For individuals

File the following:

Policy:

Standard provisions

Subrogation, insured made whole (Thiringer - Bulleting 79-4)

WAC 284-30-620 - Permissible time limit for benefits payable because of accidental injury or death

WAC 284-50-315 - Policy definitions

WAC 284-50-320 - Prohibited policy provisions

WAC 284-50-330 - General rules as to minimum standards

WAC 284-50-365 - Specified disease and specified accident coverage

WAC 284-50-377 - Experimental and investigational prescriptions, treatments, procedures, or service - Definition required - Standard for definition - Written notice of denial required - Appeal process required

RCW 48.18.190 - Policy must contain entire contract

RCW 48.20.042 through .152- Standard provisions

RCW 48.20.172 through .272- Optional provisions

RCW 48.20.420 - Dependent child coverage - Continuation for incapacity

RCW 48.20.490 - Continuation of coverage by former spouse and dependents

Waiver, rider, endorsements

  • Signed acceptance by insured when limiting, excluding or reducing benefits, see WAC 284-50-320(7) - Prohibited policy provisions, WAC 284-50-375(2) - Required disclosure provisions, general rules, and RCW 48.20.015 - Endorsements
  • Option to cancel after five years when excluding, limiting or reducing benefits, see:
  • RCW 48.20.510 - Cancellation of rider

For groups

File the following for in-state and out-of-state.

  • Policy
  • Certificate
  • Rates
  • Actuarial memorandum, see WAC 284-60-060 and RCW 48.70 - Specified disease insurance act
  • John Doe schedule of benefits page
  • Time limit for benefits, see WAC 284-30-620

Standard provisions

  • WAC 284-96-015 - Experimental and investigational prescriptions, treatments, procedures, or services - Definition required - Standard for definition - Written notice of denial required - Appeal process required
  • RCW 48.21.050 through .090- Standard provisions
  • RCW 48.21.110 - Payment of benefits