West Virginia Code
Chapter 5. General Powers and Authority of the Governor, Secretary of State and Attorney General; Board of Public Works; Miscellaneous Agencies, Commissions, Offices, Programs, etc.
Article 16. West Virginia Public Employees Insurance Act

§5-16-1. Short Title; Legislative Intent - The short title by which this article may be referred...

§5-16-2. Definitions - The following words and phrases as used in this article,...

§5-16-3. Composition of Public Employees Insurance Agency; Appointment, Qualification, Compensation and Duties of Director of Agency; Employees; Civil Service Coverage - (a) The Public Employees Insurance Agency consists of the director,...

§5-16-4. Public Employees Insurance Agency Finance Board Continued; Qualifications, Terms, and Removal of Members; Quorum; Compensation and Expenses; Termination Date - (a) The Public Employees Insurance Agency Finance Board is continued...

§5-16-5. Purpose, Powers and Duties of the Finance Board; Initial Financial Plan; Financial Plan for Following Year; and Annual Financial Plans - (a) The purpose of the finance board created by this...

§5-16-5a. Retiree Premium Subsidy From Retiree Health Benefit Trust for Hires Prior to July 1, 2010 - The Finance Board may include in its financial plans a...

§5-16-5b. Creation of Trust for Retirees Hired on or After July 1, 2010 - There is hereby created a special revenue account in the...

§5-16-7. Authorization to Establish Group Hospital and Surgical Insurance Plan, Group Major Medical Insurance Plan, Group Prescription Drug Plan, and Group Life and Accidental Death Insurance Plan; Rules for Administration of Plans; Mandated Benefits... - (a) The agency shall establish a group hospital and surgical...

§5-16-7a. Additional Mandated Benefits; Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing - (a) Notwithstanding any provision of any policy, provision, contract, plan...

§5-16-7b. Coverage for Telehealth Services - (a) The following terms are defined: (1) “Distant site” means...

§5-16-7c. Required Coverage for Reconstruction Surgery Following Mastectomies - (a) The plan shall provide, in a case of a...

§5-16-7d. Coverage for Patient Cost of Clinical Trials - (a) The provisions of this section and section seven-e of...

§5-16-7e. Definitions - For purposes of section seven-d of this article: (a) A...

§5-16-7f. Prior Authorization - (a) As used in this section, the following words and...

§5-16-7g. Coverage for Prescription Insulin Drugs - (a) A policy, plan, or contract that is issued or...

§5-16-8. Conditions of Insurance Program - The insurance plans provided for in this article shall be...

§5-16-8a. Air-Ambulance Fees - (a) The plan shall reimburse any air-ambulance provider that provides...

§5-16-9. Authorization to Execute Contracts for Group Hospital and Surgical Insurance, Group Major Medical Insurance, Group Prescription Drug Insurance, Group Life and Accidental Death Insurance, and Other Accidental Death Insurance; Mandated Benefit... - (a) The director is given exclusive authorization to execute such...

§5-16-10. Contract Provisions for Group Hospital and Surgical, Group Major Medical, Group Prescription Drug and Group Life and Accidental Death Insurance for Retired Employees, Their Spouses and Dependents - Any contract or contracts entered into hereunder may provide for...

§5-16-11. To Whom Benefits Paid - Any benefits payable under any group hospital and surgical, group...

§5-16-12. Misrepresentation by Employer, Employee or Provider; Penalty - (a) It shall be a violation of this article for...

§5-16-12a. Inspections; Violations and Penalties - (a) Employers and employees participating in any of the Public...

§5-16-12b. Privileges and Immunity - (a) Any person who makes a report or furnishes information,...

§5-16-13. Payment of Costs by Employer and Employee; Spouse and Dependent Coverage; Involuntary Employee Termination Coverage; Conversion of Annual Leave and Sick Leave Authorized for Health or Retirement Benefits; Authorization for Retiree Participa... - (a) Cost-sharing. -- The director shall provide under any contract...

§5-16-14. Program Qualifying for Favorable Federal Income Tax Treatment - The director shall develop, implement and have in place by...

§5-16-15. Optional Dental, Optical, Disability and Prepaid Retirement Plan and Audiology and Hearing-Aid Service Plan - (a) On and after July 1, 1989, the director shall...

§5-16-16. Preferred Provider Plan - The director shall, on or before April 1, 1988, or...

§5-16-17. Preexisting Conditions Not Covered; Defined - A preexisting condition is an injury, or sickness, or any...

§5-16-18. Payment of Costs by Employer; Schedule of Insurance; Special Funds Created; Duties of Treasurer With Respect Thereto - (a) All employers operating from state general revenue or special...

§5-16-19. Authorization to Take Advantage of Acts of Congress, Accept Gifts, Grants and Matching Funds - The Public Employees Insurance Agency is authorized to take full...

§5-16-20. Expense Fund - The Legislature shall annually appropriate such sums as may be...

§5-16-21. No Member or Employee of Public Employees Insurance Agency Shall Gain Directly or Indirectly From Any Contract or Contracts Provided for Hereunder; Criminal Penalties - No elected or appointed official of the State of West...

§5-16-22. Permissive Participation; Exemptions - The provisions of this article are not mandatory upon any...

§5-16-23. Members of Legislature May Be Covered, if Cost of the Entire Coverage Is Paid by Such Members - Notwithstanding the definition of the term "employee" contained in section...

§5-16-24. Rules for Administration of Article; Eligibility of Certain Retired Employees and Dependents of Deceased Members for Coverage; Employees on Medical Leave of Absence Entitled to Coverage; Life Insurance - The director shall promulgate any necessary rules for the effective...

§5-16-24a. Paper Transactions - The director may, by rule as authorized in section twenty-four...

§5-16-25. Reserve Fund - Upon the effective date of this section, the finance board...

§5-16-26. Quarterly Report - By October 30, 1991, and on or before January 30,...

§5-16-28. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs - The provision requiring coverage for 12-month refill for contraceptive drugs...

§5-16-29. Limitation on Peia Participation - Notwithstanding any other provision of this article to the contrary,...