(a) For the purpose of providing the funds necessary for the association to carry out its duties under this article, the initial assessment of health maintenance organizations shall be as follows:
(1) Each health maintenance organization possessing a valid certificate of authority issued by the commissioner on or before the effective date of this article shall pay an initial assessment of five thousand dollars.
(2) Prior to and as a condition of first receiving a certificate of authority from the commissioner after the effective date of this article, a health maintenance organization shall pay an initial assessment of five thousand dollars.
(b) To obtain funds to pay administrative expenses, including, but not limited to, legal costs, the association may make additional assessments. The association shall make only such assessments as are necessary to pay expenses or debts which have been incurred by the association, or are reasonably foreseeable. Assessments shall be based on the annual earned premium revenue for nonmedicare and nonmedicaid contracts allocated to West Virginia in the preceding calendar year unless the association, in its discretion, substitutes such other amount that more accurately reflects a health maintenance organization's current activity within this state. The rate used to compute the assessment shall be the same for all health maintenance organizations.
(c) Assessments shall be made by issuing written notice of theassessment to the health maintenance organizations, and shall be due thirty days after the issuance of such written notice. Assessments which are not paid when due shall accrue interest at a reasonable rate to be set by the association, subject to the approval of the commissioner.
(d) With the approval of the commissioner, the association may abate or defer, in whole or in part, the assessment of a health maintenance organization if, in the opinion of the association, immediate payment of the assessment would materially impair the health maintenance organization's ability to fulfill its contractual obligations. The amount by which an assessment is abated or deferred may be assessed against the other health maintenance organizations in addition to all other assessments called for by this section.
(e) The association may, by an equitable method established in its plan of operation, refund to health maintenance organizations all or part of an assessment which the association determines is unnecessary to carry out its duties. Refunds shall be proportional to the amounts actually paid by the health maintenance organizations to satisfy the assessment.
(f) It shall be proper for any health maintenance organization, in determining its premium rates, to consider the amount reasonably necessary to meet its assessment obligations under this article.
(g) The association shall issue to each health maintenanceorganization paying an assessment under this article a certificate of contribution for the amount paid. All outstanding certificates shall be of equal dignity and priority without reference to amounts or dates of issue. For purposes of determining the financial condition of the health maintenance organization, a certificate of contribution shall be treated as an asset of such form, amount and duration as the commissioner may prescribe.
Note: WV Code updated with legislation passed through the 2015 Regular Session
The WV Code Online is an unofficial copy of the annotated WV Code, provided as a convenience. It has NOT been edited for publication, and is not in any way official or authoritative.