020	Required provisions for coordination of benefits. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-020, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-020, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-030	Benefits subject to coordination. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-030, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-030, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-040	"Plan" defined. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-040, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-040, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-045	"Preventive care" defined. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-045, filed 10/3/94, effective 11/3/94.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-050	Allowable expense. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-050, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060 (3)(a), 48.44.050 and 48.46.200. WSR 91-18-026 (Order R 91-6), § 284-51-050, filed 8/23/91, effective 9/23/91. Statutory Authority: RCW 48.02.060, 48.44.050, and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-050, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-060	Claim determination period. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-060, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-060, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-070	Order of benefit determination. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-070, filed 6/18/81, effective 1/1/82.] Repealed by WSR 94-20-068 (Order R 94-15), filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a).
284-51-075	Order of benefit determination. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-075, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 86-22-051 (Order R 86-6), § 284-51-075, filed 11/4/86, effective 1/1/87.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-080	Determination of length of coverage. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-080, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-090	Coordination procedures. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-090, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-100	Time limit. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-100, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-110	Small claim waivers. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-110, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-120	Facility of payment. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-120, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-120, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-130	Right of recovery. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-130, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-130, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-140	Right to receive and release necessary information. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-140, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-140, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-150	Disclosure of coordination. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-150, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-150, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-160	Conformity of contracts. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-160, filed 6/18/81, effective 1/1/82.] Repealed by WSR 94-20-068 (Order R 94-15), filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a).
284-51-170	Effective date. [Statutory Authority: RCW 48.01.200, 48.21.200, 48.01.030 and 48.02.060 (3)(a). WSR 94-20-068 (Order R 94-15), § 284-51-170, filed 10/3/94, effective 11/3/94. Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-170, filed 6/18/81, effective 1/1/82.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.
284-51-180	Appendix A, form for "effect on benefits" provision. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 81-14-001 (Order R 81-2), § 284-51-180, filed 6/18/81, effective 1/1/82.] Repealed by WSR 98-09-041 (Matter R 98-01), filed 4/14/98, effective 5/15/98. Statutory Authority: RCW 48.02.060, 48.17.150, 48.44.040, 48.46.200 and 48.44.050.
284-51-185	Appendix B, form for "effect on benefits" provision. [Statutory Authority: RCW 48.02.060, 48.44.050 and 48.46.200. WSR 86-22-051 (Order R 86-6), § 284-51-185, filed 11/4/86, effective 1/1/87.] Repealed by WSR 07-13-008 (Matter No. R 2005-07), filed 6/8/07, effective 7/9/07. Statutory Authority: RCW 48.20.60 [48.20.060], 48.21.200, 48.44.050, and 48.46.200.