HB2457 H B&I AM 3-18



The Committee on Banking and Insurance moves to amend the bill on page one, line 15, by striking out everything after the enacting clause and inserting in lieu thereof the following:
" That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new section, designated §33-16-3c, to read as follows:
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3c. Claims loss experience to be furnished to certain employer group accident and sickness insurance policyholders.
(a) Any insurer issuing a group accident and sickness insurance policy in this state subject to the provisions of this article to an employer insuring fifty-one or more covered employees, members or enrollees, not including dependents, shall furnish, regardless of the rating methodology used, claims loss experience to the policyholder within thirty days of the date of request of the policyholder unless (1) claims loss information required in this section has been furnished to the policyholder within the preceding six months, or (2) the policyholder has been insured by the insurer less than 10 months.
(b) The claims loss experience information shall be provided for the time the policy and any renewals thereof has been in effect, but not exceeding the previous two policy years prior to the request and shall include, but not be limited to:
(1) Earned premiums separated by policy year for at least the last two policy years, if applicable;
(2) Total paid claims and total incurred claims, inclusive of any high amount or pooled claims, including both capitated and noncapitated expenses set forth in the same manner as premiums; and (3) Any amounts in excess of the individual pooling or stop loss point applicable to the group.
(c) The claims loss information shall not include any information prohibited from disclosure by any applicable federal law or law of this state. "
Adopted
Rejected