Washington Administrative Code

(1) This rule outlines the minimum standards for prescription claims processing as directed by RCW 48.43.023.(2) The pharmacy identification card or other technology must include the data element consistent with the "BIN number," "IIN/BIN number" or "RxBIN" which is the ANSI assi…

(1) Provider and facility contracts may not contain provisions that grant the carrier access to health information and other similar records unrelated to covered persons. This provision shall not limit the carrier's right to ask for and receive information relating to the ability…

Issuers must provide to billing pharmacies sufficient information about transactions initiated by the pharmacy so that pharmacy claims can be processed in a timely manner.(1) For purposes of this section "claim rejection" is an administrative step in the claim process where a cla…

(1) An issuer must file for prior approval all participating provider agreements and facility agreements thirty calendar days prior to use. If a carrier negotiates a provider or facility contract or a compensation agreement that deviates from an approved agreement, then the issue…

(1) All participating provider and facility contracts entered into after the effective date of these rules must comply with these rules no later than January 1, 2015.(2) Participating provider and facility contracts entered into prior to the effective date of these rules must be …

Definitions:(1) "Endorsee" means an unlicensed employee or agent of a rental car insurance producer who meets the requirements of this chapter.(2) "Person" means an individual or a business entity.(3) "Rental agreement" means any written master, corporate, group, or individual ag…

Any person in the business of renting cars to the public and offering rental car insurance must either:(1) Be licensed under chapter 284-17 WAC; or(2) Comply with chapter 48.115 RCW and this chapter.[Statutory Authority: RCW 48.02.060 (3)(a) and 48.17.010(5). WSR 11-01-159 (Matte…

Forms and instructions may be obtained by either calling the office of insurance commissioner or downloading them from the website: www.insurance.wa.gov/. To apply for a rental car insurance producer license, the following must be submitted:(1) A rental car insurance producer app…

(1) Yes. The list of names of all endorsees to the rental car insurance producer license must be updated quarterly on a calendar year basis and submitted at the time of license renewal. The rental car company must retain each list for a period of three years from submission. At a…

Rental car insurance producer licenses are issued for a period of two years. A renewal notice will be mailed to each licensed rental car insurance producer every other year from the date of issuance. The renewal notice must be submitted with the rental car company certification f…

Yes. An endorsee may act on behalf of the rental car insurance producer. The endorsee may act only in the offer, sale, or solicitation of rental car insurance. A rental car insurance producer is responsible for, and must supervise, all actions of its endorsees related to the offe…

An employee or agent of a rental car insurance producer may be an endorsee under the authority of the rental car agent license, if all of the following conditions are met:(1) The employee or agent is eighteen years of age or older;(2) The employee or agent is a trustworthy person…

Yes. The rental car insurance producer must provide training and education to its endorsees as described in RCW 48.115.020(4).[Statutory Authority: RCW 48.02.060 (3)(a) and 48.17.010(5). WSR 11-01-159 (Matter No. R 2010-09), § 284-17B-040, filed 12/22/10, effective 1/22/11. Statu…

A rental car insurance producer must comply with RCW 48.115.030.[Statutory Authority: RCW 48.02.060 (3)(a) and 48.17.010(5). WSR 11-01-159 (Matter No. R 2010-09), § 284-17B-045, filed 12/22/10, effective 1/22/11. Statutory Authority: RCW 48.02.060, 48.30.010, and chapter 48.115 R…

A rental car insurance producer is required to treat money collected from renters purchasing rental car insurance as funds received in a fiduciary capacity, unless:(1) The charges for rental car insurance coverage are itemized and related to a rental transaction; and(2) The insur…

The rental agreement must be in writing and include the following:(1) Evidence of the rental car insurance coverage stated on the face sheet; and(2) An itemized list of all costs.[Statutory Authority: RCW 48.02.060, 48.30.010, and chapter 48.115 RCW. WSR 04-22-045 (Matter No. R 2…

The brochure and written material must clearly, conspicuously, and in plain language:(1) Summarize, clearly and correctly, the material terms, exclusions, limitations, and conditions of coverage offered to renters, including the identity of the insurer;(2) Describe the process fo…

Approved written material must be readily available to prospective renters at every location where rental car insurance is offered.[Statutory Authority: RCW 48.02.060, 48.30.010, and chapter 48.115 RCW. WSR 04-22-045 (Matter No. R 2002-05), § 284-17B-065, filed 10/27/04, effectiv…

Yes, all changes to brochures and written materials concerning the rental car insurance must be submitted to and approved by the commissioner prior to use. If the brochures have changes unrelated to the rental car insurance, those changes do not have to be submitted and approved.…

Yes, the commissioner may fine, suspend, revoke, or refuse to issue a license to a rental car insurance producer or applicant. See RCW 48.115.035.[Statutory Authority: RCW 48.02.060 (3)(a) and 48.17.010(5). WSR 11-01-159 (Matter No. R 2010-09), § 284-17B-075, filed 12/22/10, effe…

Yes. The commissioner may waive or accept alternate arrangements for some or all of the reporting requirements in WAC 284-17B-020 and the endorsee training and education requirements in WAC 284-17B-040 when the endorsees receive no compensation in any form based on the offering o…

The purpose of these rules is to set forth rules and procedural requirements which the commissioner deems necessary to carry out the provisions of the NAIC Insurance Holding Company System Regulatory Act, chapter 48.31B RCW, of the insurance code hereinafter referred to as "the a…

(1) Forms A, B, C, D, E, and F are intended to be guides in the preparation of the statements required by RCW 48.31B.015, 48.31B.020, 48.31B.025, and 48.31B.030. They are not intended to be blank forms which are to be filled in. These statements filed must contain the numbers and…

(1) Information required by any item of Form A, B, D, E, or F may be incorporated by reference in answer or partial answer to any other item. Information contained in any financial statement, annual report, proxy statement, statement filed with a governmental authority, or any ot…

If it is impractical to furnish any required information, document, or report at the time it is required to be filed, there must be filed with the commissioner a separate document:(1) Identifying the information, document, or report in question;(2) Stating why the filing thereof …

In addition to the information expressly required to be included in Forms A, B, C, D, E, and F the commissioner may request further material information, if any, as may be necessary to make the information contained therein not misleading. The person filing may also file exhibits…

(1) "The act" means the Insurer Holding Company Act, chapter 48.31B RCW.(2) "Executive officer" means chief executive officer, chief operating officer, chief financial officer, treasurer, secretary, controller, and any other individual performing functions corresponding to those …

The authority to invest in subsidiaries under chapter 48.31B RCW is in addition to any authority to invest in subsidiaries which may be contained in any other provision of Title 48 RCW.[Statutory Authority: RCW 48.02.060, 48.31B.040, chapter 48.31B RCW, and 2015 c 122. WSR 15-22-…

A person required to file a statement under RCW 48.31B.015, must furnish the required information on Form A, set forth in WAC 284-18-910. The person must also furnish the required information on Form E set forth in WAC 284-18-950.[Statutory Authority: RCW 48.02.060, 48.31B.040, c…

The applicant must promptly advise the commissioner of any changes in the information furnished on Form A arising subsequent to the date upon which the information was furnished but prior to the commissioner's disposition of the application.[Statutory Authority: RCW 48.02.060, 48…

(1) If the person being acquired is a "domestic insurer" solely because of the provisions of RCW 48.31B.015 (1)(d), the name of the domestic insurer on the cover page should be indicated as follows:"ABC Insurance Company, a subsidiary of XYZ Holding Company."(2) Where the insurer…

If a domestic insurer, including any person controlling a domestic insurer, is proposing a merger or acquisition under RCW 48.31B.015 (1)(a) that person must file a preacquisition notification form, Form E, set forth in WAC 284-18-950.Additionally, if a nondomiciliary insurer aut…

An insurer required to file an annual registration statement under RCW 48.31B.025, must furnish the required information on Form B, set forth in WAC 284-18-920.[Statutory Authority: RCW 48.02.060, 48.31B.040, chapter 48.31B RCW, and 2015 c 122. WSR 15-22-062 (Matter No. R 2015-05…

An insurer required to file an annual registration statement under RCW 48.31B.025, is also required to furnish information required on Form C, set forth in WAC 284-18-930.[Statutory Authority: RCW 48.02.060, 48.31B.040, chapter 48.31B RCW, and 2015 c 122. WSR 15-22-062 (Matter No…

(1) An amendment to Form B must be filed within fifteen days after the end of any month in which there is a material change to the information provided in the annual registration statement.(2) Amendments must be filed in the Form B format with only those items which are being ame…

(1) Any authorized insurer may file a registration statement on behalf of any affiliated insurer or insurers which are required to register under RCW 48.31B.025. A registration statement may include information not required by the act regarding any insurer in the insurance holdin…

(1) A disclaimer of affiliation or a request for termination of registration claiming that a person does not, or will not upon the taking of some proposed action, control another person (hereinafter referred to as the "subject") must contain the following information:(a) The numb…

(1) An insurer required to give notice of a proposed transaction under RCW 48.31B.030, must furnish the required information on Form D, set forth in WAC 284-18-940.(2) Agreements for cost-sharing services and management services must at a minimum and as applicable:(a) Identify th…

The ultimate controlling person of an insurer required to file an enterprise risk report under RCW 48.31B.025(12) must furnish the required information on Form F, set forth in WAC 284-18-960.[Statutory Authority: RCW 48.02.060, 48.31B.040, chapter 48.31B RCW, and 2015 c 122. WSR …

(1) Group capital calculation. Where an insurance holding company system has previously filed the annual group capital calculation at least once, the lead state commissioner has the discretion to exempt the ultimate controlling person from filing the annual group capital calculat…

(1) Requests for approval of extraordinary dividends or any other extraordinary distribution to shareholders must include the following:(a) The amount of the proposed dividend;(b) The date established for payment of the dividend;(c) A statement as to whether the dividend is to be…

The factors set forth in RCW 48.31B.030(3), are not intended to be an exhaustive list. In determining the adequacy and reasonableness of an insurer's surplus no single factor is necessarily controlling. The commissioner, instead, will consider the net effect of all of these facto…

If any provision of this chapter or its application to any person or circumstances is held invalid, the remainder of the chapter or its application of the provision to other persons or circumstances is not affected.[Statutory Authority: RCW 48.02.060, 48.31B.040, chapter 48.31B R…

FORM ASTATEMENT REGARDING THEACQUISITION OF CONTROL OF OR MERGER WITH A DOMESTIC INSURER Name of Domestic Insurer by Name of Acquiring Person (Applicant) Filed with the Insurance Department of (State of domicile of insurer being acquired)Date: , 20 Name, Title, Address, and Telep…

FORM BINSURANCE HOLDING COMPANY SYSTEMANNUAL REGISTRATION STATEMENTFiled with the Insurance Department of the State of By Name of RegistrantOn Behalf of Following Insurance CompaniesNameAddress Date: , 20 Name, Title, Address, and Telephone Number of Individual to Whom Notices an…

FORM CSUMMARY OF REGISTRATION STATEMENTFiled with the Insurance Department of the State ofBy Name of RegistrantOn Behalf of Following Insurance CompaniesNameAddress Date: , 20 Name, Title, Address, and Telephone Number of Individual to Whom Notices and Correspondence Concerning T…

FORM DPRIOR NOTICE OF A TRANSACTIONFiled with the Insurance Department of the State ofBy Name of RegistrantOn Behalf of Following Insurance CompaniesNameAddress Date: , 20 Name, Title, Address, and Telephone Number of Individual to Whom Notices and Correspondence Concerning This …

FORM EPREACQUISITION NOTIFICATION FORMREGARDING THE POTENTIAL COMPETITIVE IMPACTOF A PROPOSED MERGER OR ACQUISITION BY ANONDOMICILIARY INSURER DOING BUSINESS IN THISSTATE OR BY A DOMESTIC INSURER Name of Applicant Name of Other PersonInvolved in Merger orAcquisition Filed with th…

FORM FENTERPRISE RISK REPORTFiled with the Insurance Department of the State of By Name of Registrant/Applicant On Behalf of/Related to Following Insurance CompaniesNameAddress Date: , 20 Name, Title, Address, and Telephone Number of Individual to Whom Notices and Correspondence …

(1) The purpose of this chapter is to establish uniform regulatory standards for health care benefit managers including, but not limited to, the processes and procedures for registration of health care benefit managers by the office of the insurance commissioner (commissioner).(2…