Issuance of a converted policy shall be subject to the following conditions:
(a) Written application for the converted policy shall be made and the first premium paid to the insurer not later than thirty-one days after termination of the group policy or contract.
(b) The converted policy shall be issued without evidence of insurability.
(c) The initial premium for the converted policy for the first twelve months and subsequent renewal premiums shall be determined in accordance with premium rates applicable to individually underwritten standard risks, to the age and class of risk of each person to be covered under the converted policy and to the type and amount of insurance provided. The experience under converted policies shall not be an acceptable basis for establishing rates for converted policies.
If an insurer experiences or incurs losses for a period of two years on conversion policies which exceed earned premiums by more than twenty percent, the insurer may file with the commissioner amended renewal rates for the subsequent year, which will produce a loss ratio of not less than one hundred twenty percent.
Conditions pertaining to health shall not be an acceptable basis for classification for the purposes of this section. The frequency of premium payment shall be the frequency customarily required by the insurer for the policy form and plan selected: Provided, That the insurer shall not require premium payments less frequently than quarterly.
Structure West Virginia Code
Article 16A. Group Health Insurance Conversion
§33-16A-1. Right of Insured to Convert From Group Coverage
§33-16A-2. Issuance of Converted Policy
§33-16A-3. Effective Date of Policy
§33-16A-4. Coverage of Dependents
§33-16A-5. Persons for Whom Coverage Not Required
§33-16A-6. Inquiries by Insurer
§33-16A-8. Preexisting Conditions; Reduction of Benefits
§33-16A-9. Alternate Plans of Conversion Coverage
§33-16A-10. Additional Coverage
§33-16A-10a. Continuum of Care Services
§33-16A-11. Combined Policy Coverage
§33-16A-12. Coverage Following Retirement