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The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
"Application fee" means a fee charged to an individual or individuals prior to the execution of a residency agreement, apart from an entrance fee.
"Care" means nursing, medical, or other health-related services, protection or supervision, assistance with activities of daily living, or any combination of those services.
"Continuing care" means directly providing or indirectly making available, upon payment of an entrance fee and under a residency agreement, housing and care for a period of greater than one year.
"Continuing care retirement community" or "life plan community" means an entity that agrees to provide continuing care to a resident under a residency agreement with an entrance fee. "Continuing care retirement community" or "life plan community" does not include an assisted living facility licensed under chapter 18.20 RCW that does not directly, or through a contractual arrangement with a separately owned and incorporated skilled nursing facility, offer or provide services under chapter 74.42 RCW.
"Department" means the department of social and health services.
"Entrance fee" means an initial or deferred transfer to a continuing care retirement community of a sum of money or other property made or promised to be made as full or partial consideration for acceptance of one or more residents in a continuing care retirement community. "Entrance fee" does not include deposits of ten thousand dollars or less or any amount that is based on rental or lease payments of one month or more.
"Life care contract," also known as a type A contract, means a contract to provide a person, for the duration of the person's life or for a term in excess of one year, nursing services, medical services, or personal care services in addition to board and lodging for the person in a continuing care retirement community, conditioned upon payment of an entrance fee in addition to or in lieu of the payment of regular periodic charges for the care and services involved, unless the contract expressly excludes some or all of such services.
"Office" means the office of the insurance commissioner.
"Prospective resident" means a person who has completed an application for admission to a continuing care retirement community and makes a refundable deposit to reserve a unit, excluding applicable administrative fees.
"Residency agreement" means a contract between a continuing care retirement community and a resident for the provision of continuing care for a period of greater than one year.
"Resident" means a person who enters into a residency agreement with a continuing care retirement community or who is designated in a residency agreement to be a person being provided with continuing care.
An applicant for a registration as a continuing care retirement community must submit the following materials to the department:
A written application to the department providing all necessary information on a form provided by the department;
Information about the licensed assisted living facility component of the continuing care retirement community and, if the continuing care retirement community operates a nursing home, information about that component;
Copies of any residency agreements that the continuing care retirement community intends to use for the certification period;
A written statement indicating whether the residency agreement includes an entrance fee in lieu of payment for future care and services and, if so, whether those services are covered completely or partially by the entrance fee;
A copy of the disclosure statement that includes current information required by RCW 18.390.060;
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Except as provided in (f)(ii) of this subsection, copies of audited financial statements for the two most recent fiscal years. The audited financial statement for the most current period may not have been prepared more than eighteen months prior to the date that the continuing care retirement community applied for its current registration;
If the continuing care retirement community:
(A) Has obtained financing, but has been in operation less than two years, a copy of the audited financial statement for the most current period, if available, and an independent accountant's report opinion letter that has evaluated the financial feasibility of the continuing care retirement community; or
(B) Has not obtained financing, a summary of the actuarial analysis for the new continuing care retirement community stating that the continuing care retirement community is in satisfactory actuarial balance;
g. An attestation by a management representative of the continuing care retirement community that the continuing care retirement community is in compliance with the disclosure notification requirements of RCW 18.390.060;
h. Beginning July 1, 2027, if the applicant offers residency agreements that include life care contracts, an actuarial analysis for review pursuant to the process in section 5 of this act. The actuarial analysis must have been prepared by a qualified actuary and include an actuarial memorandum and certification. The actuarial analysis submission requirement applies to the applicant's initial registration application and every other subsequent registration renewal application. The department may stagger the initial imposition of the requirements of this section, as applied to renewal applications, to allow the office to conduct its responsibilities under section 5 of this act on a regular basis without fluctuations in workflow; and
i. Payment of any registration fees associated with the department's cost of registering continuing care retirement communities.
The department shall base its decision to issue a registration on the completeness of the application and, as required, the receipt of a notice of a satisfactory actuarial analysis review from the office under section 5 of this act. If an application is incomplete, the department shall inform the applicant and give the applicant an opportunity to supplement its submission. An applicant may appeal a decision of the department to deny an application for registration.
The department shall issue the registration within 60 days of the receipt of a complete application, payment of fees, submission of disclosures, residency agreements, the attestation, and, as required, the actuarial analysis. If an application requires review of the actuarial analysis by the office and all other materials have been deemed sufficient by the department, the department may issue a provisional registration while the results of the review of the actuarial analysis are pending. The department's failure to timely issue a registration may not cause a delay in the change of ownership and ongoing operation of the continuing care retirement community.
Registration is valid for two years.
Registration is not transferable.
Materials submitted pursuant to this section are not subject to disclosure under the public records act, chapter 42.56 RCW.
The department shall:
Register an entity that submits a complete application that includes all of the materials required in RCW 18.390.030 and receives, as required, a notice of satisfactory actuarial analysis review from the office under section 5 of this act;
Review the disclosure statements submitted by applicants for an initial or renewal registration to operate a continuing care retirement community for completeness;
Establish and collect a fee that is sufficient to cover the department's costs associated with administering the requirements of this chapter, including the costs to reimburse the office for its costs associated with providing actuarial reviews under section 5 of this act; and
Create and maintain an online listing that is readily available to the public of the names and addresses of continuing care retirement communities that are registered with the department.
The department's registration activities consist of reviewing an application for completeness and receipt of actuarial analysis review notices from the office under section 5 of this act and do not signify that the department has otherwise issued a certification or license to the continuing care retirement community or any of its component parts.
The department may adopt rules to administer this chapter.
An entity that is not registered with the department may not represent itself, or refer to itself in advertising and marketing materials as a "registered continuing care retirement community," "continuing care retirement community," or "life plan community" as defined by this chapter.
The department and the office shall collaborate to develop a process for the department to transmit actuarial analyses received under RCW 18.390.030(1)(h) to the office for review and for the office to return the results of the review to the department for consideration in its registration decision.
The department shall adopt standards for the contents of the actuarial analysis to be submitted. The standards shall be based on information that the office determines is necessary to conduct its review in subsection (3) of this section.
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The office shall develop standards for the review of actuarial analyses received from the department. The standards must establish a process for determining the applicant's ability to meet its overall contract obligations under its residency agreements in accordance with currently accepted actuarial standards of practice, such as those adopted by the actuarial standards board. The standards shall consider whether the applicant's actuarial balance is satisfactory and reflects liabilities that are sufficient to cover obligations under moderately adverse conditions during the testing period. The term "moderately adverse conditions" anticipates unfavorable, but not extreme, events with a reasonable probability of occurring during the testing period.
The office shall review actuarial analyses as required under RCW 18.390.030(1)(h).
If the office's review of the applicant's actuarial analysis determines that the applicant will be able to meet its overall contract obligations under the standard established in (a) of this subsection, it will notify the department that the applicant has satisfied the review requirement in RCW 18.390.030(2).
If the office's review of the applicant's actuarial analysis determines that the applicant will not be able to meet its contract obligations under the standard established in (a) of this subsection, it will notify the department that the applicant has not satisfied the review requirement in RCW 18.390.030(2) and notify the applicant of the right to an appeal of the decision.
Any appeal by an applicant regarding a determination under (b)(ii) of this subsection that the applicant has not satisfied the review requirement in RCW 18.390.030 shall be made to the department.
The office is not required to prepare any materials, other than the review of the actuarial analysis, or review any materials, other than the actuarial analysis prepared by a qualified actuary and provided by the applicant.
The insurance commissioner is authorized to perform functions required under chapter 18.390 RCW related to the review of actuarial analyses submitted by applicants for registration as a continuing care retirement community, including establishing standards for actuarial materials to be submitted and for the qualifications of the actuaries preparing the actuarial analyses. The insurance commissioner may adopt rules related to its responsibilities under chapter 18.390 RCW, as necessary.
Documents, materials, or other information as described in subsections (5), (6), (7), (8), and (9) of this section are confidential by law and privileged, are not subject to public disclosure under chapter 42.56 RCW, and are not subject to subpoena directed to the commissioner or any person who received documents, materials, or other information while acting under the authority of the commissioner. The commissioner is authorized to use such documents, materials, or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties. The confidentiality and privilege created by this section and RCW 42.56.400(8) applies only to the commissioner, any person acting under the authority of the commissioner, the national association of insurance commissioners and its affiliates and subsidiaries, regulatory and law enforcement officials of other states and nations, the federal government, and international authorities.
Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner is permitted or required to testify in any private civil action concerning any confidential and privileged documents, materials, or information subject to subsection (1) of this section.
The commissioner:
May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to subsection (1) of this section, with (i) the national association of insurance commissioners and its affiliates and subsidiaries, (ii) regulatory and law enforcement officials of other states and nations, the federal government, and international authorities, and (iii) agencies of this state, if the recipient agrees to maintain the confidentiality and privileged status of the document, material, or other information;
May receive documents, materials, or information, including otherwise either confidential or privileged, or both, documents, materials, or information, from (i) the national association of insurance commissioners and its affiliates and subsidiaries, and (ii) regulatory and law enforcement officials of other states and nations, the federal government, and international authorities and shall maintain as confidential and privileged any document, material, or information received that is either confidential or privileged, or both, under the laws of the jurisdiction that is the source of the document, material, or information; and
May enter into agreements governing the sharing and use of information consistent with this subsection.
No waiver of an existing privilege or claim of confidentiality in the documents, materials, or information may occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in subsection (3) of this section.
Documents, materials, or information, which is either confidential or privileged, or both, which has been provided to the commissioner by (a) the national association of insurance commissioners and its affiliates and subsidiaries, (b) regulatory or law enforcement officials of other states and nations, the federal government, or international authorities, or (c) agencies of this state, is confidential and privileged only if the documents, materials, or information is protected from disclosure by the applicable laws of the jurisdiction that is the source of the document, material, or information.
Working papers, documents, materials, or information produced by, obtained by, or disclosed to the commissioner or any other person in the course of a financial or market conduct examination, or in the course of financial analysis or market conduct desk audit, are not required to be disclosed by the commissioner unless cited by the commissioner in connection with an agency action as defined in RCW 34.05.010(3). The commissioner shall notify a party that produced the documents, materials, or information five business days before disclosure in connection with an agency action. The notified party may seek injunctive relief in any Washington state superior court to prevent disclosure of any documents, materials, or information it believes is confidential or privileged. In civil actions between private parties or in criminal actions, disclosure to the commissioner under this section does not create any privilege or claim of confidentiality or waive any existing privilege or claim of confidentiality.
Documents, materials, or information provided to the commissioner by the federal government related to emergency management, hazard mitigation, and the national flood insurance program are confidential by law and privileged, and are not subject to public disclosure under chapter 42.56 RCW.
Data requested by the commissioner from property and casualty entities regulated by the commissioner for the purpose of understanding and studying insurance market conditions outside the context of market conduct action is confidential by law and privileged and is not subject to public disclosure under chapter 42.56 RCW. Nothing in this section prohibits the commissioner from preparing and publishing reports, analysis, or other documents using the data received from individual property and casualty companies so long as the data in the report is in aggregate form and does not permit the identification of information related to individual companies. Data in the aggregate form are deemed open records available for public inspection. Nothing in this section affects, limits, or amends the commissioner's authority under chapter 48.37 RCW.
Documents, materials, and information related to the commissioner's responsibility to review actuarial analyses under section 3 of this act as provided to the commissioner directly by applicants for registration as a continuing care retirement community under chapter 18.390 RCW or indirectly by the department of social and health services are confidential by law and privileged, and are not subject to public disclosure under changer 42.56 RCW.
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After receipt of a public disclosure request, the commissioner shall disclose the documents, materials, or information under subsection (6) of this section that relate to a financial or market conduct examination undertaken as a result of a proposed change of control of a nonprofit or mutual health insurer governed in whole or in part by chapter 48.31B RCW.
The commissioner is not required to disclose the documents, materials, or information in (a) of this subsection if:
The documents, materials, or information are otherwise privileged or exempted from public disclosure; or
The commissioner finds that the public interest in disclosure of the documents, materials, or information is outweighed by the public interest in nondisclosure in that particular instance.
Any person may petition a Washington state superior court to allow inspection of information exempt from public disclosure under subsection (6) of this section when the information is connected to allegations of negligence or malfeasance by the commissioner related to a financial or market conduct examination. The court shall conduct an in-camera review after notifying the commissioner and every party that produced the information. The court may order the commissioner to allow the petitioner to have access to the information provided the petitioner maintains the confidentiality of the information. The petitioner must not disclose the information to any other person, except upon further order of the court. After conducting a regular hearing, the court may order that the information can be disclosed publicly if the court finds that there is a public interest in the disclosure of the information and the exemption of the information from public disclosure is clearly unnecessary to protect any individual's right of privacy or any vital governmental function.
This act takes effect July 1, 2027.