Craig R Jolley, Dmd, Pllc, App V. State Of WA Office Of Insurance Commissioner., Resp

CourtCourt of Appeals of Washington
DecidedMay 28, 2025
Docket59466-8
StatusUnpublished

This text of Craig R Jolley, Dmd, Pllc, App V. State Of WA Office Of Insurance Commissioner., Resp (Craig R Jolley, Dmd, Pllc, App V. State Of WA Office Of Insurance Commissioner., Resp) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Craig R Jolley, Dmd, Pllc, App V. State Of WA Office Of Insurance Commissioner., Resp, (Wash. Ct. App. 2025).

Opinion

Filed Washington State Court of Appeals Division Two

May 28, 2025

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION II CRAIG R. JOLLEY, DMD, PLLC, No. 59466-8-II

Appellant,

v.

WASHINGTON STATE OFFICE OF UNPUBLISHED OPINION INSURANCE COMMISSIONER (Mike Kreidler, Commissioner),

Respondent.

GLASGOW, J.—The Office of the Insurance Commissioner for Washington State (Insurance

Commissioner) regulates insurers, including imposing fines for the unauthorized provision of

insurance. But health care providers who operate “direct practices” are not considered insurers.

The insurance code defines a direct practice in relevant part as a “health care provider who

furnishes primary care services through a direct agreement.” RCW 48.150.010(4)(a)(i). A provider

may not operate a direct practice unless they submit an annual statement to the Insurance

Commissioner.

Dr. Craig Jolley is a dentist and business owner who offered a membership club, allowing

uninsured patients to pay a monthly fee in exchange for certain services including dental cleanings

and exams. After an investigation, the Insurance Commissioner determined that Jolley’s

membership club met the definition of insurance and issued a cease and desist order for the No. 59466-8-II

unauthorized provision of insurance. At no point during the investigation did Jolley claim to be

operating a direct practice. The cease and desist order did not mention the direct practice provision.

Jolley sought administrative review of the cease and desist order arguing that his

membership club was a direct practice that could not be considered insurance. He also claimed

that the Insurance Commissioner had unlawfully adopted a rule excluding dentists from operating

direct practices, but the administrative law judge (ALJ) declined to consider Jolley’s rule

challenge. The ALJ’s order explained that the rule challenge could be raised directly in Thurston

County Superior Court without a need to exhaust administrative remedies. The administrative

review of the cease and desist order continued because other issues remained.

While the administrative adjudication was pending, Jolley filed a petition in Thurston

County Superior Court seeking review of an alleged rule that excluded dentists from the direct

practice program. The rule challenge was based on the Insurance Commissioner’s statements in

legislative reports, public webpages, and a letter to the Washington State Dental Association.

Jolley argued that these statements constituted “rules” that were adopted without following the

rule making procedures of the Administrative Procedure Act (APA), chapter 34.05 RCW. Jolley’s

petition also sought an injunction prohibiting enforcement of the cease and desist order,

characterizing it as unlawful enforcement of the alleged rule. But Jolley did not ask that the order

be invalidated.

The Insurance Commissioner moved to dismiss Jolley’s petition because Jolley failed to

exhaust his administrative remedies before filing. The trial court granted the Insurance

Commissioner’s motion and dismissed the petition after concluding that the APA’s exhaustion

requirement applied to all of Jolley’s claims.

2 No. 59466-8-II

Jolley appeals, arguing that exhaustion was not required for his rule challenge. Jolley’s

assignments of error and briefing do not challenge the dismissal of the portion of his petition

challenging the alleged enforcement of the rule or seeking injunctive relief from the cease and

desist order.

The Insurance Commissioner raises two threshold arguments: that Jolley lacks standing

and that the appeal is moot. We disagree. Jolley has standing to raise the alleged procedural harm

of being denied notice and an opportunity to comment on an agency’s alleged rule before adoption.

And the appeal is not moot because substantial issues remain for the trial court to consider—first

and foremost, whether the alleged statements qualify as a “rule” under the APA.

Turning to the merits, Jolley argues that the trial court erred when it dismissed his rule

challenge based on his failure to exhaust his administrative remedies. The Insurance Commissioner

responds that the petition is not a rule challenge but an attempt to obtain collateral review of the

cease and desist order, so exhaustion was required. We agree with Jolley because his petition on

its face raised a rule challenge under RCW 34.05.570(2)(b)(i), and the APA does not require

exhaustion of administrative remedies for such a claim. Jolley does not argue on appeal that the

trial court erred when it dismissed his other claims, so we need not consider them. We remand for

the trial court to conduct a review of the alleged rule where the first step is to determine whether

the agency statements that Jolley takes issue with were in fact a “rule” within the meaning of the

APA. See, e.g., Nw. Pulp & Paper Ass’n v. Dep’t of Ecology, 200 Wn.2d 666, 673-76, 520 P.3d

985 (2022); Simpson Tacoma Kraft Co. v. Dep’t of Ecology, 119 Wn.2d 640, 646-49, 835 P.2d

1030 (1992).

3 No. 59466-8-II

FACTS

I. BACKGROUND

The Insurance Commissioner is head of a state agency responsible for enforcing

Washington’s insurance code, including investigating the unauthorized provision of insurance.

RCW 48.02.060(3)(a)-(b). If someone is acting as an insurer without authorization, the Insurance

Commissioner may issue a cease and desist order and impose civil penalties. RCW

48.15.023(5)(a)(i)-(ii).

Direct practices are an alternative payment model for primary care services “in which

patients enter into a direct relationship with medical practitioners and pay a fixed amount directly

to the health care provider.” RCW 48.150.005. The Insurance Commissioner is charged with

collecting required annual statements from direct practices, which are not considered insurers

under the code. RCW 48.150.060, .100(1). Specifically, a direct practice provider may not engage

in a direct practice under the statute unless they submit an annual statement to the Insurance

Commissioner containing certain information. RCW 48.150.100(2). The statute gives the

Insurance Commissioner the authority to develop the form and content of the annual statement.

RCW 48.150.100(1).

Dr. Craig Jolley is a dentist who owns his practice, Craig R. Jolley, DMD, PLLC (Jolley).

Jolley offered a “membership club” to uninsured patients, allowing them to pay a monthly fee in

exchange for certain services including dental cleanings and exams. Clerk’s Papers (CP) at 518.

The club included three tiers with different monthly fees and varying levels of service. While

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