Revised Code of Washington
Chapter 48.49 - Balance Billing Protection Act.
48.49.130 - Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner.

RCW 48.49.130
Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner.

As authorized in 45 C.F.R. Sec. 149.30 as in effect on March 31, 2022, the provisions of this chapter apply to a self-funded group health plan whether governed by or exempt from the provisions of the federal employee retirement income security act of 1974 (29 U.S.C. Sec. 1001 et seq.) only if the self-funded group health plan elects to participate in the provisions of RCW 48.49.020 and 48.49.030, 48.49.160, and 48.49.040. To elect to participate in these provisions, the self-funded group health plan shall provide notice, on an annual basis, to the commissioner in a manner prescribed by the commissioner, attesting to the plan's participation and agreeing to be bound by RCW 48.49.020 and 48.49.030, 48.49.160, and 48.49.040. An entity administering a self-funded health benefits plan that elects to participate under this section, shall comply with the provisions of RCW 48.49.020 and 48.49.030, 48.49.160, and 48.49.040.

[ 2022 c 263 § 17; 2019 c 427 § 23.]
NOTES:

Effective date—2022 c 263: See note following RCW 43.371.100.

Structure Revised Code of Washington

Revised Code of Washington

Title 48 - Insurance

Chapter 48.49 - Balance Billing Protection Act.

48.49.003 - Findings—Intent—2019 c 427.

48.49.005 - Short title.

48.49.010 - Definitions.

48.49.020 - Balance billing—When prohibited—Carrier's duty to hold an enrollee harmless from balance billing under certain circumstances.

48.49.030 - Enrollee's obligation to pay for services.

48.49.040 - Dispute resolution process—Determination of commercially reasonable payment amount.

48.49.050 - Commissioner's annual report on dispute resolution information regarding arbitration over commercially reasonable payment amounts.

48.49.060 - Notice of consumer rights—Development of standard template language by commissioner.

48.49.070 - Hospital, ambulatory surgical facility, or behavioral health emergency services provider—Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists.

48.49.080 - Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers.

48.49.090 - Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information.

48.49.100 - Pattern of unresolved violations—Enforcement action by department of health or appropriate disciplining authority.

48.49.110 - Rule-making authority.

48.49.120 - No application of chapter to health plans under chapter 74.09 RCW.

48.49.130 - Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner.

48.49.135 - Determining the adequacy of provider networks—Required considerations.

48.49.140 - Liberal construction of chapter to promote public interest.

48.49.160 - Allowed amounts paid to nonparticipating providers.

48.49.170 - Application of state and federal requirements—Applicability information access—Waivers prohibited.

48.49.180 - Commissioner authority—Enforcement—Penalties.

48.49.190 - Reports to legislature.

48.49.900 - Effective date—2019 c 427.