Carrier — Requirement to update website and provider directory — Requirement to provide enrollee with certain information.
RCW 48.49.090
in effect(1) A carrier must update its website and provider directory no later than thirty days after the addition or termination of a facility or provider. (2) A carrier must provide an enrollee with: (a) A clear description of the health plan's out-of-network health benefits; (b) The notice of consumer rights developed under RCW 48.49.060 ; (c) Notification that if the enrollee receives services from an out-of-network provider, facility, behavioral health emergency services provider, or ground ambulance services organization, under circumstances other than those described in RCW 48.49.020 and 48.49.200 , the enrollee will have the financial responsibility applicable to services provided outside the health plan's network in excess of applicable cost-sharing amounts and that the enrollee may be responsible for any costs in excess of those allowed by the health plan; (d) Information on how to use the carrier's member transparency tools under RCW 48.43.007 ; (e) Upon request, information regarding whether a health care provider is in-network or out-of-network, and whether there are in-network providers available to provide emergency medicine, anesthesiology, pathology, radiology, neonatology, surgery, hospitalist, intensivist, and diagnostic services, including radiology and laboratory services at specified in-network hospitals or ambulatory surgical facilities; and (f) Upon request, an estimated range of the out-of-pocket costs for an out-of-network benefit.
(1) A carrier must update its website and provider directory no later than thirty days after the addition or termination of a facility or provider.
(2) A carrier must provide an enrollee with:
(a) A clear description of the health plan's out-of-network health benefits;
(b) The notice of consumer rights developed under RCW 48.49.060 ;
(c) Notification that if the enrollee receives services from an out-of-network provider, facility, behavioral health emergency services provider, or ground ambulance services organization, under circumstances other than those described in RCW 48.49.020 and 48.49.200 , the enrollee will have the financial responsibility applicable to services provided outside the health plan's network in excess of applicable cost-sharing amounts and that the enrollee may be responsible for any costs in excess of those allowed by the health plan;
(d) Information on how to use the carrier's member transparency tools under RCW 48.43.007 ;
(e) Upon request, information regarding whether a health care provider is in-network or out-of-network, and whether there are in-network providers available to provide emergency medicine, anesthesiology, pathology, radiology, neonatology, surgery, hospitalist, intensivist, and diagnostic services, including radiology and laboratory services at specified in-network hospitals or ambulatory surgical facilities; and
(f) Upon request, an estimated range of the out-of-pocket costs for an out-of-network benefit.
Source: WA Statutes (Official Site)URL: https://app.leg.wa.gov/RCW/default.aspx?cite=48.49&full=trueFetched: 6/29/2026