State Insurance Spotlight: Washington State OIC Guidance Concerning COVID-19

State insurance departments across the country are continuing to provide guidance in response to the COVID-19 outbreak. In this update, Faegre Drinker spotlights the current Washington State Office of the Insurance Commissioner (OIC) guidance with respect to COVID-19 issues.

Data Call

Special Data Call Relating to Business Interruption and Related Commercial Coverage Written in Washington State (March 25, 2020)

• OIC instructs each authorized property/casualty insurer to provide certain information regarding the commercial property insurance it has written in Washington State and details on the business interruption coverage provided in the types of policies for which it has ongoing exposure as follows:
  • First, each insurer should provide to OIC the volume of business interruption coverage, civil authority coverage, contingent business interruption coverage and supply chain coverage the insurer wrote that was in effect on March 15, 2020, which should be expressed in amounts of direct written premium, policy types and numbers of policies written of each type.
  • Second, each insurer should examine the policies it has issued and explain the coverage each policy offers in regard to COVID-19 — both presently and whether the situation could develop to change the policyholder's status (i.e., is there any potential for coverage as a result of COVID-19). For each policy type, insurers should prepare such information in a clear and concise explanation of benefits that is suitable for policyholder review. Insurers should then send such explanation to each of their policyholders of the applicable policy types. Insurers should also send copies of all such explanations to OIC, along with a representation that the explanations have been provided to the insurer’s policyholder.
  • All responses should be sent to Policy@oic.wa.gov on or before April 1, 2020 and include in the subject of your email response “COVID 19 SPECIAL REPORT_NAIC #”.

OIC Emergency Orders

• Between March 25, 2020, and May 9, 2020, all insurers, insurance producers, surplus line brokers and other entities regulated by the OIC transacting any property and casualty insurance business shall provide grace periods for nonpayment of premium and shall waive otherwise applicable charges and fees associated with nonpayment of premium, such as late fees and reinstatement fees.
• Between March 25, 2020, and May 9, 2020, no property and casualty insurer shall cancel a policy issued for nonpayment of premium, unless specifically directed to do so by the insured.
• On March 27, 2020, OIC advised:
  • We are fully aware that this order conflicts with language in most current property and casualty insurance policies regarding grace periods and cancellation for nonpayment of premium, and that it supersedes all such language.
  • We do not expect, and will not accept, any amendatory form filings modifying policy language or rate filings waiving fees related to this order. Instead, all affected companies must administer affected provisions of their policies according to the terms of this order, granting required grace periods for premium payment, refraining from any cancellation of policies due to non-payment of premium regardless of current policy language, and refraining from charging late fees or reinstatement fees.

• All health carriers authorized or admitted to offer health plans or short-term, limited duration medical plans are ordered between March 24, 2020, and May 23, 2020 to:
  • Allow in-network providers to use non-HIPAA compliant communication platforms to provide patient care, to the extent that (i) the provider and their patient are not already using a HIPAA compliant platform, or (ii) the regulated entity is not making HIPAA compliant platforms available to all in-network providers, or (iii) the use of a HIPAA compliant platform offered by the regulated entity is not readily and easily available to the provider or enrollee.
  • Allow the use of audio-only telephone as telemedicine.
  • Cover, prior to application of any deductible and without cost-sharing, diagnostic test panels for influenza A & B, norovirus and other coronaviruses, and respiratory syncytial virus (RSV), when any of this testing is determined medically necessary by the enrollee’s health care provider, and when billed in conjunction with a COVID-19 code.
  • Cover as a “provider visit” services of a health care provider within their scope of practice, or under the supervision or direction of a health care provider within their scope of practice, to assess symptoms and obtain biological samples from enrollees at a drive-through site established for testing and assessment of COVID-19.
  • When an enrollee is determined to be ready for discharge from a hospital, and insufficient time exists for long-term care facility or home health services that will follow discharge to receive approval prior to delivery of care, treat this as an extenuating circumstance, which eliminates the requirement for prior authorization.
  • Allow a grace period for payment of premiums no less than 60 days (communications to enrollees during the grace period must clearly state the enrollee’s obligation to pay back premiums or potentially be subject to billing from health care providers for unpaid claims, and must clearly state the health carrier’s obligations during the grace period in light of the state of emergency and emergency orders).

• All health carriers authorized or admitted to offer health plans or short-term, limited duration medical plans are ordered between March 24, 2020, and May 23, 2020 to:
  • Cover, prior to application of any deductible and with no cost-sharing, the health care provider visit and COVID-19 testing for enrollees who meet the Centers for Disease Control and Prevention (CDC) criteria for testing, as determined by the enrollee’s health care provider.
  • Allow enrollees to obtain a one-time refill of their covered prescription medications prior to the expiration of the waiting period so enrollees can maintain an adequate supply of necessary medication (taking into consideration patient safety risks associated with early refills for certain drug classes, such as opioids, benzodiazepines and stimulants).
  • Suspend any prior authorization requirements that apply to covered diagnostic testing and treatment of COVID-19.
  • Ensure that if a carrier has an insufficient number or type of providers in their network to provide testing and treatment for COVID-19, the carrier must ensure that the enrollee obtains the covered service from a provider or facility within reasonable proximity of the enrollee at no greater cost than if the provider were in network.

OIC Advisories

• All authorized and unauthorized property and casualty companies and licensees that conduct insurance business in Washington State are expected by OIC to:
  • Follow the minimum standard of claims handling regulations, including implementing a prompt investigation and fully disclosing all pertinent benefits and coverages of the insurance policy under which the claim is presented.
  • Provide a written communication to the insured that cites the specific policy provision, condition or exclusion that is the basis of a claim denial.
  • When a claim is accepted, the insurer will promptly pay any accepted claims as soon as a payment is owed under the policy.

Related Guidance

Commissioner Kreidler Urges Auto Insurers to Extend Coverage to Delivery Drivers’ Personal Vehicles (March 27, 2020)

This press release discusses Insurance Commissioner Mike Kreidler’s request to insurers writing auto coverage in Washington to extend automobile insurance coverage for personal delivery drivers.

• OIC will expedite review and approval of endorsement filings.
• Endorsement would apply to drivers using their personal vehicle for retail and service operations deliveries, but not to rideshare or commercial delivery businesses.
• Endorsement would be effective only during the current declared state of emergency.

• The Proclamation removes certain implementation date language in Engrossed Substitute Senate Bill (ESSB) 5385, Section 1 (Chapter 92, Laws of 2020), that will allow for immediate implementation of its provisions addressing health care provider payment parity in providing telemedicine services.
• The Proclamation, in order to encourage health care providers to provide telemedicine services, prohibits reimbursement of telemedicine claims at a lower rate than what the rate would be if the services had been provided in-person by:
  • Reimbursing in-network providers for telemedicine claims for medically necessary covered services at a rate lower than the contracted rate that would be paid if the services had been delivered through traditional (in-person) methods.
  • Denying a telemedicine claim from an in-network provider for a medically necessary covered service due to an existing provider contract term with that provider that denies reimbursement for services provided through telemedicine.
  • Establishing requirements for the payment of telemedicine services that are inconsistent with the emergency orders, rules or technical advisories to carriers issued by the Office of the Insurance Commissioner.

Additional Information

For additional Washington COVID-19 information, please visit:

• Washington OIC’s COVID-19 Website
• Washington State’s COVID-19 Website
• Washington State COVID-19 Infections