(a) The commissioner may investigate the business affairs and conduct of every person applying for or holding a discount medical plan organization license and the operational affairs of a discount prescription drug plan organization to determine whether a violation of this article or any rule promulgated hereunder has occurred or is occurring.
(b) If the commissioner has cause to believe that a violation of this article or any rule promulgated hereunder has occurred or is occurring and that an enforcement action may be warranted, he or she shall notify the discount medical plan organization or discount prescription drug plan organization in writing, specifically stating the grounds for enforcement action and informing the organization that it may pursue a hearing on the matter in accordance with the provisions of section thirteen, article two of this chapter.
(c) If, after notice and hearing, a violation of this article or any legislative rule promulgated under this article is found, the Insurance Commissioner may take one or more of the following enforcement actions:
(1) Place a discount medical plan organization on probation or suspend, revoke or refuse to issue or renew the organization's license;
(2) Levy a civil penalty on the organization in an amount not exceeding $10,000 for each violation;
(3) Issue an administrative order requiring the discount medical plan organization or discount prescription drug plan organization to cease and desist from engaging in the act or practice that constitutes the violation; or
(4) Suspend the authority of the discount medical plan organization or discount prescription drug plan organization to enroll new members.
(d) In addition to the penalties and other provisions of this article, the commissioner may seek both temporary and permanent injunctive relief in the circuit court of Kanawha County when a discount medical plan is being operated by a person or entity that is not licensed pursuant to this article or any person has engaged or is engaging in any activity prohibited by this article or any rule adopted pursuant to this article.
Structure West Virginia Code
§33-15E-4. Licensing Requirements
§33-15E-5. Minimum Capital Requirements
§33-15E-6. Surety Bond Requirements
§33-15E-8. Charges and Fees; Refund Requirements; Bundling of Services
§33-15E-9. Record Filing and Retention Requirements
§33-15E-10. Provider Agreements; Provider Listing Requirements
§33-15E-11. Marketing Requirements
§33-15E-13. Discount Prescription Drug Plan Organizations
§33-15E-14. Administrative Enforcement Actions; Injunctions
§33-15E-15. Criminal Penalties