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Introduced Version House Bill 4058 History

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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.
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