West Virginia Code
Article 24. Hospital Service Corporations, Medical Service Corporations, Dental Service Corporations and Health Service Corporations
§33-24-4. Exemptions; Applicability of Insurance Laws

(a) Every corporation defined in 33-24-2 of this code is hereby declared to be a scientific, nonprofit institution and exempt from the payment of all property and other taxes. Every corporation, to the same extent the provisions are applicable to insurers transacting similar kinds of insurance and not inconsistent with the provisions of this article, shall be governed by and be subject to the provisions as herein below indicated, of the following articles of this chapter: 33-2-1 et seq. of this code (Insurance Commissioner); 33-4-1 et seq. of this code (general provisions), except that 33-4-16 of this code may not be applicable thereto; 33-5-20 of this code (borrowing by insurers); 33-6-34 of this code (fee for form, rate and rule filing); 33-6C-1 et seq. of this code (guaranteed loss ratios as applied to individual sickness and accident insurance policies); 33-7-1 et seq. of this code (assets and liabilities); 33-8A-1 et seq. of this code (use of clearing corporations and Federal Reserve book-entry system); 33-11-1 et seq. of this code (unfair trade practices); 33-12-1 et seq. of this code (insurance producers and solicitors), except that the agents license fee shall be $25; 33-15-2a of this code (definitions); 33-15-2b of this code (guaranteed issue; limitation of coverage; election; denial of coverage; network plans); 33-15-2d of this code (exceptions to guaranteed renewability); 33-15-2e of this code (discontinuation of particular type of coverage; uniform termination of all coverage; uniform modification of coverage); 33-15-2f of this code (certification of creditable coverage); 33-15-2g (applicability); 33-15-4e of this code (benefits for mothers and newborns); 33-15-14 of this code (policies discriminating among health care providers); 33-15-16 of this code (policies not to exclude insureds children from coverage; required services; coordination with other insurance); 33-15-18 of this code (equal treatment of state agency); 33-15-19 of this code (coordination of benefits with Medicaid); 33-15A-1 et seq. of this code (West Virginia Long-Term Care Insurance Act); 33-15C-1 et seq. of this code (diabetes insurance); 33-16-3 of this code (required policy provisions); 33-16-3a of this code (same - mental health); 33-16-3d of this code (Medicare supplement insurance); 33-16-3f of this code (required policy provisions - treatment of temporomandibular joint disorder and craniomandibular disorder); 33-16-3j of this code (hospital benefits for mothers and newborns); 33-16-3k of this code (limitations on preexisting condition exclusions for health benefit plans); 33-16-3l of this code (renewability and modification of health benefit plans); 33-16-3m of this code (creditable coverage); 33-16-3n of this code (eligibility for enrollment); 33-16-11 of this code (group policies not to exclude insureds children from coverage; required services; coordination with other insurance); 33-16-13 of this code (equal treatment of state agency); 33-16-14 of this code (coordination of benefits with Medicaid); 33-16-16 of this code (insurance for diabetics); 33-16A-1 et seq. of this code (group health insurance conversion); 33-16C-1 et seq. of this code (employer group accident and sickness insurance policies); 33-16D-1 et seq. of this code (marketing and rate practices for small employer accident and sickness insurance policies); 33-26A-1 et seq. of this code (West Virginia Life and Health Insurance Guaranty Association Act), after October 1, 1991, 33-27-1 et seq. of this code (insurance holding company systems); 33-28-1 et seq. of this code (individual accident and sickness insurance minimum standards); 33-33-1 et seq. of this code (annual audited financial report); 33-34-1 et seq. of this code (administrative supervision); 33-34A-1 et seq. of this code (standards and commissioners authority for companies considered to be in hazardous financial condition); 33-35-1 et seq. of this code (criminal sanctions for failure to report impairment); 33-37-1 et seq. of this code (managing general agents); 33-40A-1 et seq. of this code (risk-based capital for health organizations); and 33-41-1 et seq. of this code (Insurance Fraud Prevention Act) and no other provision of this chapter may apply to these corporations unless specifically made applicable by the provisions of this article. If, however, the corporation is converted into a corporation organized for a pecuniary profit or if it transacts business without having obtained a license as required by 33-24-5 of this code, it shall thereupon forfeit its right to these exemptions.
(b) Every corporation subject to this article shall comply with mental health parity requirements in this chapter.

Structure West Virginia Code

West Virginia Code

Chapter 33. Insurance

Article 24. Hospital Service Corporations, Medical Service Corporations, Dental Service Corporations and Health Service Corporations

§33-24-1. Declaration of Policy

§33-24-2. Definitions

§33-24-3. Corporations Affected by Article; Eligibility of Hospitals, Physicians, Dentists, Chiropodists-Podiatrists and Chiropractors

§33-24-4. Exemptions; Applicability of Insurance Laws

§33-24-4a. Coverage for Patient Cost of Clinical Trials

§33-24-4b. Applicability of Insurance Fraud Prevention Act

§33-24-5. Licenses; Name of Corporation

§33-24-6. Commissioner to Enforce Article; Approval of Contracts, Forms, Rates and Fees

§33-24-6a. Loss Ratio

§33-24-7. Required Provisions in Contracts Made by Corporations With Hospitals, Physicians, Dentists and Other Health Agencies

§33-24-7a. Contracts to Cover Nursing Service

§33-24-7b. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing

§33-24-7c. Third Party Reimbursement for Rehabilitation Services

§33-24-7d. Required Provisions in Contracts Which Include Child Immunization Services in the Terms of the Contract

§33-24-7e. Coverage of Emergency Services

§33-24-7f. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing

§33-24-7g. Required Coverage for Reconstruction Surgery Following Mastectomies

§33-24-7h. Required Use of Mail-Order Pharmacy Prohibited

§33-24-7i. Third-Party Reimbursement for Kidney Disease Screening

§33-24-7j. Required Coverage for Dental Anesthesia Services

§33-24-7k. Coverage for Diagnosis and Treatment of Autism Spectrum Disorders

§33-24-7l. Maternity Coverage

§33-24-7m. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications

§33-24-7n. Eye Drop Prescription Refills

§33-24-7o. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs

§33-24-7p. Step Therapy

§33-24-7q. Coverage for Amino Acid-Based Formulas

§33-24-7r. Substance Use Disorder

§33-24-7s. Prior Authorization

§33-24-7t. Fairness in Cost-Sharing Calculation

§33-24-7u. Mental Health Parity

§33-24-7v. Incorporation of the Health Benefit Plan Network Access and Adequacy Act

§33-24-7w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs

§33-24-8. Contract or Certificate to Be Furnished to Policyholders and Subscribers; Payment for Health Care Rendered Needy Persons

§33-24-9. Payroll Deduction for Governmental Employees

§33-24-10. Investments; Bonds of Corporate Officers and Employees, Minimum Statutory Surplus

§33-24-11. Reciprocity With Other Service Plans; Payment Authorized

§33-24-12. Creation of Subsidiary Corporation or Corporations

§33-24-13. Continuum of Care Services

§33-24-14. Delinquency Proceedings

§33-24-43. Policies Discriminating Among Health Care Providers

§33-24-44. Authority of Commissioner to Promulgate Rules and Regulations Regarding Affiliate and Subsidiary Operating Results

§33-24-45. Assignment of Certain Benefits in Dental Care Insurance Coverage