Committee Substitute
House Bill 2457 History
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Introduced Version
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Key: Green = existing Code. Red = new code to be enacted
COMMITTEE SUBSTITUTE
FOR
H. B. 2457
(By Delegates Walters, Ashley and Hartman)
(Originating in the House Committee on the Judiciary)
[March 27, 2009]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new section, designated §33-16-18, relating
to requiring insurers issuing group accident and sickness
insurance policies to certain employers to furnish claims loss
experience to policyholders upon request of a policyholder;
and identifying the claims loss experience information to be
provided.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new section, designated §33-16-18, to read as
follows:
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-18. Claims loss experience to be furnished to certain
employer group accident and sickness policyholders.
(a) In cases of employers insuring fifty-one or more covered
employees, members or enrollees, not including dependents, an
insurer issuing a group accident and sickness insurance policy in this state subject to the provisions of this article
shall furnish
to the policyholder, within thirty days of the date of request,
the
policyholder's claims loss experience
,
regardless of the rating
methodology used, unless (1) claims loss information required by
this section has been furnished to the policyholder within the
preceding six months, or (2) the policyholder has been insured by
the insurer less than 10 months
: Provided, That insurers are not
required to furnish such information for insurance which is not
rated based on claims experience.
(b) The claims loss experience information shall be provided
for the time the policy and any renewals thereof have been in
effect, but not exceeding the previous two policy years prior to
the request, and shall include:
(1) Earned premiums separated by policy year for at least the
last two policy years, if applicable;
(2) Total paid claims and total incurred claims, inclusive of
any high amount or pooled claims, including both capitated and
noncapitated expenses set forth in the same manner as premiums; and
(3) Any amounts in excess of the individual pooling or stop
loss point applicable to the group.
(c) The claims loss information shall not include any
information prohibited from disclosure by any applicable federal
law or law of this state.
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