Section 284-43-6540. Summary for group contract filings other than small group contract filings.

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Groups Other Than Small Groups Filing Summary

If additional space is required to list the contract/rate form number and product name, attach a separate sheet.

Proposed Rate Schedules: Attach a separate sheet to list all proposed tier rates.

Rate Summary

Summary of Contract Experience

[Statutory Authority: RCW 48.02.060, 48.44.050, 48.46.200, 48.44.020 (2)(d), 48.44.022, 48.44.023, 48.46.060 (3)(d) and (5), 48.46.064, 48.46.066, and 2015 c 19. WSR 16-03-018 (Matter No. R 2015-04), § 284-43-6540, filed 1/8/16, effective 1/8/16.]

RCW 48.02.060, 48.44.050, 48.46.200, 48.44.020 (2)(d), 48.44.022, 48.44.023, 48.46.060 (3)(d) and (5), 48.46.064, 48.46.066, and 2015 c 19. WSR 16-03-018 (Matter No. R 2015-04), § 284-43-6540, filed 1/8/16, effective 1/8/16.

                    
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