Wash. Rev. Code § 48.125.003
Short title
This chapter may be cited as the "self-funded multiple employer welfare arrangement regulation act."
Revised Code of Washington Chapter 48.125 — Self-Funded Multiple Employer Welfare Arrangements
Washington · statute · Wash. Rev. Code ch. 48.125 · 20 active provisions
Wash. Rev. Code § 48.125.005
Purposes
The purposes of this chapter are to:(1) Provide for the authorization and registration of self-funded multiple employer welfare arrangements;(2) Regulate self-funded multiple employer welfare arrangements in order to ensure the financial integrity of the arrangements;(3) Provide reporting requirements for self-funded m…
Wash. Rev. Code § 48.125.010
Definitions
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Bona fide association" means an association of employers that has been in existence for a period of not less than ten years prior to sponsoring a self-funded multiple employer welfare arrangement, during whi…
Wash. Rev. Code § 48.125.020
Certificate of authority required
(1) Except as provided in subsection (3) of this section, a person may not establish, operate, provide benefits, or maintain a self-funded multiple employer welfare arrangement in this state unless the arrangement first obtains a certificate of authority from the commissioner.(2) An arrangement is considered to be esta…
Wash. Rev. Code § 48.125.030
Certificate of authority—Requirements for issuance
The commissioner may not issue a certificate of authority to a self-funded multiple employer welfare arrangement unless the arrangement establishes to the satisfaction of the commissioner that the following requirements have been satisfied by the arrangement:(1) The employers participating in the arrangement are member…
Wash. Rev. Code § 48.125.040
Certificate of authority—Continued compliance with certain conditions—Commissioner's discretion
(1) In addition to the requirements under RCW 48.125.030, self-funded multiple employer welfare arrangements are subject to the following requirements:(a) Arrangements must maintain a calendar year for operations and reporting purposes;(b) Arrangements must satisfy one of the following requirements:(i)(A) The arrangeme…
Wash. Rev. Code § 48.125.050
Certificate of authority—Application—Form—Documentation
A self-funded multiple employer welfare arrangement must apply for a certificate of authority on a form prescribed by the commissioner and must submit the application, together with the following documents, to the commissioner:(1) A copy of all articles, bylaws, agreements, trusts, or other documents or instruments des…
Wash. Rev. Code § 48.125.060
Surplus required—Amount—Enforcement
Self-funded multiple employer welfare arrangements must maintain continuously a surplus equal to at least ten percent of the next twelve months projected incurred claims or two million dollars, whichever is greater. The commissioner may proceed against self-funded multiple employer welfare arrangements that fail to mai…
Wash. Rev. Code § 48.125.070
Contribution rates
A self-funded multiple employer welfare arrangement must establish and maintain contribution rates for participation under the arrangement that satisfy either of the following requirements:(1) Contribution rates must equal or exceed the sum of projected incurred claims for the year, plus all projected costs of operatio…
Wash. Rev. Code § 48.125.080
Certificate of authority—Granting or denying application
(1) The commissioner shall grant or deny an application for a certificate of authority within one hundred eighty days of the date that a completed application, together with the items designated in RCW 48.125.050, is submitted to the commissioner.(2) The commissioner shall grant the application of an arrangement that s…
Wash. Rev. Code § 48.125.090
Reporting requirements
(1) A self-funded multiple employer welfare arrangement must comply with the reporting requirements of this section.(2) Every arrangement holding a certificate of authority from the commissioner must file its financial statements as required by this title and by the commissioner in accordance with the accounting practi…
Wash. Rev. Code § 48.125.100
Failure to comply with chapter—Sanctions
(1) The commissioner may impose sanctions against a self-funded multiple employer welfare arrangement that fails to comply with this chapter. The maximum fine may not exceed ten thousand dollars for each violation.(2) The commissioner may issue a notice of intent to revoke the certificate of authority of a self-funded…
Wash. Rev. Code § 48.125.110
Certificate of authority—Failure to obtain
A self-funded multiple employer welfare arrangement organized, operated, providing benefits, or maintained in this state without a certificate of authority is in violation of this title.
Wash. Rev. Code § 48.125.120
Policy must contain specific notice
Each policy issued by a self-funded multiple employer welfare arrangement must contain, in ten-point type on the front page and the declaration page, the following notice:"NOTICEThis policy is issued by a self-funded multiple employer welfare arrangement. A self-funded multiple employer welfare arrangement may not be s…
Wash. Rev. Code § 48.125.130
Additional compliance requirements
A self-funded multiple employer welfare arrangement is subject to RCW 48.43.300 through 48.43.370, the rehabilitation provisions under chapter 48.31 RCW, and chapter 48.99 RCW.
Wash. Rev. Code § 48.125.140
Examination of operations—Commissioner's powers—Definition of affiliate
(1) The commissioner may make an examination of the operations of any self-funded multiple employer welfare arrangement as often as he or she deems necessary in order to carry out the purposes of this chapter.(2) Every self-funded multiple employer welfare arrangement shall submit its books and records relating to its…
Wash. Rev. Code § 48.125.150
Chapter not applicable
This chapter does not apply to:(1) Single employer entities;(2) Taft-Hartley plans; or(3) Self-funded multiple employer welfare arrangements that do not provide coverage for health care services.
Wash. Rev. Code § 48.125.160
Taxable amounts—Participant contributions
Participant contributions used to determine the taxable amounts in this state under RCW 48.14.0201 shall be determined in the same manner as premiums taxable in this state are determined under RCW 48.14.090.
Wash. Rev. Code § 48.125.200
Prostate cancer screening. (Effective until June 30, 2027.)
(1) Each self-funded multiple employer welfare arrangement established, operated, providing benefits, or maintained in this state after December 31, 2006, that provides coverage for hospital or medical expenses shall provide coverage for prostate cancer screening, provided that the screening is delivered upon the recom…
Wash. Rev. Code § 48.125.901
Effective date—2004 c 260
This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [March 31, 2004].