WAC 284-52-030. Other provisions applicable to mandated conversion plans

Except as otherwise required or permitted by this chapter, mandated conversion plans shall: (1) Use a format no less favorable to the covered individual than those set forth in RCW 48.20.012 , with respect to insurers, or WAC 284-44-030 , with respect to health care service contractors and health maintenance organizations; (2) Contain a provision providing for the return of the contract for a refund of payment, consistent with RCW 48.20.013 , 48.44.230 or 48.46.260 , as appropriate; (3) Contain provisions consistent with and no less favorable to the covered individual than the following laws and regulations thereunder: (a) With respect to insurers, the requirements and standard provisions set forth in chapter 48.20 RCW; (b) With respect to health care service contractors, the requirements of chapter 48.44 RCW and WAC 284-44-040 , except that lifetime maximum benefits under a conversion plan are not required to be renewed or restored; (c) With respect to health maintenance organizations, the requirements of chapter 48.46 RCW; (4) Be administered by the carrier in full compliance with any applicable laws which prohibit denials of payments for services performed by certain licensed providers of service.