West Virginia Code
Article 25A. Health Maintenance Organization Act
§33-25A-8k. Maternity Coverage

Notwithstanding any provision of any policy, provision, contract, plan or agreement applicable to this article, a health insurance policy subject to this article, issued or renewed on or after January 1, 2014, which provides health insurance coverage for maternity services, shall provide coverage for maternity services for all persons participating in, or receiving coverage under the policy. To the extent that the provisions of this section require benefits that exceed the essential health benefits specified under section 1302(b) of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended, the specific benefits that exceed the specified essential health benefits are not required of a health benefit plan when the plan is offered by a health care insurer in this state. Coverage required under this section may not be subject to exclusions or limitations which are not applied to other maternity coverage under the policy.

Structure West Virginia Code

West Virginia Code

Chapter 33. Insurance

Article 25A. Health Maintenance Organization Act

§33-25A-1. Short Title and Purpose

§33-25A-2. Definitions

§33-25A-3. Application for Certificate of Authority

§33-25A-3a. Conditions Precedent to Issuance or Maintenance of a Certificate of Authority; Renewal of Certificate of Authority; Effect of Bankruptcy Proceedings

§33-25A-4. Issuance of Certificate of Authority

§33-25A-5. Powers of Health Maintenance Organizations

§33-25A-6. Governing Body

§33-25A-7. Fiduciary Responsibilities of Officers; Fidelity Bond; Approval of Contracts by Commissioner

§33-25A-7a. Provider Contracts

§33-25A-7b. Loss Ratio

§33-25A-8. Evidence of Coverage; Charges for Health Care Services; Review of Enrollee Records; Cancellation of Contract by Enrollee

§33-25A-8a. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing

§33-25A-8b. Third Party Reimbursement for Rehabilitation Services

§33-25A-8c. Third Party Payment for Child Immunization Services

§33-25A-8d. Coverage of Emergency Services

§33-25A-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing

§33-25A-8f. Required Coverage for Reconstruction Surgery Following Mastectomies

§33-25A-8g. Required Use of Mail-Order Pharmacy Prohibited

§33-25A-8h. Third-Party Reimbursement for Kidney Disease Screening

§33-25A-8i. Third-Party Reimbursement for Dental Anesthesia Services

§33-25A-8j. Coverage for Diagnosis and Treatment of Autism Spectrum Disorders

§33-25A-8k. Maternity Coverage

§33-25A-8l. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications

§33-25A-8m. Eye Drop Prescription Refills

§33-25A-8n. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs

§33-25A-8o. Step Therapy

§33-25A-8p. Lyme Disease to Be Covered by All Health Insurance Policies

§33-25A-8q. Coverage for Amino Acid-Based Formulas

§33-25A-8r. Substance Use Disorder

§33-25A-8s. Prior Authorization

§33-25A-8t. Fairness in Cost-Sharing Calculation

§33-25A-8u. Mental Health Parity

§33-25A-8v. Incorporation of the Health Benefit Plan Access and Adequacy Act

§33-25A-8w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs

§33-25A-9. Annual Report

§33-25A-10. Information to Enrollees

§33-25A-11. Open Enrollment Period

§33-25A-12. Grievance Procedure

§33-25A-13. Investments

§33-25A-14. Prohibited Advertising Practices

§33-25A-14a. Other Prohibited Practices

§33-25A-15. Agent Licensing and Appointment Required; Regulation of Marketing

§33-25A-16. Powers of Insurers and Hospital and Medical Service Corporations

§33-25A-17. Examinations

§33-25A-17a. Quality Assurance

§33-25A-18. Suspension or Revocation of Certificate of Authority

§33-25A-19. Rehabilitation, Liquidation or Conservation of Health Maintenance Organization

§33-25A-20. Regulations

§33-25A-21. Administrative Procedures

§33-25A-22. Fees

§33-25A-23. Penalties and Enforcement

§33-25A-23a. Civil Penalty Imposed by Commissioner

§33-25A-24. Scope of Provisions; Applicability of Other Laws

§33-25A-25. Filings and Reports as Public Documents

§33-25A-26. Confidentiality of Medical Information

§33-25A-27. Authority to Contract With Health Maintenance Organizations Under Medicaid

§33-25A-28. Required Health Maintenance Organization Option

§33-25A-31. Policies Discriminating Among Health Care Providers

§33-25A-32. Authority of Commissioner to Promulgate Rules and Regulations Regarding Affiliate and Subsidiary Operating Results

§33-25A-33. Guaranty Fund

§33-25A-34. Ambulance Services

§33-25A-35. Rural Health Maintenance Organizations

§33-25A-36. Assignment of Certain Benefits in Dental Care Insurance Coverage