WAC 284-180-120. Applicability and scope

(1) This chapter applies to:

(a) Health care benefit managers as defined in RCW 48.200.020 , and health carriers who contract with health care benefit managers; and

(b) Pharmacy benefit managers who contract with pharmacies on behalf of health carriers, medicaid managed care organizations, and employee benefits programs as defined in RCW 48.200.020 .

(2) Effective January 1, 2026, RCW 48.200.280 , 48.200.310 , and 48.200.320 and WAC 284-180-500 , 284-180-507 , 284-180-517 , and 284-180-522 apply to self-funded group health plans that have elected to participate under RCW 48.200.330 .

(3) This chapter does not apply to health care benefit managers providing services exclusively to, or acting exclusively on behalf of:

(a) Self-funded group health plans, other than an employee benefit program as defined in RCW 48.200.020 or with respect to compliance with RCW 48.200.280 , 48.200.310 , and 48.200.320 , a self-funded group health plan that has elected to participate under RCW 48.200.330 ;

(b) Medicare supplement plans;

(c) Medicare advantage plans;

(d) Medicare Part D prescription drug plans;

(e) Medicaid, except that pharmacy benefit managers that contract with pharmacies on behalf of medicaid managed care plans are subject to chapter 48.200 RCW and this chapter;

(f) Children's health insurance program plans;

(g) Discount plans;

(h) Union plans, other than a union plan that is a self-funded group health plan that has elected to participate under RCW 48.43.330 with respect to compliance with RCW 48.200.280 , 48.200.310 , and 48.200.320 ; and

(i) Plans that provide monetary payment, such as income replacement disability plans or life insurance accelerated benefits, unless these plans provide coverage for health care services, drugs, or supplies.