Revised Code of Washington
Chapter 48.44 - Health Care Services.
48.44.160 - Revocation, suspension, refusal of registration—Hearing—Cease and desist orders, injunctive action—Grounds.

RCW 48.44.160
Revocation, suspension, refusal of registration—Hearing—Cease and desist orders, injunctive action—Grounds.

The insurance commissioner may, subject to a hearing if one is demanded pursuant to chapters 48.04 and 34.05 RCW, revoke, suspend, or refuse to accept or renew registration from any health care service contractor, or he or she may issue a cease and desist order, or bring an action in any court of competent jurisdiction to enjoin a health care service contractor from doing further business in this state, if such health care service contractor:
(1) Fails to comply with any provision of chapter 48.44 RCW or any proper order or regulation of the commissioner.
(2) Is found by the commissioner to be in such financial condition that its further transaction of business in this state would jeopardize the payment of claims and refunds to subscribers.
(3) Has refused to remove or discharge a director or officer who has been convicted of any crime involving fraud, dishonesty, or like moral turpitude, after written request by the commissioner for such removal, and expiration of a reasonable time therefor as specified in such request.
(4) Usually compels claimants under contracts either to accept less than the amount due them or to bring suit against it to secure full payment of the amount due.
(5) Is affiliated with and under the same general management, or interlocking directorate, or ownership as another health care contractor which operates in this state without having registered therefor, except as is permitted by this chapter.
(6) Refuses to be examined, or if its directors, officers, employees or representatives refuse to submit to examination or to produce its accounts, records, and files for examination by the commissioner when required, or refuse to perform any legal obligation relative to the examination.
(7) Fails to pay any final judgment rendered against it in this state upon any contract, bond, recognizance, or undertaking issued or guaranteed by it, within thirty days after the judgment became final or within thirty days after time for taking an appeal has expired, or within thirty days after dismissal of an appeal before final determination, whichever date is the later.
(8) Is found by the commissioner, after investigation or upon receipt of reliable information, to be managed by persons, whether by its directors, officers, or by any other means, who are incompetent or untrustworthy or so lacking in health care contracting or related managerial experience as to make the operation hazardous to the subscribing public; or that there is good reason to believe it is affiliated directly or indirectly through ownership, control, or other business relations, with any person or persons whose business operations are or have been marked, to the detriment of policyholders or stockholders, or investors or creditors or subscribers or of the public, by bad faith or by manipulation of assets, or of accounts, or of reinsurance.

[ 2009 c 549 § 7148; 1988 c 248 § 19; 1973 1st ex.s. c 65 § 2; 1969 c 115 § 3; 1961 c 197 § 13.]

Structure Revised Code of Washington

Revised Code of Washington

Title 48 - Insurance

Chapter 48.44 - Health Care Services.

48.44.010 - Definitions.

48.44.011 - Insurance producer—Definition—License required—Application, issuance, renewal, fees—Penalties involving license.

48.44.013 - Filings with secretary of state—Copy for commissioner.

48.44.015 - Registration by health care service contractors required—Penalty.

48.44.016 - Unregistered activities—Acts committed in this state—Sanctions.

48.44.017 - Schedule of rates for individual contracts—Loss ratio—Definitions.

48.44.020 - Contracts for services—Examination of contract forms by commissioner—Grounds for disapproval—Liability of participant.

48.44.021 - Calculation of premiums—Members of a purchasing pool—Adjusted community rating method—Definitions.

48.44.022 - Calculation of premiums—Adjusted community rate—Definitions.

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

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

48.44.026 - Payment for certain health care services.

48.44.030 - Underwriting of indemnity by insurance policy, bond, securities, or cash deposit.

48.44.033 - Financial failure—Supervision of commissioner—Priority of distribution of assets.

48.44.035 - Limited health care service—Uncovered expenditures—Minimum net worth requirements.

48.44.037 - Minimum net worth—Requirement to maintain—Determination of amount.

48.44.039 - Minimum net worth—Domestic or foreign health care service contractor.

48.44.040 - Registration with commissioner—Fee.

48.44.050 - Rules and regulations.

48.44.055 - Plan for handling insolvency—Commissioner's review.

48.44.057 - Insolvency—Commissioner's duties—Participants' options—Allocation of coverage.

48.44.060 - Penalty.

48.44.080 - Master lists of contractor's participating providers—Filing with commissioner—Notice of termination or participation.

48.44.090 - Refusal to register corporate, etc., contractor if name confusing with existing contractor or insurance company.

48.44.095 - Annual financial statement—Filings—Contents—Fee—Penalty for failure to file.

48.44.100 - Filing inaccurate financial statement prohibited.

48.44.110 - False representation, advertising.

48.44.120 - Misrepresentations of contract terms, benefits, etc.

48.44.130 - Future dividends or refunds—When permissible.

48.44.140 - Misleading comparisons to terminate or retain contract.

48.44.145 - Examination of contractors—Duties of contractor, powers of commissioner—Independent audit reports.

48.44.150 - Certificate of registration not an endorsement—Display in solicitation prohibited.

48.44.160 - Revocation, suspension, refusal of registration—Hearing—Cease and desist orders, injunctive action—Grounds.

48.44.164 - Notice of suspension, revocation, or refusal to be given contractor—Authority of insurance producers.

48.44.166 - Fine in addition to or in lieu of suspension, revocation, or refusal.

48.44.170 - Hearings and appeals.

48.44.180 - Enforcement.

48.44.200 - Individual health care service plan contracts—Coverage of dependent child with developmental or physical disability.

48.44.210 - Group health care service plan contracts—Coverage of dependent child with developmental or physical disability.

48.44.212 - Coverage of dependent children to include newborn infants and congenital anomalies from moment of birth—Notification period.

48.44.215 - Option to cover child under age twenty-six.

48.44.220 - Discrimination prohibited.

48.44.225 - Podiatric physicians and surgeons not excluded.

48.44.230 - Individual health service plan contract—Return within ten days of delivery—Refunds—Void from beginning—Notice required.

48.44.240 - Chemical dependency benefits—Provisions of group contracts delivered or renewed after January 1, 1988.

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

48.44.245 - "Chemical dependency" defined.

48.44.250 - Payment of premium by employee in event of suspension of compensation due to labor dispute.

48.44.260 - Notice of reason for cancellation, denial, or refusal to renew contract.

48.44.270 - Immunity from libel or slander.

48.44.290 - Registered nurses or advanced registered nurses.

48.44.299 - Legislative finding.

48.44.300 - Podiatric medicine and surgery—Benefits not to be denied.

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

48.44.309 - Legislative finding.

48.44.310 - Chiropractic care, coverage required, exceptions.

48.44.315 - Diabetes coverage—Definitions.

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

48.44.323 - Prescribed, self-administered anticancer medication.

48.44.325 - Mammograms—Insurance coverage.

48.44.327 - Prostate cancer screening.

48.44.330 - Reconstructive breast surgery.

48.44.335 - Mastectomy, lumpectomy.

48.44.341 - Mental health services—Health plans—Definition—Coverage required, when.

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

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

48.44.350 - Financial interests of health care service contractors, restricted—Exceptions, regulations.

48.44.360 - Continuation option to be offered.

48.44.370 - Conversion contract to be offered—Exceptions, conditions.

48.44.380 - Conversion contract—Restrictions and requirements—Rules.

48.44.390 - Modification of basis of agreement, endorsement required.

48.44.400 - Continuance provisions for former family members.

48.44.420 - Coverage for adopted children.

48.44.430 - Cancellation of rider.

48.44.440 - Phenylketonuria.

48.44.450 - Neurodevelopmental therapies—Employer-sponsored group contracts.

48.44.460 - Temporomandibular joint disorders—Insurance coverage.

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

48.44.470 - Nonresident pharmacies.

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

48.44.500 - Denturist services.

48.44.530 - Disclosure of certain material transactions—Report—Information is confidential.

48.44.535 - Material acquisitions or dispositions.

48.44.540 - Asset acquisitions—Asset dispositions.

48.44.545 - Report of a material acquisition or disposition of assets—Information required.

48.44.550 - Material nonrenewals, cancellations, or revisions of ceded reinsurance agreements.

48.44.555 - Report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements—Information required.

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