West Virginia Code
Article 24. Hospital Service Corporations, Medical Service Corporations, Dental Service Corporations and Health Service Corporations
§33-24-5. Licenses; Name of Corporation

(a) No such corporation shall enter into any contract with a subscriber until it has obtained from the commissioner a license as provided in this section. Application for a license shall be made on forms to be prescribed and furnished by the commissioner.
(b) The application shall be accompanied by a copy of the following documents: (1) Certificate of incorporation; (2) bylaws; (3) contracts between the corporation and participating hospitals, physicians, dentists or other health agencies; (4) proposed contracts to be issued to subscribers, setting forth the hospital, medical or dental service to which subscribers are entitled, and the table of rates to be charged for such service; and (5) financial statement showing the amount of contributions paid, or agreed to be paid, to the corporation for working capital, the name or names of each contributor and the terms of each contribution.
(c) The commissioner shall, upon payment to him of a license fee of $200, issue a license authorizing the corporation to transact business in this state in the area to be served by it, if he is satisfied (1) that the applicant is incorporated in this state under the provisions of article one, chapter thirty-one of this code, as a bona fide nonprofit corporation, (2) that the contracts between the corporation and participating hospitals, physicians, dentists and other health agencies contain all the terms required by section seven of this article, (3) that the working capital available to the corporation will be sufficient to pay all operating expenses, other than payment for hospital, medical or dental services, for a reasonable period after the issuance of the license, and (4) that the proposed plan will serve the best interests of all of the people of the area in which the corporation intends to operate, regardless of their race, color or economic status. Any license so issued may be renewed annually upon payment to the commissioner of a renewal fee of $200.
(d) The term of such license, renewal, refusal to license, revocation, suspension or penalty in lieu thereof shall be governed by the provisions of sections eight, nine, ten and eleven, article three of this chapter, in the same manner that these sections are applicable to insurers generally.
(e) No such corporation shall include in its name the words "insurance," "casualty," "surety," "health and accident," "accident and sickness," "mutual," or any other words descriptive of the insurance business; nor shall its name be so similar to that of any insurer which was licensed to transact insurance in this state when such corporation was formed, as to tend, in the opinion of the commissioner, to confuse the public.

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