(a) An insurer may discontinue offering a particular type of accident and sickness insurance coverage in the individual market only if:
(1) The insurer provides written notice to each individual provided this type of coverage at least ninety days prior to the date of the discontinuation of coverage;
(2) The insurer offers to each individual in the individual market provided this type of coverage the option to purchase any other type of individual accident and sickness insurance policy currently offered by that insurer; and
(3) The insurer acts uniformly without regard to any health status-related factor of enrolled individuals or individuals who may become eligible for coverage.
(b) An insurer may discontinue offering all individual accident and sickness insurance coverage in the individual market offered in this state only if:
(1) The insurer provides written notice to the Insurance Commissioner and to each insured of the discontinuation at least one hundred eighty days prior to the expiration of coverage; and
(2) All accident and sickness insurance policies issued or delivered for issuance in this state in the individual market are discontinued and coverage under the policies in the individual market is not renewed.
(c) In the case of discontinuation under subsection (b) of this section, the insurer may not provide for the issuance of any accident and sickness insurance coverage in the individual market and state during the five-year period beginning on the date of the discontinuation of the last accident and sickness insurance coverage not so renewed.
(d) At the time of renewal, an insurer may modify coverage under an accident and sickness policy only if the modification is consistent with the provisions of this article and article twenty-eight of this chapter and is effective on a uniform basis among all individuals with that policy form. For individuals who are eligible for Medicare at the time of renewal, the insurer may modify coverage to reduce benefits by an amount no more than that paid by Medicare.
(e) This section applies to individual accident and sickness insurance coverage offered, sold, issued, renewed or in effect after June 30, 1997.
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