West Virginia Code
Article 24. Hospital Service Corporations, Medical Service Corporations, Dental Service Corporations and Health Service Corporations
§33-24-6. Commissioner to Enforce Article; Approval of Contracts, Forms, Rates and Fees

(a) It shall be the duty of the commissioner to enforce the provisions of this article. If the commissioner finds that a corporation is impaired, he may issue such orders and otherwise require that the corporation take all actions that in his judgment are necessary for the corporation to cure the impairment. Failure of the corporation to follow such orders and directions is evidence that the management is incompetent and grounds for an order of rehabilitation or liquidation, as the commissioner deems appropriate.
(b) No such corporation shall deliver or issue for delivery any subscriber's contract, changes in the terms of such contract, application, rider or endorsement, until a copy thereof and the rates pertaining thereto have been filed with and approved by the commissioner. All such forms filed with the commissioner shall be deemed approved after the expiration of sixty days from the date of such filing unless the commissioner shall have disapproved the same, stating his reasons for such disapproval in writing. Such forms may be used prior to the expiration of such periods if written approval thereof has been received from the commissioner.
(c) No rates to be charged subscribers shall be used or established by any such corporation unless and until the same have been filed with the commissioner and approved by him The procedure for such filing and approval shall be the same as that prescribed in subsection (b) of this section for the approval of forms. The commissioner shall approve all such rates which are not excessive, inadequate or unfairly discriminatory.
(d) The commissioner shall pass upon the actuarial soundness of the schedule of fees to be paid hospitals, physicians, dentists and other health agencies.

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