HB4080 H B&I AM 1-22

Archibald 3192

    The Committee on Banking and Insurance moves to amend the bill on page 2, section 1, line 5, after the word “authorized” by striking out the period and inserting in lieu thereof a comma, and the words “with the following amendments:

    On page 1, section 2, by striking out the heading “§114-96-1. Definitions." and inserting in lieu thereof “§114-96-2. Definitions.";

    On page 1, subsection 2.1, after the word “terminated” by adding a period;

    On page 1, subsection 2.1, after the word “other” by striking out the word “healthcare” and inserting in lieu thereof the words “health care”;

    On page 2, subdivision 2.3.a, after the words “person in an” by striking out the word “external” and inserting in lieu thereof the word “internal”;

    On page 2, subdivision 2.3.c, after the word “professional” by inserting a semicolon;

    On page 2, subsection 2.6, after the word “specialty” by striking out the word “as” and inserting in lieu thereof the word “that”;

    On page 3, subsection 2.15, after the words “including but” by striking out the word “no” and inserting in lieu thereof the word “not”;

    On page 4, subsection 2.18, after the words “cost-incurred basis,” by striking out the words “except as otherwise specifically exempted in this definition” and inserting in lieu thereof the words “but excluding the excepted benefits defined in 42 U.S.C. § 300gg-91 and as otherwise specifically excepted in this rule”;

    On page 5, subsection 2.19, after the words “consistent with” by striking out the word “state” and inserting in lieu thereof the words “West Virginia”;

    On page 6, subsection 2.26 after the word “means” by striking out the word “in” and inserting in lieu thereof the word “an”;

    On page 7, subsection 2.30, after the words “other than” by striking out the word “that” and inserting in lieu thereof the words “the one”;

    On page 7, subdivision 2.32.c, after the words “provided in subdivision” by striking out the reference “2.35.b” and inserting in lieu thereof the reference “2.32.d”;

    On page 9, subsection 4.2, after the words “in accordance with” by striking out the words “subdivision a of”;

    On page 10, subdivision 5.4.a, after “5.4.a.” by striking out the second period;

    On page 11, after subdivision 5.6.c, by inserting a new subdivision “5.6.d. The issuer shall make the provisions of subsection 5.4 known to the covered person within three working days after the date of receipt of the grievance.”;

    On page 13, subdivision 5.8.g, after the words “pursuant to subsection 5.6 that” by striking out the word “upholds” and inserting in lieu thereof the word “denies”;

    On page 13, paragraph 5.8.g.4, after the word “either” by adding the word “the”;

    On page 13, paragraph 5.8.g.5, after the word “circumstances” by adding a comma;

    On page 13, paragraph 5.8.g.5, after the words “will be” by striking out the word “provide” and inserting in lieu thereof the word “provided”;

    On page 13, subparagraph 5.8.g.6.A, after the words “in paragraph” by striking out the reference “5.4.g.4" and inserting in lieu thereof the reference “5.8.g.4";

    On page 13, subparagraph 5.8.g.6.B, after the words “in paragraph” by striking out the reference “5.4.g.5" and inserting in lieu thereof the reference “5.8.g.5";

    On page 13, by striking out paragraph 5.8.h.1 in its entirety;

    On page 14, by striking out paragraph 5.8.h.2 in its entirety and renumbering the remaining paragraphs accordingly;

    On page 14, renumbered paragraph 5.8.h.2, after the words “W. Va. Code of St. R.” by striking out “§114-97-1 et seq. if the covered person decides not to file for an additional voluntary review of the first level review decision involving an adverse determination” and inserting in lieu thereof the word “§114-97";

    On page 14, paragraph 5.9.a.3, after the words “notices” by striking out the comma;

    On page 15, subdivision 6.4.b, after “6.4.b.” by striking out the extra period;

    On page 16, subdivision 6.5.d., after the semicolon, by adding the word “and”;

    On page 16, by striking out subdivision 6.5.e in its entirety, striking out paragraph 6.5.e.1 in its entirety, and striking out paragraph 6.5.e.2 in its entirety and renumbering the remaining subdivision accordingly;

    On page 16, subsection 7.2, after the word “subsection” by striking out the reference “5.1" and inserting in lieu thereof the reference “7.1";

    On page 18, subparagraph 7.8.a.7.A, after the words “as well as” by adding the word “a”;

    On page 18, subparagraph 7.8.a.7.A, after the word “reaching” by adding the word “the”;

    On page 19, subparagraph 7.8.a.7.E, after the word “circumstances” by adding a comma;

    On page 19, part 7.8.a.7.F.6, after the word “claim” by adding a comma;

    And

    On page 20, subparagraph 7.8.b.1.B, after the word “and” by adding thereto a new subparagraph “7.8.b.1.C. Include in the English versions of all notices a statement prominently displayed in any applicable non-English language clearly indicating how to access the language services provided by the carrier.”