Title 41 — Title 41 PUBLIC EMPLOYMENT, CIVIL SERVICE, AND PENSIONS
37 chapters · 1,408 sections in this title.
RCW 41.05.004 Intent—Use of word "board."
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It is the intent of the legislature that the word "board" be read to mean both the school employees' benefits board and the public employees' benefits board throughout this chapter. The use of "board" should be liberally construed to mean both boards, to the extent not in conflic…
RCW 41.05.006 Purpose.
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(1) The legislature recognizes that (a) the state is a major purchaser of health care services, (b) the increasing costs of such health care services are posing and will continue to pose a great financial burden on the state, (c) it is the state's policy, consistent with the best…
RCW 41.05.008 Duties of employing agencies.
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(1) Every employing agency shall carry out all actions required by the authority under this chapter including, but not limited to, those necessary for the operation of benefit plans, education of employees, claims administration, and appeals process.(2) Employing agencies shall r…
RCW 41.05.009 Determination of public employee eligibility for benefits.
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(1) The authority, or an employing agency at the authority's direction, shall initially determine and periodically review whether a public employee is eligible for benefits pursuant to the criteria established under this chapter.(2) An employing agency shall inform a public emplo…
RCW 41.05.0091 Eligibility exists prior to January 1, 2010.
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An employee determined eligible for benefits prior to January 1, 2010, shall not have his or her eligibility terminated pursuant to the criteria established under chapter 537, Laws of 2009 unless the termination is the result of: (1) A voluntary reduction in work hours; or (2) th…
RCW 41.05.011 Definitions.
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*** CHANGE IN 2026 *** (SEE 2034-S2.SL) ***The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Authority" means the Washington state health care authority.(2) "Board" means the public employees' benefits board establish…
RCW 41.05.013 State purchased health care programs—Uniform policies.
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(1) The authority shall coordinate state agency efforts to develop and implement uniform policies across state purchased health care programs that will ensure prudent, cost-effective health services purchasing, maximize efficiencies in administration of state purchased health car…
RCW 41.05.014 Applications, enrollment forms, and eligibility certification documents—Signatures.
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(1) The director may require applications, enrollment forms, and eligibility certification documents for benefits that are administered by the authority under this chapter and chapter 70.47 RCW to be signed by the person submitting them. The director may accept electronic signatu…
RCW 41.05.015 Medical director—Appointment of personnel.
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The director shall designate a medical director who is licensed under chapter 18.57 or 18.71 RCW. The director shall also appoint such professional personnel and other assistants and employees, including professional medical screeners, as may be reasonably necessary to carry out …
RCW 41.05.017 Provisions applicable to health plans offered under this chapter.
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*** CHANGE IN 2026 *** (SEE 5845-S.SL) ****** CHANGE IN 2026 *** (SEE 6183-S.SL) ***Each health plan that provides medical insurance offered under this chapter, including plans created by insuring entities, plans not subject to the provisions of Title 48 RCW, and plans created un…
RCW 41.05.018 Transfer of certain behavioral health-related powers, duties, and functions from the department of social and health services.
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(1) The powers, duties, and functions of the department of social and health services pertaining to the behavioral health system and purchasing function of the behavioral health administration, except for oversight and management of state-run mental health institutions and licens…
RCW 41.05.021 State health care authority—Director—Cost control and delivery strategies—Health information technology—Managed competition—Rules.
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(1) The Washington state health care authority is created within the executive branch. The authority shall have a director appointed by the governor, with the consent of the senate. The director shall serve at the pleasure of the governor. The director may employ a deputy directo…
RCW 41.05.022 State agent for purchasing health services—Single community-rated risk pool.
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(1) The health care authority is hereby designated as the single state agent for purchasing health services.(2) On and after January 1, 1995, at least the following state-purchased health services programs shall be merged into a single, community-rated risk pool: Health benefits …
RCW 41.05.023 Chronic care management program—Uniform medical plan—Definitions.
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(1) The health care authority, in collaboration with the department of health, shall design and implement a chronic care management program for employees and school employees enrolled in the state's self-insured uniform medical plan. Programs must be evidence based, facilitating …
RCW 41.05.026 Contracts—Proprietary data, trade secrets, actuarial formulas, statistics, cost and utilization data—Exemption from public inspection—Executive sessions.
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(1) When soliciting proposals for the purpose of awarding contracts for goods or services, the director shall, upon written request by the bidder, exempt from public inspection and copying such proprietary data, trade secrets, or other information contained in the bidder's propos…
RCW 41.05.028 Health plan reimbursement rates.
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(1) For purposes of this section:(a) "Contractor" means a health carrier that provides medical insurance offered to public employees and their covered dependents under this chapter, or a third-party administrator contracted by the authority to provide medical coverage to public e…
RCW 41.05.031 Health information technology office—Agencies to establish health care information systems.
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The Washington state health information technology office is located within the authority. The following state agencies are directed to cooperate with the authority to establish appropriate health care information systems in their programs: The department of social and health ser…
RCW 41.05.035 Exchange of health information—Advisory board, discretionary—Director's authority.
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(1) The director shall design, implement, and maintain a consumer-centric health information infrastructure and the state electronic health record repositories that will facilitate the secure exchange of health information when and where needed and shall:(a) Complete the plan of …
RCW 41.05.036 Health information—Definitions.
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The definitions in this section apply throughout RCW 41.05.039 through 41.05.046 unless the context clearly requires otherwise.(1) "Director" means the director of the state health care authority under this chapter.(2) "Exchange" means the methods or medium by which health care i…
RCW 41.05.037 Nurse hotline, when funded.
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To the extent that funding is provided specifically for this purpose, the director shall provide all persons enrolled in health plans under this chapter and chapters 70.47 and 74.09 RCW with access to a twenty-four hour, seven day a week nurse hotline.[ 2011 1st sp.s. c 15 s 58; …
RCW 41.05.039 Health information—Secure access—Lead organization—Director's duties.
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(1) By August 1, 2009, the director shall designate one or more lead organizations to coordinate development of processes, guidelines, and standards to:(a) Improve patient access to and control of their own health care information and thereby enable their active participation in …
RCW 41.05.042 Health information—Processes, guidelines, and standards.
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By December 1, 2011, the lead organization shall, consistent with the federal health insurance portability and accountability act, develop processes, guidelines, and standards that address:(1) Identification and prioritization of high value health data from health data providers.…
RCW 41.05.046 Health information—Conflict with federal requirements.
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If any provision in RCW 41.05.036, 41.05.039, and 41.05.042 conflicts with existing or new federal requirements, the director shall recommend modifications, as needed, to assure compliance with the aims of RCW 41.05.036, 41.05.039, and 41.05.042 and federal requirements.[ 2023 c …
RCW 41.05.050 Contributions for employees and dependents.
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(1)(a) Every employer and employer group as defined in RCW 41.05.011 shall provide contributions to insurance and health care plans for its employees and their dependents, the content of such plans to be determined by the authority.(b) Contributions paid by employer groups for th…
RCW 41.05.055 Public employees' benefits board—Members.
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(1) The public employees' benefits board is created within the authority. The function of the public employees' benefits board is to design and approve insurance benefit plans for employees and to establish eligibility criteria for participation in insurance benefit plans.(2) The…
RCW 41.05.065 Public employees' benefits board—Duties—Eligibility—Definitions—Penalties.
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(1) The public employees' benefits board shall study all matters connected with the provision of health care coverage, life insurance, liability insurance, accidental death and dismemberment insurance, and disability income insurance or any of, or a combination of, the enumerated…
RCW 41.05.066 Domestic partner benefits.
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A certificate of domestic partnership qualified under the provisions of RCW 26.60.030 shall be recognized as evidence of a state registered domestic partnership fulfilling all necessary eligibility criteria for the partner of the public employee to receive benefits. Nothing in th…
RCW 41.05.068 Federal employer incentive program—Authority to participate.
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The authority may participate as an employer-sponsored program established in section 1860D-22 of the medicare prescription drug, improvement, and modernization act of 2003, P.L. 108-173 et seq., to receive federal employer subsidy funds for continuing to provide retired employee…
RCW 41.05.074 Public employees—Prior authorization standards and criteria—Health plan requirements—Definitions.
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(1) A health plan offered to public employees and their covered dependents under this chapter that imposes different prior authorization standards and criteria for a covered service among tiers of contracting providers of the same licensed profession in the same health plan shall…
RCW 41.05.075 Employee benefit plans—Contracts with insuring entities—Performance measures—Financial incentives—Health information technology.
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(1) The director shall provide benefit plans designed by the board through a contract or contracts with insuring entities, through self-funding, self-insurance, or other methods of providing insurance coverage authorized by RCW 41.05.140. The process of contracting for plans offe…
RCW 41.05.080 Participation in insurance plans and contracts—Retired, disabled, or separated employees—Certain surviving spouses, state registered domestic partners, and dependent children.
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(1) Under the qualifications, terms, conditions, and benefits set by the public employees' benefits board:(a)(i) Retired or disabled state employees, retired or disabled school employees, or retired or disabled employees of employer groups covered by this chapter may continue the…
RCW 41.05.083 Employer groups—Participation in insurance plans and contracts—Termination of agreement—Payment for retired or disabled employees.
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(1) Employer groups that enter into a contractual agreement with the authority after May 4, 2023, and whose contractual agreement with the authority is subsequently terminated, shall make a one-time payment as calculated in subsection (2) of this section to the authority for each…
RCW 41.05.085 Retired state employee and retired or disabled school employee health insurance subsidy.
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(1) The legislature shall establish as part of both the state employees' and the school and educational service district employees' insurance benefit allocation the portion of the allocation to be used to provide a subsidy to reduce the medical and prescription drug insurance pre…
RCW 41.05.095 Coverage for dependents under the age of twenty-six.
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(1) Any plan offered to employees under this chapter must offer each employee the option of covering any dependent of the employee under the age of twenty-six.(2) Coverage must terminate upon attainment of age twenty-six except in the case of a child who is and continues to be bo…
RCW 41.05.100 Chapter not applicable to certain employees of Cooperative Extension Service.
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The provisions of this chapter shall not be applicable to any employee of the Washington State University Cooperative Extension Service who holds a federal civil service appointment and is thereby eligible for insurance coverage under the regulations of the United States Departme…
RCW 41.05.120 Public employees' and retirees' insurance account—School employees' insurance account.
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(1) The public employees' and retirees' insurance account is hereby established in the custody of the state treasurer, to be used by the director for the deposit of contributions, the remittance paid by school districts and educational service districts under RCW 28A.400.410, res…
RCW 41.05.123 Flexible spending administrative account—Salary reduction account—School employees' benefits board flexible spending and dependent care administrative account—School employees' benefits board salary reduction account.
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(1) For the public employees' benefits board program, the flexible spending administrative account is created in the custody of the state treasurer.(a) All receipts from the following must be deposited in the account:(i) Revenues from employing agencies for costs associated with …
RCW 41.05.130 State health care authority administrative account—School employees' insurance administrative account.
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(1) The state health care authority administrative account is hereby created in the state treasury. Moneys in the account, including unanticipated revenues under RCW 43.79.270, may be spent only after appropriation by statute, and may be used only for operating expenses of the au…
RCW 41.05.140 Payment of claims—Self-insurance—Insurance reserve fund created.
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(1) Except for property and casualty insurance, the authority may self-fund, self-insure, or enter into other methods of providing insurance coverage for insurance programs under its jurisdiction, including the basic health plan as provided in chapter 70.47 RCW. The authority sha…
RCW 41.05.143 Uniform medical plan benefits administration account—Uniform dental plan benefits administration account—School employees' benefits board medical benefits administrative account—School employees' benefits board dental benefits administration account.
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(1) The uniform medical plan benefits administration account is created in the custody of the state treasurer. Only the director or the director's designee may authorize expenditures from the account. Moneys in the account shall be used exclusively for contracted expenditures for…
RCW 41.05.155 Fern Lodge maintenance account.
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The Fern Lodge maintenance account is created in the custody of the state treasurer. All receipts from the collection of rents for the Snohomish county long-term civil commitment facility known as Fern Lodge must be deposited into the account. Expenditures from the account may on…
RCW 41.05.160 Rules.
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The director may promulgate and adopt rules consistent with this chapter to carry out the purposes of this chapter. All rules shall be adopted in accordance with chapter 34.05 RCW.[ 2023 c 51 s 14; 1988 c 107 s 15.]Notes:
RCW 41.05.165 Rules—Insurance benefit reimbursement.
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The authority shall adopt rules that provide for members of the legislature who choose reimbursement under RCW 44.04.230 in lieu of insurance benefits under this chapter.[ 1998 c 62 s 2.]Notes:Effective date—1998 c 62: See note following RCW 44.04.230.
RCW 41.05.170 Neurodevelopmental therapies—Employer-sponsored group contracts.
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(1) Each health plan offered to public employees and their covered dependents under this chapter which is not subject to the provisions of Title 48 RCW and is established or renewed on or after twelve months after July 23, 1989, shall include coverage for neurodevelopmental thera…
RCW 41.05.175 Prescribed, self-administered anticancer medication.
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(1) Each health plan offered to public employees and their covered dependents under this chapter, including those subject to the provision of Title 48 RCW, and is issued or renewed beginning January 1, 2012, and provides coverage for cancer chemotherapy treatment must provide cov…
RCW 41.05.177 Prostate cancer screening—Required coverage.
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(1) Each plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is issued or renewed after December 31, 2006, shall provide coverage for prostate cancer screening, provided that the screening is d…
RCW 41.05.180 Mammograms—Insurance coverage.
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Each health plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is established or renewed after January 1, 1990, and that provides benefits for hospital or medical care shall provide benefits f…
RCW 41.05.183 General anesthesia services for dental procedures—Public employee benefit plans.
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(1) Each employee benefit plan offered to public employees that provides coverage for hospital, medical, or ambulatory surgery center services must cover general anesthesia services and related facility charges in conjunction with any dental procedure performed in a hospital or a…
RCW 41.05.185 Diabetes benefits—State purchased health care.
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The legislature finds that diabetes imposes a significant health risk and tremendous financial burden on the citizens and government of the state of Washington, and that access to the medically accepted standards of care for diabetes, its treatment and supplies, and self-manageme…
RCW 41.05.188 Eosinophilic gastrointestinal associated disorder—Elemental formula.
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(1) Each health benefit plan offered to public employees and their covered dependents under this chapter that is not subject to chapter 48.43 RCW and that is issued or renewed after December 31, 2015, must offer benefits or coverage for medically necessary elemental formula, rega…