Revised Code of Washington
Chapter 48.46 - Health Maintenance Organizations.
48.46.225 - Financial failure—Supervision of commissioner—Priority of distribution of assets.

RCW 48.46.225
Financial failure—Supervision of commissioner—Priority of distribution of assets.

(1) Any rehabilitation, liquidation, or conservation of a health maintenance organization is the same as the rehabilitation, liquidation, or conservation of an insurance company and must be conducted under the supervision of the commissioner pursuant to the law governing the rehabilitation, liquidation, or conservation of insurance companies. The commissioner may apply for an order directing the commissioner to rehabilitate, liquidate, or conserve a health maintenance organization upon any one or more grounds set out in RCW 48.31.030, 48.31.050, and 48.31.080. Enrolled participants have the same priority in the event of liquidation or rehabilitation as the law provides to policyholders of an insurer.
(2) For purposes of determining the priority of distribution of general assets, claims of enrolled participants and enrolled participants' beneficiaries have the same priority as established by RCW 48.31.280 for policyholders and beneficiaries of insureds of insurance companies. If an enrolled participant is liable to any provider for services provided pursuant to and covered by the health maintenance agreement, that liability has the status of an enrolled participant claim for distribution of general assets.
(3) A provider who is obligated by statute or agreement to hold enrolled participants harmless from liability for services provided pursuant to and covered by a health care plan has a priority of distribution of the general assets immediately following that of enrolled participants and enrolled participants' beneficiaries under this section.

[ 2003 c 248 § 18; 1990 c 119 § 4.]

Structure Revised Code of Washington

Revised Code of Washington

Title 48 - Insurance

Chapter 48.46 - Health Maintenance Organizations.

48.46.010 - Legislative declaration—Purpose.

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

48.46.020 - Definitions.

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

48.46.027 - Registration, required—Issuance of securities—Penalty.

48.46.030 - Eligibility requirements for certificate of registration—Application requirements, information—Provider compensation.

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

48.46.040 - Certificate of registration—Issuance—Grounds for refusal—Name restrictions—Inspection and review of facilities.

48.46.045 - Catastrophic health plans permitted.

48.46.060 - Prepayment agreements—Standards for forms and documents—Grounds for disapproval—Cancellation or failure to renew—Filing of agreement forms.

48.46.062 - Schedule of rates for individual agreements—Loss ratio—Definitions.

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

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

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

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

48.46.070 - Governing body.

48.46.080 - Annual statement—Filings—Contents—Fee—Penalty for failure to file—Accuracy required.

48.46.090 - Standard of services provided.

48.46.100 - Grievance procedure.

48.46.110 - Name restrictions—Discrimination—Recovery of costs of health care services participant not entitled to.

48.46.120 - Examination of health maintenance organizations—Duties of organizations, powers of commissioner—Independent audit reports.

48.46.130 - Investigation of violations—Hearing—Findings—Penalties—Order requiring compliance, etc.—Suspension or revocation of certificate, effect—Application to courts.

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

48.46.140 - Fees.

48.46.170 - Effect of chapter as to other laws—Construction.

48.46.180 - Duty of employer to inform and make available to employees option of enrolling in health maintenance organization.

48.46.190 - Payroll deductions for capitation payments to health maintenance organizations.

48.46.200 - Rules and regulations.

48.46.210 - Compliance with federal funding requirements—Construction.

48.46.220 - Review of administrative action.

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

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

48.46.237 - Minimum net worth—Domestic or foreign health maintenance organization.

48.46.240 - Funded reserve requirements.

48.46.243 - Contract—Participant liability.

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

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

48.46.250 - Coverage of dependent children—Newborn infants, congenital anomalies—Notification period.

48.46.260 - Individual health maintenance agreement—Return within ten days of delivery—Refunds—Void from beginning.

48.46.270 - Financial interests of health maintenance organization authorities, restricted—Exceptions, regulations.

48.46.272 - Diabetes coverage—Definitions.

48.46.274 - Prescribed, self-administered anticancer medication.

48.46.275 - Mammograms—Insurance coverage.

48.46.277 - Prostate cancer screening.

48.46.280 - Reconstructive breast surgery.

48.46.285 - Mastectomy, lumpectomy.

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

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

48.46.300 - Future dividends or refunds, restricted—Issuance or sale of securities regulated.

48.46.310 - Registration not endorsement.

48.46.320 - Dependent children, termination of coverage, conditions.

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

48.46.340 - Return of agreement within ten days.

48.46.350 - Chemical dependency treatment.

48.46.355 - "Chemical dependency" defined.

48.46.360 - Payment of cost of agreement directly to holder during labor dispute—Changes restricted—Notice to employee.

48.46.370 - Coverage not denied for disability.

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

48.46.380 - Notice of reason for cancellation, denial, or refusal to renew agreement.

48.46.390 - Providing information on cancellation or refusal—No liability for insurance commissioner or health maintenance organization.

48.46.400 - False or misleading advertising prohibited.

48.46.410 - Misrepresentations to induce termination or retention of agreement prohibited.

48.46.420 - Penalty for violations.

48.46.430 - Enforcement authority of commissioner.

48.46.440 - Continuation option to be offered.

48.46.450 - Conversion agreement to be offered—Exceptions, conditions.

48.46.460 - Conversion agreement—Restrictions and requirements—Rules.

48.46.470 - Endorsement of modifications.

48.46.480 - Continuation of coverage of former family members.

48.46.490 - Coverage for adopted children.

48.46.500 - Cancellation of rider.

48.46.510 - Phenylketonuria.

48.46.520 - Neurodevelopmental therapies—Employer-sponsored group contracts.

48.46.530 - Temporomandibular joint disorders—Insurance coverage.

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

48.46.540 - Nonresident pharmacies.

48.46.565 - Foot care services.

48.46.570 - Denturist services.

48.46.575 - Doctor of osteopathic medicine and surgery—Discrimination based on board certification is prohibited.

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

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

48.46.605 - Material acquisitions or dispositions.

48.46.610 - Asset acquisitions—Asset dispositions.

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

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

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

48.46.900 - Liberal construction.

48.46.920 - Short title.

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