A preexisting condition is an injury, or sickness, or any condition relating to that injury, or sickness, for which a participant is diagnosed, receives treatment, or incurs expenses prior to the effective date of coverage.
For all participants enrolling in the plan after the effective date of this section, payment shall be made for expenses incurred for or in connection with a preexisting condition: Provided, That participants may enroll or make plan selections only at the time of hire, during annual open enrollment or upon the occurrence of a "qualifying event" under section 125 of the United States Internal Revenue Code.
Structure West Virginia Code
Article 16. West Virginia Public Employees Insurance Act
§5-16-1. Short Title; Legislative Intent
§5-16-5a. Retiree Premium Subsidy From Retiree Health Benefit Trust for Hires Prior to July 1, 2010
§5-16-5b. Creation of Trust for Retirees Hired on or After July 1, 2010
§5-16-7b. Coverage for Telehealth Services
§5-16-7c. Required Coverage for Reconstruction Surgery Following Mastectomies
§5-16-7d. Coverage for Patient Cost of Clinical Trials
§5-16-7g. Coverage for Prescription Insulin Drugs
§5-16-8. Conditions of Insurance Program
§5-16-11. To Whom Benefits Paid
§5-16-12. Misrepresentation by Employer, Employee or Provider; Penalty
§5-16-12a. Inspections; Violations and Penalties
§5-16-12b. Privileges and Immunity
§5-16-14. Program Qualifying for Favorable Federal Income Tax Treatment
§5-16-16. Preferred Provider Plan
§5-16-17. Preexisting Conditions Not Covered; Defined
§5-16-22. Permissive Participation; Exemptions
§5-16-28. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs