GroundRules
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- RCW 48.41.170 · Required rule making.
- RCW 48.41.190 · Civil and criminal immunity.
- RCW 48.41.200 · Rates—Standard risk and maximum.
- RCW 48.41.210 · Last payor of benefits.
- RCW 48.41.220 · Mental health services—Definition—Coverage required, when. (Effective until January 1, 2027.)
- RCW 48.41.240 · Review of populations needing coverage through pool—Analysis and recommendations—Report.
- RCW 48.41.250 · Administration of risk management functions—Contract with commissioner authorized—Recommendations—Report to legislature.
- RCW 48.41.900 · Federal supremacy.
- RCW 48.41.920 · Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.
- RCW 48.42.010 · Personal coverage, authority of commissioner—Definition.
- RCW 48.42.020 · Showing regulation by other agency, how done—Definition.
- RCW 48.42.030 · Examination by commissioner—When required, scope of.
- RCW 48.42.040 · Application of this title to otherwise unregulated entities.
- RCW 48.42.050 · Notice to purchasers by uninsured production agency—Notice to production agency by administrator of coverage.
- RCW 48.42.090 · Prenatal testing—Limitation on changes to coverage.
- RCW 48.42.100 · Women's health care services—Duties of health care carriers. (Effective until June 30, 2027.)
- RCW 48.43.001 · Intent.
- RCW 48.43.005 · Definitions.
- RCW 48.43.007 · Availability of price and quality information—Transparency tools for members—Requirements.
- RCW 48.43.008 · Enrollment in employer-sponsored health plan—Person eligible for medical assistance.
- RCW 48.43.009 · Health care sharing ministries.
- RCW 48.43.012 · Health plans—Preexisting conditions—Rules.
- RCW 48.43.01211 · Health plans—Eligibility—Health status-related factors—Rules.
- RCW 48.43.0122 · Individual health benefit plans—Open enrollment and special enrollment periods—Rules—Enforcement.
- RCW 48.43.0123 · Health plans—Rescission of coverage—Rules.
- RCW 48.43.0124 · Health plans—Cost sharing for essential health benefits—Rules.
- RCW 48.43.0125 · Essential health benefits—Annual or lifetime dollar limits.
- RCW 48.43.0126 · Summary of benefits and explanation of coverage—Standards and requirements—Notice of modification—Fines—Standards for definitions of health insurance terms—Rules.
- RCW 48.43.0127 · Group health plans—Waiting period—Rules.
- RCW 48.43.0128 · Nongrandfathered health plans and plans issued or renewed on or after January 1, 2022—Prohibited discrimination—Rules.
- RCW 48.43.013 · Health carriers—Timely payments.
- RCW 48.43.016 · Utilization management standards and criteria—Health carrier requirements—Definitions. (Effective until January 1, 2027.)
- RCW 48.43.0161 · Prior authorization practices—Carrier annual reporting requirements—Commissioner's standardized report.
- RCW 48.43.021 · Personally identifiable health information—Restrictions on release.
- RCW 48.43.022 · Enrollee identification card—Social security number restriction.
- RCW 48.43.023 · Pharmacy identification cards—Rules.
- RCW 48.43.028 · Eligibility to purchase certain health benefit plans—Small employers and small groups.
- RCW 48.43.035 · Group health benefit plans—Guaranteed issue and continuity of coverage—Exceptions.
- RCW 48.43.038 · Individual health plans—Guarantee of continuity of coverage—Exceptions.
- RCW 48.43.039 · Grace period—Notification or information—Information concerning delinquencies or nonpayment of premiums—Defined.
- RCW 48.43.041 · Individual health benefit plans—Mandatory benefits.
- RCW 48.43.043 · Colorectal cancer examinations and laboratory tests—Required benefits or coverage.
- RCW 48.43.045 · Health plan requirements—Annual reports—Exemptions.
- RCW 48.43.047 · Health plans—Minimum coverage for preventive services—No cost-sharing requirements.
- RCW 48.43.055 · Procedures for review and adjudication of health care provider complaints—Requirements.
- RCW 48.43.059 · Payments made by a second-party payment process—Definition.
- RCW 48.43.065 · Right of individuals to receive services—Right of providers, carriers, and facilities to refuse to participate in or pay for services for reason of conscience or religion—Requirements.
- RCW 48.43.071 · Health care information—Requirement to provide free copy to covered person appealing denial of social security benefits—Exceptions.
- RCW 48.43.072 · Required reproductive health care coverage—Restrictions on copayments, deductibles, and other form of cost sharing.
- RCW 48.43.0725 · Reproductive health plan coverage—Immediate postpartum contraception devices.
- RCW 48.43.073 · Required abortion coverage—Limitations.
- RCW 48.43.074 · Qualified health plans—Single invoice billing—Certification of compliance required in the segregation plan for premium amounts attributable to coverage of abortion services.
- RCW 48.43.076 · Digital breast examinations—Cost sharing.
- RCW 48.43.078 · Digital breast tomosynthesis—Intent to ensure women with access—Commissioner's and health care authority's duty to clarify mandates.
- RCW 48.43.081 · Anatomic pathology services—Payment for services—Definitions.
- RCW 48.43.083 · Chiropractor services—Participating provider agreement—Health carrier reimbursement.
- RCW 48.43.085 · Health carrier may not prohibit its enrollees from contracting for services outside the health care plan.
- RCW 48.43.087 · Contracting for services at enrollee's expense—Mental health care practitioner—Conditions—Exception.
- RCW 48.43.091 · Health carrier coverage of outpatient mental health services—Requirements.
- RCW 48.43.093 · Health carrier coverage of emergency medical services—Requirements—Conditions.
- RCW 48.43.094 · Pharmacist provided services—Health plan requirements. (Effective until June 30, 2027.)
- RCW 48.43.096 · Medication synchronization policy required for health plans covering prescription drugs—Requirements—Definitions.
- RCW 48.43.0961 · Continuity of coverage for health plans covering prescription drugs for behavioral health.
- RCW 48.43.097 · Filing of financial statements—Every health carrier.
- RCW 48.43.105 · Preparation of documents that compare health carriers—Immunity—Due diligence.
- RCW 48.43.115 · Maternity services—Intent—Definitions—Patient preference—Clinical sovereignty of provider—Notice to policyholders—Application. (Effective until June 30, 2027.)
- RCW 48.43.121 · Ground ambulance services organizations—Coverage.
- RCW 48.43.125 · Coverage at a long-term care facility following hospitalization—Definition.
- RCW 48.43.135 · Hearing instruments—Coverage.
- RCW 48.43.176 · Eosinophilic gastrointestinal associated disorder—Elemental formula.
- RCW 48.43.180 · Denturist services.
- RCW 48.43.185 · General anesthesia services for dental procedures.
- RCW 48.43.190 · Payment of chiropractic services—Parity.
- RCW 48.43.195 · Contraceptive drugs—Twelve-month refill coverage.
- RCW 48.43.200 · Disclosure of certain material transactions—Report—Information is confidential.
- RCW 48.43.205 · Material acquisitions or dispositions.
- RCW 48.43.210 · Asset acquisitions—Asset dispositions.
- RCW 48.43.215 · Report of a material acquisition or disposition of assets—Information required.
- RCW 48.43.220 · Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.
- RCW 48.43.225 · Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.
- RCW 48.43.290 · Coverage for prescribed durable medical equipment and mobility enhancing equipment—Sales and use taxes—Definitions.
- RCW 48.43.300 · Definitions.
- RCW 48.43.305 · Report of RBC levels—Distribution of report—Formula for determination—Commissioner may make adjustments.
- RCW 48.43.310 · Company action level event—Required RBC plan—Commissioner's review—Notification—Challenge by carrier.
- RCW 48.43.315 · Regulatory action level event—Required RBC plan—Commissioner's review—Notification—Challenge by carrier.
- RCW 48.43.320 · Authorized control level event—Commissioner's options.
- RCW 48.43.325 · Mandatory control level event—Commissioner's duty—Regulatory control.
- RCW 48.43.330 · Carrier's right to hearing—Request by carrier—Date set by commissioner.
- RCW 48.43.335 · Confidentiality of RBC reports and plans—Use of certain comparisons prohibited—Certain information intended solely for use by commissioner.
- RCW 48.43.340 · Powers or duties of commissioner not limited—Rules.
- RCW 48.43.345 · Foreign or alien carriers—Required RBC report—Commissioner may require RBC plan—Mandatory control level event.
- RCW 48.43.350 · No liability or cause of action against commissioner or department.
- RCW 48.43.355 · Notice by commissioner to carrier—When effective.
- RCW 48.43.360 · Initial RBC reports—Calculation of initial RBC levels—Subsequent reports.
- RCW 48.43.366 · Self-funded multiple employer welfare arrangements.
- RCW 48.43.370 · RBC standards not applicable to certain carriers.
- RCW 48.43.400 · Prescription drug utilization management—Definitions.
- RCW 48.43.410 · Prescription drug utilization management—Clinical review criteria—Requirement to be evidence-based and updated regularly. (Effective until January 1, 2027.)
- RCW 48.43.420 · Prescription drug utilization management—Exception request process—Conditions, requirements, and time frames for approval or denial of requests—Emergency fill coverage—Notice of new policies and procedures.
- RCW 48.43.430 · Prescription medication—Maximum charge at point of sale—Requirements.