RCW 51.14.170
Administration of claims—Third-party administrators.
(1) Self-insured employers may elect to have their claims administered by a third party or they may elect to self-administer their claims. Third-party administrators given the responsibility of administering the claims of workers by an employer shall be licensed by the department. All employer claims administrators given the responsibility of administering the claims of workers shall maintain certification established by the department.
(2) The department shall adopt rules to administer this section. The rules for licensing third-party administrators must:
(a) Incorporate the department's rules for self-insurers in effect as of March 2020;
(b) Include criteria for determining appropriate penalties for violation of their responsibilities and duties, including managing claims, engaging in the department's management of claims, coordinating proper employment of injured workers during the pendency of the worker's claim, making requests of the department in individual cases, or participating in appeals involving a worker's benefits in a way that furthers the purpose of this title;
(c) Consider recognized and approved claim processing practices within the industrial insurance industry, and the industrial insurance laws and rules of this state;
(d) Consider similar licensure rules under the insurance laws and rules of this state; and
(e) Include requirements for maintaining a license, and any penalties for violation of those licensing requirements.
[ 2020 c 277 § 8.]
NOTES:
Effective date—2020 c 277 § 8: "Section 8 of this act takes effect July 1, 2021." [ 2020 c 277 § 10.]
Structure Revised Code of Washington
Title 51 - Industrial Insurance
Chapter 51.14 - Self-Insurers.
51.14.010 - Duty to secure payment of compensation—Options.
51.14.030 - Certification of employer as self-insurer.
51.14.040 - Surety liability—Termination.
51.14.050 - Termination of status—Notice—Financial requirements.
51.14.060 - Default by self-insurer—Authority of director—Liability for reimbursement.
51.14.070 - Payments upon default.
51.14.077 - Self-insurers' insolvency trust—Assessments—Rules.
51.14.080 - Withdrawal of certification—Grounds.
51.14.090 - Withdrawal of certification, corrective action upon employees' petition.
51.14.095 - Corrective action—Appeal.
51.14.100 - Notice of compliance to be posted—Penalty.
51.14.120 - Copy of claim file—Notice of protest or appeal—Medical report.
51.14.130 - Request for claim resolution—Time.
51.14.140 - Violations of disclosure or request for resolution—Order by director.
51.14.160 - School districts, ESDs, or hospitals as self-insurers—Rules—Scope.
51.14.170 - Administration of claims—Third-party administrators.
51.14.300 - Ombuds office created—Appointment—Open and competitive contracting.
51.14.310 - Ombuds—Term of office—Removal—Vacancies.
51.14.320 - Ombuds—Training or experience qualifications.
51.14.330 - Ombuds office—Staffing level.
51.14.340 - Ombuds office—Powers and duties.
51.14.350 - Ombuds office—Referral procedures—Department response to referred complaints.
51.14.370 - Confidentiality of ombuds records and files—Disclosure prohibited—Exception.
51.14.380 - Explaining ombuds program—Posters and brochures.