Senate Bill No. 488

(By Senator Helmick)

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[Introduced February 15, 2000; referred to the Committee on Banking and Insurance; and then to the Committee on Finance.]
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A BILL to repeal section eighteen, article two, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended; and to amend and reenact sections sixteen and seventeen of said article, all relating to the office of consumer advocacy within the agency of the insurance commissioner; eliminating funding for the office of consumer advocacy from special revenue funds appropriated by the Legislature; and providing funding for the office through the insurance commissioner's general account.

Be it enacted by the Legislature of West Virginia:
That section eighteen, article two, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be repealed; and that sections sixteen and seventeen of said article be amended and reenacted, all to read as follows:
ARTICLE 2. INSURANCE COMMISSIONER.
§33-2-16. Office of consumer advocacy established; appointed by insurance commissioner; director of consumer advocacy; promulgation of rules and regulations.

There is hereby created within the agency of the insurance commissioner the office of consumer advocacy. The director of the office of consumer advocacy shall be a full-time position and shall be appointed by the commissioner for a term of four years and may be discharged only for failure to carry out the duties of the office or for other good and sufficient cause.
The insurance commissioner shall provide office space, equipment and supplies for the office. All compensation for salaries and expenses of the office of consumer advocacy shall be paid monthly out of the state treasury by requisition upon the auditor, properly certified by the commissioner.
The director shall promulgate rules pursuant to article three, chapter twenty-nine-a of this code in order to effect the purposes of this section, and section seventeen and section eighteen of this article.
On or before the first day of each regular session of the Legislature, the director shall file with the governor, the clerk of the Senate and the clerk of the House of Delegates a report detailing the actions taken by the division in the preceding calendar year.
§33-2-17. Authority of office of consumer advocacy; retroactive effect of authority prohibited.

(a) In addition to the authority established under the rules promulgated by the director, the office of consumer advocacy is authorized to:
(1) Institute, intervene in, or otherwise participate in, as an advocate for the public interest and the interests of insurance consumers, proceedings in state and federal courts, before administrative agencies, or before the health care cost review authority, concerning applications or proceedings before the health care cost review authority or the review of any act, failure to act, or order of the health care cost review authority;
(2) At the request of one or more policyholders, or whenever the public interest is served, to advocate the interests of those policyholders in proceedings arising out of any filing made with the insurance commissioner by any insurance company or relating to any complaint alleging an unfair or deceptive act or practice in the business of insurance;
(3) Institute, intervene in, or otherwise participate in, as an advocate for the public interest and the interests of insurance consumers, proceedings in state and federal courts, before administrative agencies, or before the insurance commissioner, concerning applications or proceedings before the commissioner or the review of any act, failure to act, or order of the insurance commissioner;
(4) Review and compile information, data and studies of the reasonable and customary rate schedules of health care providers and health insurers, for the purposes of reviewing, establishing, investigating, or supporting any policy regarding health care insurance rates;
(5) Exercise all the same rights and powers regarding examination and cross-examination of witnesses, presentation of evidence, rights of appeal and other matters as any party in interest appearing before the insurance commissioner or the health care cost review authority;
(6) Hire consultants, experts, lawyers, actuaries, economists, statisticians, accountants, clerks, stenographers, support staff, assistants, and other personnel necessary to carry out the provisions of this section and sections section sixteen and eighteen of this article; which personnel shall be paid from special revenue funds appropriated for the use of the office
(7) Contract for the services of technically qualified persons in the area of insurance matters to assist in the preparation and presentation of matters before the courts, the insurance commissioner, administrative agencies, or the health care cost review authority, which persons shall be paid from special revenue funds appropriated for the use of the office;
(8) Make recommendations to the Legislature concerning legislation to assist the office in the performance of its duties;
(9) Communicate and exchange data and information with other federal or state agencies, divisions, departments, or officers, and with other interested parties including, but not limited to, health care providers, insurance companies, consumers or other interested parties; and
(10) Perform other duties to effect the purposes of the office.
(b) The provisions of this section do not apply to any filing made by an insurance company, or act or order performed or issued by the commissioner, or complaint filed by a policyholder with the commissioner prior to the thirtieth day of June, one thousand nine hundred ninety-one. All proceedings and orders in connection with these prior matters shall be governed by the law in effect at the time of the filing, or performance or issuance of the act or order.
(c) The scope of authority granted under this section and section sixteen of this article is restricted to matters related to health care costs and health insurance policies, subscriber contracts issued by organizations under article twenty-four of this chapter, health care corporations under article twenty-five of this chapter, health maintenance organizations under article twenty-five-a of this chapter, contracts supplemental to health insurance policies, and other matters related to health insurance issues identified by rules of the commissioner promulgated under section one of this article and chapter twenty-nine-a of this code.



NOTE: The purpose of this bill is to provide funding for the office of consumer advocacy through the insurance commissioner's general account.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.