(a) The requirements of sections two-b, two-d, two-e and two-f of this article and the provisions of this article which generally require policies of accident and sickness insurance to cover specific conditions or treatments, but which are not expressly made applicable to the following types of policies, do not apply to:
(1) Coverage only for accident, or disability income insurance or any combination thereof;
(2) Coverage issued as a supplement to liability insurance;
(3) Liability insurance, including general liability insurance and automobile liability insurance;
(4) Workers' Compensation or similar insurance;
(5) Automobile medical payment insurance;
(6) Credit-only insurance;
(7) Coverage for on-site medical clinics; and
(8) Other similar insurance coverage, which may be specified by rule, under which benefits for medical care are secondary or incidental to other insurance benefits.
(b) The requirements of sections two-b, two-d, two-e and two-f of this article and the provisions of this article which generally require policies of accident and sickness insurance to cover specific conditions or treatments, but which are not expressly made applicable to the following types of policies, do not apply to the following if provided under a separate policy, certificate, or contract of insurance:
(1) Limited scope dental or vision benefits;
(2) Benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof;
(3) Coverage for only a specified disease or illness;
(4) Hospital indemnity or other fixed indemnity insurance;
(5) Medicare supplement insurance (as defined under section 1882(g)(1) of the Social Security Act), coverage supplemental to the coverage provided under chapter 55 of title 10, United States Code, and similar supplemental coverage provided to coverage under group accident and sickness insurance; and
(6) Any other benefits as may be specified by rule.
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