West Virginia Code
Article 16. Group Accident and Sickness Insurance
§33-16-5. Contingencies for Which Benefits or Reimbursement of Expenses Permitted

Any such policy may provide, in addition to such other indemnities, if any, as are provided in the policy on account of sickness or bodily injury or death of insured employees or members by accident, for the payment of benefits or reimbursement for expenses with respect to any one or more of the following contingencies: Hospitalization, nursing care, medical or surgical examination or treatment, or ambulance transportation, of insured employees or members, or of their spouses or children, or of dependents living with them.

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