West Virginia Code
Article 16. Group Accident and Sickness Insurance
§33-16-3u. Special Enrollment Period Under the American Recovery and Reinvestment Act of 2009

(a) The Legislature finds that recent attempts to assist unemployed persons during the economic downturn beginning at the end of 2008 included a federal initiative to provide subsidies to certain persons who have lost their employer-sponsored health insurance coverage. As part of the American Recovery and Reinvestment Act of 2009, certain involuntarily terminated employees and their dependents were given an second opportunity to elect subsidized COBRA coverage. This federal initiative also included relief to certain persons not covered by the federal COBRA laws, but access to such relief was made dependent on the states acting to require that such persons be given notice of their right to elect such coverage. Therefore, the Legislature intends that this section be interpreted in such a manner as to maximize the opportunity of West Virginians to obtain these much needed subsidies.
(b) Definitions. -- As used in this section:
(1) "Assistance eligible individual" means any qualified beneficiary who was eligible for continuation coverage between September 1, 2008, and February 17, 2009, due to a covered employee's termination from employment during this period and who elected such coverage.
(2) "Continuation coverage" means accident and sickness insurance coverage offered to persons pursuant to policy provisions required by subsection (e), section three of this article.
(3) "Covered employee" means a person who was involuntarily terminated by a small employer between September 1, 2008, and February 16, 2009, and at the time of his or her termination either: (i) Was eligible for but did not elect to enroll in continuation coverage; or (ii) enrolled but subsequently discontinued enrollment in continuation coverage.
(4) "Qualified beneficiary" has the same meaning as that term is defined in §607(3) of the Employee Retirement Income Security Act of 1974, 29 U.S.C. §1167(3).
(5) "Small employer" means any employer that had fewer than twenty (20) employees during fifty percent (50%) or more of its typical business days in the previous calendar year.
(c) An individual who does not have an election of continuation coverage in effect on February 17, 2009, but who would be an assistance eligible individual if such election were in effect, may elect continuation coverage pursuant to this section. Such election shall be made no later than sixty days after the date the administrator of the group health plan (or other entity involved) provides the notice required by Section 3001(a)(7) of the American Recovery and Reinvestment Act of 2009. The administrator of the group health plan (or other entity involved) shall provide such individuals with additional notice of the right to elect coverage pursuant to this subsection prior to April 18, 2009.
(d) Continuation coverage elected pursuant to subsection (c) of this section shall commence with the first period of coverage beginning on or after February 17, 2009: Provided, That continuation coverage elected pursuant to this subsection shall not extend beyond the maximum eighteen-month period provided for by subsection (e), section three of this article.
(e) With respect to an individual who elects continuation coverage pursuant to subsection (b) of this section, the period beginning on the date of the involuntary termination and ending on the date of the first period of coverage on or after February 17, 2009, shall be disregarded for purposes of determining the sixty-three day period referred to in subsection (b), section three-m of this article.

Structure West Virginia Code

West Virginia Code

Chapter 33. Insurance

Article 16. Group Accident and Sickness Insurance

§33-16-1. Scope of Article

§33-16-1a. Definitions

§33-16-1b. Applicability

§33-16-2. Eligible Groups

§33-16-3. Required Policy Provisions

§33-16-3a. Same-Mental Health

§33-16-3aa. Step Therapy

§33-16-3b. Home Health Care Coverage

§33-16-3bb. Coverage for Amino Acid-Based Formulas

§33-16-3c. Loss Ratio

§33-16-3cc. Substance Use Disorder

§33-16-3d. Medicare Supplement Insurance

§33-16-3dd. Prior Authorization

§33-16-3e. Policies to Cover Nursing Services

§33-16-3ee. Fairness in Cost-Sharing Calculation

§33-16-3f. Required Policy Provisions -- Treatment of Temporomandibular Joint Disorder and Craniomandibular Disorder

§33-16-3ff. Mental Health Parity

§33-16-3g. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing

§33-16-3gg. Incorporation of the Health Benefit Plan Network Access and Adequacy Act

§33-16-3h. Third Party Reimbursement for Rehabilitation Services

§33-16-3hh. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs

§33-16-3i. Coverage of Emergency Services

§33-16-3j. Hospital Benefits for Mothers and Newborns

§33-16-3k. Limitations on Preexisting Condition Exclusions for Health Benefit Plans

§33-16-3l. Renewability and Modification of Health Benefit Plans

§33-16-3m. Creditable Coverage

§33-16-3n. Eligibility for Enrollment

§33-16-3o. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing

§33-16-3p. Required Coverage for Reconstruction Surgery Following Mastectomies

§33-16-3q. Required Use of Mail-Order Pharmacy Prohibited

§33-16-3r. Coverage for Patient Cost of Clinical Trials

§33-16-3s. Third-Party Reimbursement for Kidney Disease Screening

§33-16-3t. Required Coverage for Dental Anesthesia Services

§33-16-3u. Special Enrollment Period Under the American Recovery and Reinvestment Act of 2009

§33-16-3v. Required Coverage for Treatment of Autism Spectrum Disorders

§33-16-3w. Maternity Coverage

§33-16-3x. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications

§33-16-3y. Eye Drop Prescription Refills

§33-16-3z. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs

§33-16-3zz. Lyme Disease to Be Covered by All Health Insurance Policies

§33-16-4. Size of Type

§33-16-5. Contingencies for Which Benefits or Reimbursement of Expenses Permitted

§33-16-6. Rider Changing Individual Policy to Group Policy Prohibited

§33-16-7. Hospital Indemnity Policies Not to Exclude Coverage for Confinement in Government Hospital

§33-16-8. Continuum of Care Services

§33-16-9. Policies Not to Terminate Coverage Because of Diagnosis or Treatment of Acquired Immune Deficiency Syndrome

§33-16-10. Policies Discriminating Among Health Care Providers

§33-16-11. Group Policies Not to Exclude Insured's Children From Coverage; Required Services; Coordination With Other Insurance

§33-16-12. Child Immunization Services Coverage

§33-16-13. Equal Treatment of State Agency

§33-16-14. Coordination of Benefits With Medicaid

§33-16-15. Individual Medical Savings Accounts; Definitions; Ownership; Contributions; Trustees; Regulations

§33-16-16. Insurance for Diabetics

§33-16-17. Commissioner to Propose Rules

§33-16-18. Assignment of Certain Benefits in Dental Care Insurance Coverage