No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless:
(a) The entire money and other considerations therefor are expressed therein; and
(b) The time at which the insurance takes effect and terminates is expressed therein; and
(c) It purports to insure only one person, except that a policy may insure, originally or by subsequent amendment upon the application of an adult member of a family who shall be deemed the policyholder, any two or more eligible members of that family, including husband, wife, dependent children or any children under a specified age which shall not exceed nineteen years and any other person dependent upon the policyholder; and
(d) The policy is guaranteed to be renewable at the option of the insured except as provided in section two-d of this article; and
(e) The style, arrangement and over-all appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any endorsements or attached papers is plainly printed in light-faced type of a style in general use, the size of which shall be uniform and not less than ten-point with a lowercase unspaced alphabet length not less than one hundred and twenty-point (the "text" shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description, if any, and captions and subcaptions), the policy shall clearly indicate on the first page the conditions of renewability; and
(f) The exceptions and reductions of indemnity are set forth in the policy and, except those which are set forth in sections four and five of this article, are printed, at the insurer's option, either included with the benefit provisions to which they apply, or under an appropriate caption such as "Exceptions," or "Exceptions and Reductions": Provided, That if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of such exception or reduction shall be included with the benefit provision to which it applies; and
(g) Each such form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first part thereof; and
(h) It contains no provision purporting to make any portion of the charter, rules, Constitution, or bylaws of the insurer a part of the policy unless such portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short-rate table filed with the commissioner; and
(i) Effective July 1, 1997, the insurer offers and accepts for enrollment pursuant to section two-b of this article every eligible individual who applies for coverage within sixty-three days after termination of the individual's prior creditable coverage.
Structure West Virginia Code
Article 15. Accident and Sickness Insurance
§33-15-1a. Premium Rate Increase Requests; Loss Ratio Requirement
§33-15-1b. Rates, Individual Major Medical Policies
§33-15-2. Scope and Format of Policy
§33-15-2b. Guaranteed Issue; Limitation of Coverage; Election; Denial of Coverage; Network Plans
§33-15-2c. Feasibility Study for Alternatives to Guaranteed Issue
§33-15-2d. Exceptions to Guaranteed Renewability
§33-15-2f. Certification of Creditable Coverage
§33-15-4. Required Policy Provisions
§33-15-4a. Required Policy Provisions-Mental Illness
§33-15-4b. Policies to Cover Nursing Services; Definition
§33-15-4c. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-15-4d. Third Party Reimbursement for Rehabilitation Services
§33-15-4e. Benefits for Mothers and Newborns
§33-15-4f. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-15-4g. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-15-4h. Coverage for Patient Cost of Clinical Trials
§33-15-4i. Third-Party Reimbursement for Kidney Disease Screening
§33-15-4j. Required Coverage for Dental Anesthesia Services
§33-15-4l. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-15-4m. Eye Drop Prescription Refills
§33-15-4n. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-15-4p. Lyme Disease to Be Covered by All Health Insurance Policies
§33-15-4q. Coverage for Amino Acid-Based Formulas
§33-15-4r. Substance Use Disorder
§33-15-4s. Prior Authorization
§33-15-4t. Fairness in Cost-Sharing Calculation
§33-15-4u. Mental Health Parity
§33-15-4v. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-15-4w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-15-5. Optional Policy Provisions
§33-15-6. Inapplicable or Inconsistent Provisions
§33-15-7. Order of Certain Provisions
§33-15-8. Third Party Ownership of Policy Covering Insured
§33-15-9. Requirements of Other Jurisdictions
§33-15-10. Franchise Insurance
§33-15-12. Continuum of Care Services
§33-15-14. Policies Discriminating Among Health Care Providers
§33-15-17. Child Immunization Services Coverage
§33-15-18. Equal Treatment of State Agency
§33-15-19. Coordination of Benefits With Medicaid
§33-15-20. Individual Medical Savings Accounts; Definitions; Ownership; Trustees; Regulations
§33-15-21. Coverage of Emergency Services
§33-15-22. Assignment of Certain Benefits in Dental Care Insurance Coverage