Title 48 — Title 48 INSURANCE
101 chapters · 2,134 sections in this title.
RCW 48.201.060 Commissioner's rule-making authority.
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The commissioner may adopt rules as necessary to implement chapter 281, Laws of 2021.[ 2021 c 281 s 6.]Notes:Effective date—2021 c 281: See note following RCW 48.201.010.
RCW 48.205.010 Application.
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(1) The requirements of this chapter shall apply to pet insurance policies that are issued to any resident of this state, are sold, solicited, negotiated, or offered in this state, and policies or certificates that are delivered or issued for delivery in this state.(2) All other …
RCW 48.205.020 Definitions.
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The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Chronic condition" means a condition that can be treated or managed, but not cured.(2) "Congenital anomaly" and "congenital disorder" mean a condition that is present …
RCW 48.205.030 Definitions—Usage.
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(1) If a pet insurer uses any of the terms in RCW 48.205.020 in a policy of pet insurance, the pet insurer shall use the definition of each of those terms as set forth in RCW 48.205.020 and include the definition of the terms in the policy. The pet insurer shall also make the def…
RCW 48.205.040 Policy disclosures—Returns.
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(1) A pet insurer transacting pet insurance shall disclose the following to consumers:(a) If the policy excludes coverage due to any of the following:(i) A preexisting condition;(ii) A hereditary disorder;(iii) Either a congenital anomaly or a congenital disorder, or both; or(iv)…
RCW 48.205.050 Exclusions—Waiting periods—Requirements.
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(1) A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim…
RCW 48.205.060 Wellness programs—Marketing—Requirements.
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(1) A pet insurer and insurance producer may not:(a) Market a wellness program as pet insurance; or(b) Market a wellness program during the sale, solicitation, or negotiation of pet insurance.(2) If a wellness program is sold by either a pet insurer or an insurance producer, or b…
RCW 48.205.070 Insurance producers—Training.
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(1) An insurance producer may not sell, solicit, or negotiate a pet insurance product until after the producer is appropriately licensed and has completed the required training identified in subsection (3) of this section.(2) An insurer shall ensure that its producers are trained…
RCW 48.205.080 Rules.
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The insurance commissioner may adopt rules as necessary to implement and administer this chapter.[ 2023 c 42 s 8.]Notes:Effective date—2023 c 42: See note following RCW 48.205.010.
RCW 48.208.010 Covered lives assessment—Notification.
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(1) All health carriers and medicaid managed care organizations shall pay an annual covered lives assessment under RCW 74.76.030.(2) The commissioner shall assess a per member per month assessment for health carriers pursuant to RCW 74.76.030.(3) The commissioner shall annually n…
RCW 48.208.020 Rules.
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The commissioner may adopt rules and undertake actions necessary to carry out RCW 48.208.010 including, but not limited to, rules prescribing the medicaid access program plan of operations, measures to enforce reporting of covered lives, audits of covered lives reporting, and pay…
RCW 48.208.030 Medicaid access program—Liability.
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The medicaid access program, health carriers and medicaid managed care organizations assessed by the program, the commissioner, the commissioner's representatives, and the commissioner's employees are not civilly or criminally liable and may not have any penalty or cause of actio…
RCW 48.212.005 Intent.
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The intent of this chapter is to promote the public interest, support the availability of supplemental long-term care coverage, establish standards for supplemental long-term care coverage, facilitate public understanding and comparison of supplemental long-term care contract ben…
RCW 48.212.010 Application.
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(1) This chapter applies to all supplemental long-term care insurance policies, contracts, or riders delivered or issued for delivery in this state on or after May 1, 2026. This chapter does not supersede the obligations of entities subject to this chapter to comply with other ap…
RCW 48.212.020 Definitions.
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The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Applicant" means: (a) In the case of an individual supplemental long-term care insurance policy, the person who seeks to contract for benefits; and (b) in the case of …
RCW 48.212.030 Documents filed with commissioner—Requirements.
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(1) A supplemental long-term care insurance policy, contract, rider, or certificate form or application form shall not be issued, delivered, or used unless it has been filed with and approved by the commissioner.(2) Rates, or modification of rates, for supplemental long-term care…
RCW 48.212.040 Group policy issued in another state—Restrictions.
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A group supplemental long-term care insurance policy may not be offered to a resident of this state under a group policy issued in another state to a group described in RCW 48.212.020(5)(d), unless this state or another state having statutory and regulatory supplemental long-term…
RCW 48.212.050 Preexisting conditions.
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(1) A supplemental long-term care insurance policy or certificate may not define "preexisting condition" more restrictively than as a condition for which medical advice or treatment was recommended by or received from a provider of health care services, within six months precedin…
RCW 48.212.060 Prohibited policy terms and practices.
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(1) No supplemental long-term care insurance policy may:(a) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder;(b) Contain a provision establishing a new …
RCW 48.212.070 Returns of policies or certificates.
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(1) Supplemental long-term care insurance applicants may return a policy or certificate for any reason within 30 days after its delivery and to have the premium refunded.(2) All supplemental long-term care insurance policies and certificates must have a notice prominently printed…
RCW 48.212.080 Outline of coverage—Contract delivery—Policy summary.
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(1) An outline of coverage must be delivered to a prospective applicant for supplemental long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its purpose.(a) The commissioner must pre…
RCW 48.212.090 Required options for policyholders.
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A supplemental long-term care insurance policy, contract, or rider must:(1) Allow the policyholder options for reduction of benefits or nonforfeiture of premiums as provided in RCW 48.212.150 if the premiums increase or the policyholder's circumstances change and the policyholder…
RCW 48.212.100 Consent to share information—Limitations on sharing.
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(1) When a policyholder purchases a supplemental long-term care insurance policy, the issuer must request written consent from the policyholder to share information with the department of social and health services. If the policyholder provides written consent, the issuer must in…
RCW 48.212.110 Supplemental long-term care benefits funded by specific life insurance policies—Reporting.
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If a supplemental long-term care benefit funded through a life insurance policy by the acceleration of the death benefit is in benefit payment status, a monthly report must be provided to the policyholder. The report must include:(1) A record of all supplemental long-term care be…
RCW 48.212.120 Deadline to pay or decline to pay claims.
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Within 30 business days after receipt of all the requested additional information, an insurer must pay a claim for benefits under a supplemental long-term care insurance policy or certificate if it is a clean claim, or send a written notice that the insurer is declining to pay al…
RCW 48.212.130 Recission of policy or certificate.
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(1) An issuer may rescind a supplemental long-term care insurance policy or certificate or deny an otherwise valid supplemental long-term care insurance claim if:(a) A policy or certificate has been in force for less than six months and upon a showing of misrepresentation that is…
RCW 48.212.140 Inflation protection features—Rules.
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(1) The commissioner must establish minimum standards for inflation protection features.(2) An issuer must comply with the rules adopted by the commissioner that establish minimum standards for inflation protection features.[ 2025 c 380 s 31.]Notes:Effective date—2025 c 380 ss 17…
RCW 48.212.150 Nonforfeiture benefit option—Offer required—Rules.
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(1) Except as provided by this section, a supplemental long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that includes a nonforf…
RCW 48.212.160 Insurance producers—Requirements—Duties.
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(1) A person may not sell, solicit, or negotiate supplemental long-term care insurance unless the person is appropriately licensed as an insurance producer and has successfully completed supplemental long-term care coverage education that meets the requirements of this section an…
RCW 48.212.170 Issuers—Determinations—Standards—Rules.
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(1) Issuers and their agents, if any, must determine whether issuing supplemental long-term care insurance coverage to a particular person is appropriate, except in the case of a life insurance policy that accelerates benefits for supplemental long-term care.(2) An issuer must:(a…
RCW 48.212.180 Unfair or deceptive acts or practices prohibited.
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A person engaged in the issuance or solicitation of supplemental long-term care coverage may not engage in unfair methods of competition or unfair or deceptive acts or practices, as such methods, acts, or practices are defined in chapter 48.30 RCW, or as defined by the commission…
RCW 48.212.190 Violations.
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An issuer or an insurance producer who violates a law or rule relating to the regulation of supplemental long-term care insurance or its marketing is subject to a fine of up to three times the amount of the commission paid for each policy involved in the violation or $10,000, whi…
RCW 48.212.200 Rules.
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(1) The commissioner must adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of supplemental long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligib…
RCW 48.212.210 Consumer education guide and programs.
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(1) The commissioner must:(a) Develop a consumer education guide designed to educate consumers and help them make informed decisions as to the purchase of supplemental long-term care insurance policies provided under this chapter; and(b) Expand programs to educate consumers as to…