# WAC 284-43-6520: WAC 284-43-6520. Definitions > Washington · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_6520 ## Section - **Citation:** WAC 284-43-6520 - **Heading:** WAC 284-43-6520. Definitions - **Jurisdiction:** Washington - **Kind:** Regulations - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Washington Administrative Code / Title 284 / Chapter 284-43 / Section 284-43-6520 ## Text For the purpose of this subchapter: (1) "Contract" means an agreement to provide health care services or pay health care costs for or on behalf of a "subscriber" or group of "subscribers" and such eligible dependents as may be included therein. (2) "Contract form" means the prototype of a "contract" and any associated riders and endorsements filed with the commissioner by a carrier. (3) "Covered person" or "enrollee" has the same meaning as that contained in RCW 48.43.005 . (4) "Dependent" has the same meaning as that contained in RCW 48.43.005 . (5) "Health carrier" or "carrier" has the same meaning as that contained in RCW 48.43.005 . (6) "Individual market" has the same meaning as that contained in RCW 48.43.005 . (7) "Individual health plan" means a health plan issued in the individual market. (8) "Large group contracts" or "large group plans" include group health benefit plans and stand-alone dental plans or stand-alone vision plans that are not small group plans and are not individual plans. (9) "Limited health care service contractor" means a health care service contractor that offers one and only one limited health care service. (10) "Negotiated contract" form means a health benefit plan or stand-alone dental plan or stand-alone vision plan where benefits and other terms and conditions, including the applicable rate schedules, are negotiated and agreed to by the carrier or limited health care service contractor and the policy or contract holder. The only plans that carriers can negotiate are large group plans. The negotiated policy form and associated rate schedule must otherwise comply with state and federal laws governing the content and schedule of rates for the negotiated plans. luding the applicable rate schedules, are negotiated and agreed to by the carrier or limited health care service contractor and the policy or contract holder. The only plans that carriers can negotiate are large group plans. The negotiated policy form and associated rate schedule must otherwise comply with state and federal laws governing the content and schedule of rates for the negotiated plans. (11) "Premium" means all sums charged, received, or deposited as consideration for a contract or the continuance of a contract. Any assessment, or any "membership," "policy," "survey," "inspection," "service," or similar fee or charge made by the carrier in consideration for a contract is part of the premium. Premium does not include amounts paid as enrollee point-of-service cost-sharing. (12) "Rate" or "rates" means all classification manuals, rate manuals, rating schedules, class rates, and rating rules. (13) "Rate schedule" means the schedule of rates that includes the description of methodology used to obtain the premium rate for a specific individual or group, if given the necessary information such as the demographic data and plan design of the individual or group. For a single negotiated contract form, the rate schedule also includes the premium for the employer. (14) "Small employer" has the same meaning as defined in 42 U.S.C. 18024. (15) "Small group plans" means the class of "group contracts" issued to "small employers." For the purposes of this section, "small group contracts" and "small group plans" also apply to stand-alone dental plans or stand-alone vision plans. (16) "Stand-alone dental plan" means coverage for a set of benefits limited to oral care including, but not necessarily limited to, pediatric oral care. (17) "Stand-alone vision plan" means coverage for a set of benefits limited to vision care including, but not necessarily limited to, materials. (18) "Subscriber" means a person on whose behalf a "contract" or "certificate" is issued. ## Nearby sections - [WAC 284-43-0110 WAC 284-43-0110. Purpose](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0110.md) - [WAC 284-43-0120 WAC 284-43-0120. Applicability and scope](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0120.md) - [WAC 284-43-0140 WAC 284-43-0140. Compliance with state and federal laws](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0140.md) - [WAC 284-43-0160 WAC 284-43-0160. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0160.md) - [WAC 284-43-0200 WAC 284-43-0200. Deadline for filing individual health plans, small group health plans, and stand-alone dental plans](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0200.md) - [WAC 284-43-0210 WAC 284-43-0210. Transitional reinsurance program](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0210.md) - [WAC 284-43-0230 WAC 284-43-0230. Risk adjustment program](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0230.md) - [WAC 284-43-0250 WAC 284-43-0250. Grandfathered health plan status](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0250.md) - [WAC 284-43-0270 WAC 284-43-0270. Market conduct requirements related to grandfathered status](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0270.md) - [WAC 284-43-0290 WAC 284-43-0290. Small group coverage market transition requirements](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0290.md) - [WAC 284-43-0350 WAC 284-43-0350. Individual coverage market transition requirements](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0350.md) - [WAC 284-43-0400 WAC 284-43-0400. Purpose and scope](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0400.md) - [WAC 284-43-0410 WAC 284-43-0410. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0410.md) - [WAC 284-43-0420 WAC 284-43-0420. Sensitive health care services](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_0420.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43_6520. Check the current official text before relying on it. Not legal advice.