Revised Code of Washington
Chapter 48.21 - Group and Blanket Disability Insurance.
48.21.147 - Dental services that are not subject to contract or provider agreement.

RCW 48.21.147
Dental services that are not subject to contract or provider agreement.

(1) Notwithstanding any other provisions of law, no group disability insurance contract or blanket disability insurance contract of any disability insurer as provided for in this chapter subject to the jurisdiction of the state of Washington that covers any dental services, and no contract or participating provider agreement with a dentist may:
(a) Require, directly or indirectly, that a dentist who is a participating provider provide services to a subscriber at a fee set by, or at a fee subject to the approval of, the disability insurer unless the dental services are covered services, including services that would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods, or frequency limitations, under the applicable group plan or disability insurance policy; nor
(b) Prohibit, directly or indirectly, a dentist who is a participating provider from offering or providing to a subscriber dental services that are not covered services on any terms or conditions acceptable to the dentist and the subscriber.
(2) For the purposes of this section, "covered services" means dental services that are reimbursable under the applicable insurance policy, group plan, or subscriber agreement or would be reimbursable but for the application of contractual limitations such as benefit maximums, deductibles, coinsurance, waiting periods or frequency limitations.

[ 2010 c 228 § 2.]

Structure Revised Code of Washington

Revised Code of Washington

Title 48 - Insurance

Chapter 48.21 - Group and Blanket Disability Insurance.

48.21.010 - "Group disability insurance" defined—Issuance.

48.21.015 - "Group stop loss insurance" defined for the purpose of exemption—Scope of application.

48.21.020 - "Employees," "employer" defined.

48.21.030 - Health care groups.

48.21.040 - "Blanket disability insurance" defined.

48.21.045 - Health plan benefits for small employers—Coverage—Exemption from statutory requirements—Premium rates—Requirements for providing coverage for small employers—Definitions.

48.21.047 - Requirements for plans offered to small employers—Definitions.

48.21.050 - Standard provisions required.

48.21.060 - The contract—Representations.

48.21.070 - Payment of premiums.

48.21.075 - Payment of premiums by employee in event of suspension of compensation due to labor dispute.

48.21.080 - Certificates of coverage.

48.21.090 - Age limitations.

48.21.100 - Examination and autopsy.

48.21.110 - Payment of benefits.

48.21.120 - Readjustment of premiums—Dividends.

48.21.125 - When injury caused by intoxication or use of narcotics.

48.21.130 - Podiatric medicine and surgery.

48.21.140 - Optometry.

48.21.141 - Registered nurses or advanced registered nurses.

48.21.142 - Chiropractic.

48.21.143 - Diabetes coverage—Definitions.

48.21.144 - Psychological services.

48.21.146 - Dentistry.

48.21.147 - Dental services that are not subject to contract or provider agreement.

48.21.148 - Denturist services.

48.21.150 - Dependent child coverage—Continuation for incapacity.

48.21.155 - Dependent child coverage—From moment of birth—Congenital anomalies—Notification of birth.

48.21.157 - Option to cover dependents under age twenty-six.

48.21.160 - Chemical dependency benefits—Legislative declaration.

48.21.180 - Chemical dependency benefits—Contracts issued or renewed after January 1, 1988.

48.21.190 - Chemical dependency benefits—RCW 48.21.160 through 48.21.190, 48.44.240 inapplicable, when.

48.21.195 - "Chemical dependency" defined.

48.21.197 - Chemical dependency benefits—Rules.

48.21.200 - Individual or group disability, health care service contract, health maintenance agreement—Reduction of benefits on basis of other existing coverages.

48.21.220 - Home health care, hospice care, optional coverage required—Standards, limitations, restrictions—Rules—Medicare supplemental contracts excluded.

48.21.223 - Prescribed, self-administered anticancer medication.

48.21.225 - Mammograms—Insurance coverage.

48.21.227 - Prostate cancer screening.

48.21.230 - Reconstructive breast surgery.

48.21.235 - Mastectomy, lumpectomy.

48.21.241 - Mental health services—Group health plans—Definition—Coverage required, when.

48.21.242 - Mental health treatment—Waiver of preauthorization for persons involuntarily committed.

48.21.244 - Benefits for prenatal diagnosis of congenital disorders—Contracts entered into or renewed on or after January 1, 1990.

48.21.250 - Continuation option to be offered.

48.21.260 - Conversion policy to be offered—Exceptions, conditions.

48.21.270 - Conversion policy—Restrictions and requirements—Rules.

48.21.280 - Coverage for adopted children.

48.21.290 - Cancellation of rider.

48.21.300 - Phenylketonuria.

48.21.310 - Neurodevelopmental therapies—Employer-sponsored group contracts.

48.21.320 - Temporomandibular joint disorders—Insurance coverage.

48.21.325 - Prescriptions—Preapproval of individual claims—Subsequent rejection prohibited—Written record required.

48.21.330 - Nonresident pharmacies.

48.21.370 - Fixed payment insurance—Standard disclosure form.

48.21.375 - Fixed payment insurance—Benefit restrictions.

48.21.380 - Noninsurance benefits.

48.21.900 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.