Washington Administrative Code

The purpose of this regulation, WAC 284-34-100 through 284-34-260, is to protect debtors and the public by establishing a system of rate, policy form, and operating standards for the transaction of consumer credit insurance. This regulation interprets and implements the sections …

(1) "Affiliate" has the same meaning as stated in RCW 48.31B.005(1).(2) "Closed-end credit" means any credit transaction that does not meet the definition of open-end credit.(3) "Control" has the same meaning as stated in RCW 48.31B.005(2).(4) "Compensation" means any form of pay…

(1) A debtor has the right to know about all available credit insurance plans. The creditor must inform every debtor about:(a) Each plan of insurance for which the debtor is eligible; and(b) The premium or insurance charge for each plan of insurance.(2) If the creditor requires c…

(1) If the creditor adds insurance charges or premiums to the debt, the insurer must collect the premium or charges within sixty days after it is added to the debt.(2) If the debtor refinances and pays off the debt before the scheduled maturity date, the insurer must terminate ex…

(1) Insurers must provide consumer credit insurance benefits that are reasonable in relation to the premium charged. This means that debtors must be provided reasonable benefits in return for their premium payments.(a) The commissioner presumes that the rates in WAC 284-34-150 an…

Subject to WAC 284-34-160 and 284-34-220, the commissioner presumes the prima facie rates shown below meet the requirements of WAC 284-34-140. An insurer may use these rates without filing additional actuarial support.(1) Monthly outstanding balance basis:(a) Outstanding insured …

The premium rates in WAC 284-34-150 apply to credit life insurance contracts that contain terms as favorable to insured debtors as the terms below:(1) Suicide:(a) An insurer may exclude coverage for suicide occurring within one year after the effective date of the coverage.(b) Op…

(1) Subject to WAC 284-34-180 and 284-34-220, the commissioner presumes the prima facie rates shown below meet the requirements of WAC 284-34-140. An insurer may use these rates without filing additional actuarial support.(a) Single-premium basis for the entire period of debt: Th…

The premium rates in WAC 284-34-170 apply to contracts providing credit accident and health insurance that contain terms as favorable to insured debtors as the terms below:(1) The insurer may exclude benefits for disabilities that result from the following:(a) War or any act of w…

(1) The commissioner must approve refund formulas before they are used. The insurer must state the basis for the refund in the policy or certificate delivered to the debtor. The following methods, or other methods approved by the commissioner must be used:(a) Pro rata method. The…

Each authorized insurer in this state must file an annual report of consumer credit insurance written on a calendar year basis. The insurer must file the report with the commissioner and the National Association of Insurance Commissioners (NAIC). The report must:(1) Use the Credi…

(1) Every three years, the commissioner will review the loss ratio standards in WAC 284-34-140 and the prima facie rates in WAC 284-34-150 and 284-34-170 to:(a) Determine the rate of expected claims on a statewide basis;(b) Compare the rate of expected claims with the rate of act…

(1) An insurer may file rates that are equivalent to the prima facie rates in WAC 284-34-150 and 284-34-170 and use those rates without further proof of their reasonableness.(2) An insurer must file rates and supporting actuarial documentation if it proposes:(a) Policy provisions…

Each insurer transacting credit insurance in this state must:(1) Periodically conduct a complete review of creditors. This review must include all aspects of the credit insurance business and assure compliance with all state insurance laws and regulations.(2) Maintain written rec…

The following practices, when engaged in by insurers in connection with the sale or placement of credit insurance, or as an inducement thereto, constitute unfair methods of competition and are subject to the enforcement provisions of RCW 48.30.010. An insurer must not:(1) Offer o…

(1) If a debtor buys consumer credit insurance in connection with a credit transaction, the creditor must disclose this information to the debtor in writing:(a) The debtor does not have to buy consumer credit insurance.(b) The debtor may not need consumer credit insurance if the …

(1) This regulation takes effect on April 1, 2005.(2) Approval of all forms that do not comply with this regulation is withdrawn as of October 1, 2005. No form may be issued on or after October 1, 2005, unless it has been approved by the commissioner and conforms to this regulati…

This regulation, WAC 284-36-010 through 284-36-040, shall apply only as to domestic fraternal mutual property insurers, as defined in RCW 48.36A.040 and 48.36A.390, and to any domestic stock insurer while it is a subsidiary of such a fraternal mutual property insurer.[Statutory A…

Pursuant to the authority vested in the commissioner under RCW 48.07.130(3) up to one-third (to the nearest whole number) of the members of the board of directors of such an insurer may also be insurance agents of the insurer, and be entitled to receive, and receive from the insu…

No individual who is an insurance agent of such an insurer shall be elected or serve as a member of the insurer's board of directors if thereby the number of agent-directors of the insurer would exceed one-third (to the nearest whole number) of the total regular membership of the…

Nothing in this regulations shall be deemed to affect the responsibilities of a director as a fiduciary of the insurer, its members or stockholders, or other legal responsibilities of a director.[Order R 75-5, § 284-36-040, filed 10/22/75.]

This chapter applies to all fraternal benefit societies transacting the business of life and disability insurance in this state. The risk-based surplus standard in this chapter provide a mechanism for the commissioner to evaluate the ability of a fraternal benefit society to mana…

(1) "Adjusted RBS report" means an RBS report which has been adjusted by the commissioner in accordance with WAC 284-36A-020(4).(2) "AVR" means asset valuation reserve.(3) "Corrective order" means an order issued by the commissioner specifying corrective actions which the commiss…

(1) On or prior to the annual filing date, which is hereby established as March 1, every fraternal benefit society authorized to transact insurance business in this state, shall prepare and submit to the commissioner a report of its RBS level as of the end of the calendar year ju…

(1) All RBS reports, to the extent the information is not required to be set forth in a publicly available annual statement schedule, including the results or report of any examination or analysis of a fraternal benefit society that are filed with the commissioner constitute info…

(1) "Society action level event" means any of the following events:(a) The filing of an RBS report by a fraternal benefit society which indicates that the fraternal benefit society's has total adjusted surplus which is greater than or equal to its society action level RBS but les…

(1) "Regulatory action level event" means, with respect to a fraternal benefit society, any of the following events:(a) The filing of an RBS report by the fraternal benefit society which indicates that the fraternal benefit society's total adjusted surplus is greater than or equa…

(1) "Authorized control level event" means any of the following events:(a) The filing of an RBS report by the fraternal benefit society which indicates that the fraternal benefit society's total adjusted capital is greater than or equal to its mandatory control level RBS but less…

(1) "Mandatory control level event" means any of the following events:(a) The filing of an RBS report which indicates that the fraternal benefit society's total adjusted surplus is less than its mandatory control level RBS;(b) Notification by the commissioner to the fraternal ben…

(1) Upon notification to a fraternal benefit society by the commissioner of any of the following, the fraternal benefit society shall have the right to a hearing, in accordance with chapters 48.04 and 34.05 RCW, at which the fraternal benefit society may challenge any determinati…

(1) In the event of a company action level event, regulatory action level event or authorized control level event with respect to any foreign fraternal benefit society as determined under the RBS statute applicable in the state of domicile of the fraternal benefit society (or, if…

The following definitions apply throughout this chapter unless the context requires otherwise:(1) "Insurer" shall have the same meaning as set forth in chapter 82, section 5(4), Laws of 2007, and specifically includes health care service contractors, health maintenance organizati…

To foster nationwide consistency in market conduct oversight, and as authorized by chapter 82, sections 6, 7 and 8, Laws of 2007 the commissioner adopts the following procedures and handbooks published by the NAIC and in effect on July 31, 2007, or as later amended. The applicabl…

During the market analysis process, the commissioner may require access to identifiable records in the possession of, or subject to control or access by the insurer. This section sets forth the process that the commissioner will follow when requesting records. Whenever possible a…

(1) Every insurer shall file with the commissioner its market conduct annual statement, as required by chapter 82, section 6, Laws of 2007, in accordance with filing instructions published by the NAIC.(2) For purposes of this chapter, the market conduct annual statement filing is…

If a complaint is filed against an insurer, the commissioner will notify the insurer following this process. Whenever possible and appropriate, the commissioner will provide the notices detailed below to the insurer electronically.(1) Initial notice to the insurer. The commission…

As required at chapter 82, section 14(3), Laws of 2007, after the deputy insurance commissioner responsible for market conduct oversight has responded to an insurer's issues, the insurer may request mediation of the issues. The following process governs mediation of insurer marke…

The definitions in this section apply throughout this chapter:"Certificate holder" means any insurer or educational, religious, charitable, or scientific institution that has been issued a certificate of exemption by the commissioner to conduct a charitable gift annuity business.…

SERFF is a dynamic application that the NAIC will revise and enhance over time. To be consistent with NAIC filing standards and provide timely instructions to filers, the commissioner must incorporate documents posted on the SERFF website into this chapter. By reference, the comm…

Filers and certificate holders must submit complete filings that comply with these rules:(1) Filers must submit complete filings that comply with the SERFF Industry Manual available within the SERFF application as well as state specific instructions applicable to the particular f…

If a revised or replaced charitable gift annuity contract form is being filed, in addition to the requirements of WAC 284-38-110, the filer must provide the following supporting documentation:(1) If a contract is revised due to an objection(s) from the commissioner, the filer mus…

(1) A certificate holder may authorize a third party to file charitable gift annuity contracts on its behalf.(2) If a certificate holder delegates filing authority to a third party, each filing must include a letter signed by an employee of the certificate holder authorizing the …

(1) The commissioner may reject and close any filing that does not comply with WAC 284-38-100. If the commissioner rejects a filing, the certificate holder has not filed the charitable gift annuity contract with the commissioner.(2) If the commissioner rejects a filing and the fi…

If the commissioner disapproves a filing under RCW 48.38.010(9), 48.18.110, 48.38.030, or 48.38.042, the objection letter will state the reason(s) for disapproval, including relevant law and administrative rules. Filers must:(1) Provide a complete response to an objection letter.…

(1) Every certificate holder must electronically file with the commissioner a completed annual report within 60 days of its fiscal year end. A copy of the annual report form and instructions for completing and filing the annual report are available on the commissioner's website a…

The purpose of this chapter is to establish uniform regulatory standards for health carriers and to create minimum standards for health plans that ensure consumer access to the health care services promised in these health plans.[WSR 16-01-081, recodified as § 284-43-0110, filed …

(1) This chapter shall apply to all health plans and all health carriers subject to the jurisdiction of the state of Washington except as otherwise expressly provided in this chapter. Health carriers are responsible for compliance with the provisions of this chapter. A carrier's …

Health carriers shall comply with all Washington state and federal laws relating to the acts and practices of carriers and laws relating to health plan benefits.[WSR 16-01-081, recodified as § 284-43-0140, filed 12/14/15, effective 12/14/15. Statutory Authority: RCW 48.02.060, 48…

Except as defined in other subchapters and unless the context requires otherwise, the following definitions shall apply throughout this chapter.(1) "Adverse determination" has the same meaning as the definition of adverse benefit determination in RCW 48.43.005, and includes:(a) T…

This section applies to all individual health plans, small group health plans, and stand-alone dental plans that provide pediatric dental benefits as one of the essential health benefits. Each year, issuers must file with the commissioner a complete rate and form filing for the n…