If a corporation considers a loss ratio at the time of renewal of a policy, plan, or contract, the corporation shall, upon request of a subscriber, provide the loss ratio and the components of the loss ratio calculation to the subscriber no more than 90 days but no less than 60 days before the renewal date of the policy, plan, or contract. For purposes of this section, "loss ratio" means the total losses paid out in medical claims divided by the total earned premiums.
Medical claims do not include dental only or vision only coverage.
Structure West Virginia Code
Article 25. Health Care Corporations
§33-25-1. Declaration of Policy
§33-25-3. Incorporation; Purposes; Name; Limitations
§33-25-5. Exemption From Taxes
§33-25-6. Supervision and Regulation by Insurance Commissioner; Exemption From Insurance Laws
§33-25-6a. Applicability of Insurance Fraud Prevention Act
§33-25-8a. Third Party Reimbursement for Mammography or Pap Smear or Human Papilloma Virus Testing
§33-25-8b. Third Party Reimbursement for Rehabilitation Services
§33-25-8c. Third Party Payment for Child Immunization Services
§33-25-8d. Coverage of Emergency Services
§33-25-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-25-8f. Required Use of Mail-Order Pharmacy Prohibited
§33-25-8g. Third-Party Reimbursement for Kidney Disease Screening
§33-25-8h. Required Coverage for Dental Anesthesia Services
§33-25-8j. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-25-8k. Eye Drop Prescription Refills
§33-25-8l. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-25-8n. Coverage for Amino Acid-Based Formulas
§33-25-8o. Substance Use Disorder
§33-25-8p. Prior Authorization
§33-25-8q. Fairness in Cost-Sharing Calculation
§33-25-8r. Mental Health Parity
§33-25-8s. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-25-8t. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-25-11. Rules and Regulations
§33-25-14. Advancement of Money to Corporation
§33-25-16. Disposition of Fees and Charges
§33-25-17. Bonds of Corporation Officers and Employees
§33-25-18. Annual Audited Financial Report
§33-25-19. Administrative Supervision
§33-25-20. Policies Discriminating Among Health Care Providers
§33-25-22. Assignment of Certain Benefits in Dental Care Insurance Coverage