H. B. 2444
(By Delegates L. White, Carper, Huntwork and Tribett)
[Introduced March 2, 1993; referred to the
Committee on Banking and Insurance.]
A BILL to amend and reenact section three, article sixteen,
chapter thirty-three of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, relating to
the promulgation of rules for minimum policy provisions on
group accident and sickness coverage.
Be it enacted by the Legislature of West Virginia:
That section three, article sixteen, chapter thirty-three of
the code of West Virginia, one thousand nine hundred thirty-one,
as amended, be amended and reenacted to read as follows:
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3. Required policy provisions.
Each such policy hereafter delivered or issued for delivery
in this state shall contain in substance the following
provisions:
(a) A provision that the policy, the application of the
policyholder, a copy of which shall be attached to such policy,
and the individual applications, if any, submitted in connectionwith such policy by the employees or members, shall constitute
the entire contract between the parties, and that all statements
made by any applicant or applicants shall be deemed
representations and not warranties, and that no such statement
shall void the insurance or reduce benefits thereunder unless
contained in a written application.
(b) A provision that the insurer will furnish to the
policyholder, for delivery to each employee or member of the
insured group, an individual certificate setting forth in
substance the essential features of the insurance coverage of
such employee or member and to whom benefits thereunder are
payable. If dependents are included in the coverage, only one
certificate need be issued for each family unit.
(c) A provision that all new employees or members, as the
case may be, in the groups or classes eligible for insurance,
shall from time to time be added to such groups or classes
eligible to obtain such insurance in accordance with the terms of
the policy.
(d) No provision relative to notice or proof of loss or the
time for paying benefits or the time within which suit may be
brought upon the policy shall be less favorable to the insured
than would be permitted in the case of an individual policy by
the provisions set forth in article fifteen of this chapter.
(e) A provision that all members in groups or classes
eligible for insurance provided through an employee's group plan
shall be permitted to pay the premiums at the same group rate andreceive the same coverages for a period not to exceed eighteen
months when they are involuntarily laid off from work.
(f) Such further provisions establishing group accident and
sickness minimum policy coverage standards as the commissioner
shall promulgate by rule pursuant to chapter twenty-nine-a of
this code. The commissioner shall promulgate the first set of
such standards as emergency rules within forty-five days of the
effective date of this subsection.
NOTE: The purpose of this bill is to authorize and require
the Insurance Commissioner to promulgate rules which establish
minimum policy coverage standards for group accident and sickness
insurance in West Virginia.
Strike-throughs indicate language that would be stricken
from the present law, and underscoring indicates new language
that would be added.