Introduced Version
House Bill 4058 History
| Email
Key: Green = existing Code. Red = new code to be enacted
H. B. 4058
(By Delegates Walters, Ashley, Hartman and Kominar)
[Introduced January 16, 2008; referred to the
Committee on Banking and Insurance then the Judiciary.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new section, designated §33-4-22, relating to
requiring group insurance companies and third party
administrators to furnish claims experience to policyholders.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new section, designated §33-4-22, to read as
follows:
ARTICLE 4. GENERAL PROVISIONS.
§33-4-22. Claims experience to be furnished to group
policyholders.
All insurers and third party administrators shall furnish,
regardless of the rating methodology used, claims experience to
group policyholders within thirty days of any policyholder's
request unless that information has been furnished to the group policyholder within the preceding six months. The claims
experience shall be furnished for all employer groups of fifty-one
or more covered employees, members or enrollees, not including
dependents, and shall include, but not be limited to:
(a) Earned premiums separated by policy year for at least the
last two policy years, if applicable;
(b) Total paid claims and total incurred claims, inclusive of
any high amount or pooled claims, including both capitated an
noncapitated expenses set forth in the same manner as premiums; and
(c) Any amounts in excess of the individual pooling or stop
loss point applicable to the group.
NOTE: The purpose of this bill is to
require group insurance
companies to furnish claims experience to policyholders.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.