Chapter 114

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 43 HEALTH MAINTENANCE ORGANIZATIONS '114-43-1. General. 1.1. Scope. -- This rule applies to all persons or entities which are licensed or which may be required to be licensed pursuant to the provisions of W. Va. Code '33-25…

114-43A Provider Sponsored Networks The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=8751 The SOS document metadata indicates status "Historical" with document description "…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 44 MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP HEALTH INSURANCE CONTRACTS '114-44-1. General. 1.1. Scope. -- This legislative rule establishes minimum reserve standards for all individual and group health [accident a…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 45 RECOGNIZING ANNUITY MORTALITY TABLES FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES '114-45-1. General. This Legislative rule applies to all life insurance companies and fraternal benefit societies doing busine…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 46 FILING PROCEDURES FOR HEALTH MAINTENANCE ORGANIZATIONS '114-46-1. General. 1.1. Scope. -- This rule applies to all persons or entities which are licensed or which may be required to be licensed pursuant to the provisions…

114-47 Individual Medical Savings Account The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3445 The SOS document metadata indicates status "Historical" with document descrip…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 48 LIFE AND HEALTH REINSURANCE AGREEMENTS '114-48-1. General. 1.1. Scope. -- This rule shall apply to all domestic life and accident and sickness insurers and to all other licensed life and accident and sickness insurers wh…

114-49 Valuation Of Life Insurance Policies The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3449 The SOS document metadata indicates status "Historical" with document descr…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 50 EMERGENCY MEDICAL SERVICES '114-50-1. General. 1.1. Scope. The purpose of this rule is to set forth requirements for a health maintenance organization=s provision of emergency medical services to its enrollees. 1.2. Appl…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 51 UTILIZATION MANAGEMENT '114-51-1. General. 1.1. Scope. -- The purpose of this rule is to set forth standards for utilization management programs established as a component of the health maintenance organizations= quality…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 52 DIABETES REGULATIONS '114-52-1. General. 1.1. Scope. -- The purpose of this rule is to set forth the equipment and supplies for the treatment and/or management of diabetes which shall be covered by major medical or simil…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 53 QUALITY ASSURANCE §114-53-1. General. 1.1. Scope. -- The purpose of this rule is to set forth standards for quality assurance programs established as a component of a health maintenance organization's overall structure. …

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 54 GROUP ACCIDENT AND SICKNESS INSURANCE ISSUANCE, PORTABILITY AND MARKETING REQUIREMENTS '114-54-1. General. 1.1. Scope and applicability. -- This rule applies to health benefit plans issued in connection with a group heal…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 55 GUARANTEED ISSUE OF INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE '114-55-1. General. 1.1. Scope. -- The purpose of this rule is to set forth guidelines for insurers required to provide accident and sickness insurance cover…

TITLE 114 WEST VIRGINIA LEGISLATIVE RULE INSURANCE COMMISSION SERIES 56 QUALITY ASSURANCE STANDARDS FOR PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS '114-56-1. General. 1.1. Scope. -- The purpose of this rule is to set forth standards for quality assurance programs established as…

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TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 58 EXTERNAL REVIEW OF COVERAGE DENIALS '114-58-1. General. 1.1. Scope. -- The purpose of this rule is to provide standards for the external review process set forth in W. Va. Code '33-25C-6, including the procedures for sel…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 59 MEDICAL MALPRACTICE INSURANCE CONSENT TO RATE AND GUIDE "A" RATE AGREEMENTS §114-59-1. General. 1.1. Scope. -- Except as otherwise provided, this rule applies to any insurer authorized to transact insurance in West Virgi…

TITLE 114 PROCEDURAL RULE INSURANCE COMMISSIONER SERIES 60 AFFIDAVITS OF CUSTODIAN BANKS §114-60-1. General. 1.1. Scope. -- This procedural rule prescribes the form for affidavits of custodian banks for use in the following situations: a. Where securities entrusted to its care ha…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 61 CREDIT PERSONAL PROPERTY INSURANCE §114-61-1. General. 1.1. Scope. -- 1.1.a. The purposes of this rule are to promote the public welfare by regulating personal property insurance; create a legal framework within which cr…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 62 STANDARDS FOR SAFEGUARDING CUSTOMER INFORMATION §114-62-1. General. 1.1. Scope. -- This rule establishes standards for developing and implementing administrative, technical and physical safeguards to protect the security…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 63 STANDARD MOTOR VEHICLE POLICY PROVISIONS §114-63-1. General. 1.1. Scope. -- This rule establishes the standard motor vehicle insurance policy provisions as required by W. Va. Code §33-6-31(i). 1.2. Authority. -- W. Va. C…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 64 MENTAL HEALTH PARITY §114-64-1. General. 1.1. Scope. -- The purposes of this rule are to: 1.1.a. 1.1.a.1. Create a legal framework within which insurers can develop an environment of parity between mental health and medi…

114-65 Self-Insurance Pools For Political Subdivisions The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3472 The SOS document metadata indicates status "LegislativeActive" w…

114-66 Mental Health Parity Cost Containment Measures Application And Annual Reporting Requirements The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3474 The SOS document me…

114-67 Rate And Form Filing Abstracts The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3476 The SOS document metadata indicates status "Historical" with document description…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 68 VALUATION OF LIFE INSURANCE POLICIES §114-68-1. General. 1.1. Scope. -- 1.1.a. The purpose of this rule is to provide: 1.1.a.1. Tables of select mortality factors and rules for their use; 1.1.a.2. Rules concerning a mini…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 69 RECOGNITION OF THE 2001 CSO MORTALITY TABLE FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NONFORFEITURE BENEFITS §114-69-1. General. 1.1. Scope. -- The purpose of this rule is to recognize, permit and prescribe …

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 69A RECOGNITION OF PREFERRED MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES §114-69A-1. General. 1.1. Scope. -- The purpose of this rule is to recognize, permit and prescribe the use of mortality tables…

TITLE 114 INTERPRETIVE RULE INSURANCE COMMISSIONER SERIES 70 REBATES AND REFERRALS §114-70-1. General. 1.1. Scope. -- The purpose of this interpretive rule is to set a reasonable monetary limit upon the value of items given to a consumer or prospective consumer by insurance compa…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 71 INSURANCE FRAUD PREVENTION §114-71-1. General. 1.1. Scope. -- This legislative rule establishes standards for reporting insurance fraud. 1.2. Authority. -- W. Va. Code §§33-2-10 and 33-41-10. 1.3. Filing Date. -- May 6, …

TITLE 114 PROCEDURAL RULE INSURANCE COMMISSIONER SERIES 72 PERSONAL PRIVATE PASSENGER AUTOMOBILE LIABILITY INSURANCE AND PROPERTY INSURANCE WITHDRAWAL PLAN PROCEDURES §114-72-1. General. 1.1. Scope. -- The purpose of this rule is to provide orderly and uniform procedures, as requ…

TITLE 114 WEST VIRGINIA LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 73 SMALL EMPLOYER ELIGIBILITY REQUIREMENTS §114-73-1. General. 1.1. Scope. -- The purpose of this rule is to facilitate the offering of a health benefit plan under W. Va. Code §33-16D-16 by any licensed carrie…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 74 NONRENEWAL OF PROPERTY INSURANCE POLICIES §114-74-1. General. 1.1. Scope. -- This rule addresses various aspects of the alternative percentage method for the nonrenewal of property insurance policies set forth in W. Va. …

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 75 PRIVATE PASSENGER AUTOMOBILE AND PROPERTY INSURANCE - BIANNUAL RATE FILING REQUIREMENTS §114-75-1. General. 1.1. Scope -- This rule establishes guidelines and procedures under which every insurer providing five percent (…

TITLE 114 PROCEDURAL RULE INSURANCE COMMISSIONER SERIES 76 RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE PROCEEDINGS BROUGHT BY THIRD PARTY CLAIMANTS §114-76-1. General. 1.1. Scope. -- These procedural rules shall govern the initiation and conduct of administrative proceedin…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 77 RATE FILING REQUIREMENTS FOR TITLE INSURANCE COMPANIES §114-77-1. General. 1.1. Scope. -- This rule establishes guidelines and procedures under which title insurance companies shall submit rate filings. 1.2. Authority. -…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 78 INDIVIDUAL LIMITED HEALTH BENEFITS PLANS §114-78-1. General. 1.1. Scope. -- The purpose of this legislative rule is to establish requirements for information and data to be provided with the filing of rates and rate adju…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 79 GROUP LIMITED HEALTH BENEFITS PLANS §114-79-1. General. 1.1. Scope. -- This rule establishes guidelines and procedures under which the Commissioner may approve group limited health benefit plans. 1.2. Authority. -- W. Va…

114-80 Special Provisions Regarding Workers' Compensation Rates The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3493 The SOS document metadata indicates status "Historical"…

TITLE 114 PROCEDURAL RULE OFFICES OF THE INSURANCE COMMISSIONER SERIES 81 PROCEDURES FOR ANALYTICAL CRITERIA AND METHODOLOGY §114-81-1. General. 1.1. Scope. -- The purpose of this rule is to set forth the analytical criteria and methodology of all factors to be considered by the …

TITLE 114 LEGISLATIVE RULE OFFICES OF THE INSURANCE COMMISSIONER SERIES 82 MILITARY SALES PRACTICES §114-82-1. General. 1.1. Scope. -- This rule applies only to the solicitation or sale of any life insurance or annuity product by an insurer or insurance producer to an active duty…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 83 DISCOUNT MEDICAL PLAN ORGANIZATIONS AND DISCOUNT PRESCRIPTION DRUG PLAN ORGANIZATIONS §114-83-1. General. 1.1. Scope. -- The purpose of this rule is to implement W. Va. Code §33-15E, et seq. relating to Discount Medical …

114-84 Health Policy Rate And Form Filings The West Virginia Secretary of State Code of State Rules record for this citation is available at: https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=3499 The SOS document metadata indicates status "Historical" with document descri…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 85 PROFESSIONAL EMPLOYER ORGANIZATIONS §114-85-1. General. 1.1. Scope. -- This rule establishes procedures for the licensing and regulation of professional employer organizations ("PEOs") doing business in the State of West…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIS 86 PRE NEED LIFE INSURANCE MINIMUM STANDARDS FOR DETERMINING RESERVE LIABILITIES AND NON FORFEITURE VALUES §114-86-1. General. 1.1. Scope. -- This rule establishes minimum mortality standards to be used in determining reserv…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 87 PREVENTIVE CARE PILOT PROGRAM §114-87-1. General. 1.1. Scope. -- The purpose of this rule is to permit participation in the Preventive Care Pilot Program by an individual or employer with a comprehensive high deductible …