H. B. 4282
(By Delegates J. Miller, Blair, Cowles,
Lane, Walters, McGeehan, Shott, C. Miller,
Andes, Armstead, Sobonya)
[Introduced February 2, 2010; referred to the
Committee on Banking and Insurance then the Judiciary.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new section, designated §33-44-14, relating
to creating the "Health Care Choice Act"; and enabling
insurers authorized to sell insurance coverage in selected
states to engage in the business of insurance in West
Virginia.
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 §33-44-14, to read as
follows:
ARTICLE 44. UNAUTHORIZED INSURERS ACT.
§33-44-14. The sale of insurance by insurers licensed in
selective states.
(a) This section may be cited as the "Health Care Choice Act".
(b) The West Virginia Legislature recognizes the need for
individuals, employers and other purchasers of health insurance
coverage in this state to have the opportunity to choose health insurance plans that are more affordable and flexible than existing
market policies offering accident and sickness insurance coverage.
Therefore, the West Virginia Legislature seeks to increase the
availability of health insurance coverage by allowing insurers
authorized to engage in the business of insurance in Kentucky,
Ohio, Maryland, Pennsylvania and Virginia to issue accident and
sickness policies in West Virginia.
(c) The selected out-of-state insurers may not be required to
offer or provide state-mandated health benefits required by West
Virginia law or regulations in health insurance policies sold to
West Virginia residents.
(d) Each written application for participation in an out-of-
state health benefit plan shall contain the following language in
boldface type at the beginning of the document:
"This policy is primarily governed by the laws of {insert
state where the master policy is filed}; therefore, all of the
rating laws applicable to policies filed in West Virginia do not
apply to this policy, which may result in increases in your premium
at renewal that would not be permissible in a West Virginia-
approved policy. Any purchase of individual health insurance
should be considered carefully since future medical conditions may
make it impossible to qualify for another individual health policy.
For information concerning individual health coverage under a West
Virginia-approved policy, please consult your insurance agent or
the West Virginia Insurance Commissioner."
(e) Each out-of-state health benefit plan shall contain the
following language in boldface type at the beginning of the
document:
"The benefits of this policy providing your coverage are
governed primarily by the laws of a state other than West Virginia.
While this health benefit plan may provide you a more affordable
health insurance policy, it may also provide fewer health benefits
than those normally included as state mandated health benefits in
policies in West Virginia. Please consult your insurance agent to
determine which state-mandated health benefits are excluded under
this policy."
(f) The West Virginia Insurance Commissioner is authorized to
conduct market conduct and solvency examinations of all out-of-
state companies seeking to offer health benefit plans in this state
or who have been given approval to offer health benefit plans in
this state. These examinations shall be conducted in the same
manner and under the same terms and conditions as for companies
located in this state.
(g) The West Virginia Insurance Commissioner shall adopt rules
necessary to implement this section, including but not limited to,
determining which health insurance companies located in other
states are authorized to offer plans to West Virginia residents and
determining the manner of approving the health benefit plans
offered by these companies.
NOTE: The purpose of this bill is to create the "Health Care
Choice Act" and to allow insurance providers in selected states the
ability to engage in the practice of selling insurance in West
Virginia.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.