The forms of
the policies, applications, certificates or other evidence of
insurance coverage and applicable premium rates relating thereto
shall be filed with the commissioner. No such policy, contract,
or other evidence of insurance, application or other form shall
be sold, issued or used and no endorsement shall be attached to
or printed or stamped thereon unless the form thereof shall have
been approved by the commissioner or thirty days shall have
expired after such filing without written notice from the
commissioner of disapproval thereof. The commissioner shall
disapprove the forms of such insurance if he or she finds that
they are unjust, unfair, inequitable, misleading or deceptive or
that the rates are by reasonable assumption excessive in relation
to the benefits provided. In determining whether such rates by
reasonable assumptions are excessive in relation to the benefits
provided, the commissioner shall give due consideration to past
and prospective claim experience, within and outside this state,
and to fluctuations in such claim experience, to a reasonable
risk charge, to contribution to surplus and contingency funds, to
past and prospective expenses, both within and outside this
state, and to all other relevant factors within and outside this
state including any differing operating methods of the insurers
joining in the issue of the policy. In exercising the powers
conferred upon him or her by this chapter, the commissioner shall
not be bound by any other requirement of this code with respect
to standard provisions to be included in disability policies or
forms.
The commissioner may, after hearing upon written notice,
withdraw an approval previously given, upon such grounds as in
his or her opinion would authorize disapproval upon original
submission thereof. Any such withdrawal of approval after
hearing shall be by notice in writing specifying the ground
thereof and shall be effective at the expiration of such period,
not less than ninety days after the giving of notice of
withdrawal, as the commissioner shall in such notice prescribe.
If and when a program of hospital, surgical and medical
benefits is enacted by the federal government or the state of
Washington, the extended health insurance benefits provided by
policies issued under this chapter shall be adjusted to avoid any
duplication of benefits offered by the federal or state programs
and the premium rates applicable thereto shall be adjusted to
conform with the adjusted benefits.
The association shall submit an annual report to the
insurance commissioner which shall become public information and
shall provide information as to the number of persons insured,
the names of the insurers participating in the association with
respect to insurance offered under this chapter and the calendar
year experience applicable to such insurance offered under this
chapter, including premiums earned, claims paid during the
calendar year, the amount of claims reserve established,
administrative expenses, commissions, promotional expenses,
taxes, contingency reserve, other expenses, and profit and loss
for the year. The commissioner shall require the association to
provide any and all information concerning the operations of the
association deemed relevant by him for inclusion in the report.
[2009 c 549 § 7105; 1965 ex.s. c 70 § 32.]