Examination/ the contract. Disapproval Cannot contain any title, heading, or other indication of provisions which is misleading Must contain clear, definitive, WA state specific language for all terms, benefits, and conditions May not unreasonably restrict treatment or services RCW Benefits must be reasonable in relation to the amount charged for the contract. 48.18.110(2) Definitions in the contract must be consistent with those in RCW 48.43.005 and RCW 48.21. RCW 48.43.005 Exclusions, RCW 48.18.140(f) Does the contract or certificate of coverage contain a listing of exclusions, reductions, and reductions limitations to covered benefits either included with the benefit provisions, or under an and appropriate caption? limitations Is any exclusion, reduction, or limitation which applies only to a particular benefit Included with the applicable benefit provision? Required WAC The style, arrangement, and over-all appearance of the contract must give no undue 284-58-050(3) Format prominence to any portion of the text Is the type of a general style? Is the font size uniform, and of acceptable point size? means all printed matter except the name and address of the issuer, name or “Text” title of the policy, a brief description (if any), and captions and subcaptions WAC Is there a form number in the lower left-hand corner of the page of each form, including riders and 284-58-030(3) endorsements?
Examination/ Disapproval RCW 48.18.110(2) RCW 48.43.005 the contract. Cannot contain any title, heading, or other indication of provisions which is misleading Must contain clear, definitive, WA state specific language for all terms, benefits, and conditions May not unreasonably restrict treatment or services Benefits must be reasonable in relation to the amount charged for the contract. Definitions in the contract must be consistent with those in RCW 48.43.005 and RCW 48.21. Exclusions, reductions and limitations RCW 48.18.140(f) Does the contract or certificate of coverage contain a listing of exclusions, reductions, and limitations to covered benefits either included with the benefit provisions, or under an appropriate caption? Is any exclusion, reduction, or limitation which applies only to a particular benefit Included with the applicable benefit provision? Required Format WAC 284-58-050(3) WAC 284-58-030(3) The style, arrangement, and over-all appearance of the contract must give no undue prominence to any portion of the text Is the type of a general style? Is the font size uniform, and of acceptable point size? “Text” means all printed matter except the name and address of the issuer, name or title of the policy, a brief description (if any), and captions and subcaptions Is there a form number in the lower left-hand corner of the page of each form, including riders and endorsements?
checklist-forms-disability-large-group.docx