West Virginia Administrative Code

114-29 Health Insurance Benefits For Temporomandibular And Craniomandibular Disorders 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=3400 The SOS document metadata indicat…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 30 "TAIL" MALPRACTICE INSURANCE COVERING CERTAIN MEDICAL AND ALLIED HEALTH CARE PROVIDERS §114-30-1. General. 1.1. Scope. -- This legislative rule provides for premium payment amortization, under certain circumstances speci…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 31 GUARANTEED LOSS RATIOS AS APPLIED TO INDIVIDUAL SICKNESS AND ACCIDENT INSURANCE POLICIES §114-31-1. General. 1.1. Scope. -- This legislative rule implements the provisions of Article 6C, Chapter thirty-three of the West …

TITLE 114 LEGISLATIVE RULE OFFICES OF THE INSURANCE COMMISSIONER SERIES 32 LONG-TERM CARE INSURANCE §114-32-1. General. 1.1. Scope. -- The purpose of this rule is to implement W. Va. Code §33-15A-1 et seq., to promote the public interest, to promote the availability of long-term …

114-33 Individual And Employer Group Minimum Benefits Accident And Sickness 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=3410 The SOS document metadat…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 34 FILING FEES FOR PURCHASING GROUPS, AND FOR RISK RETENTION GROUPS NOT CHARTERED IN THIS STATE '114-34-1. General. 1.1. Scope. -- This legislative rule implements the provisions of W. Va. Code ''33-32-17 and 33-32-4 relati…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 35 INSURANCE HOLDING COMPANY SYSTEMS §114-35-1. General. 1.1. Scope. -- The purpose of this rule is to set forth rules and procedural requirements that the Commissioner deems necessary to carry out the provisions of the Wes…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 36 WEST VIRGINIA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION ACT NOTICE REQUIREMENTS §114-36-1. General. 1.1. Scope. -- This rule applies to Member Insurers and their agents that provide insurance coverage for direct, no…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 37 SUBSTANDARD RISK MOTOR VEHICLE INSURANCE NOTICE REQUIREMENTS '114-37-1. General. 1.1. Scope. -- This legislative rule implements the provisions of West Virginia Code '33-6-31c requiring a written notification on automobi…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 38 CONTINUATION OF COVERAGE UNDER AUTOMOBILE LIABILITY POLICIES '114-38-1. General. 1.1. Scope. -- This rule establishes the form and procedures for notice to be given by insurers to named insureds and spouses of named insu…

114-39 Group Accident And Sickness Insurance Minimum Policy Coverage Standards 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=3425 The SOS document metadata indicates stat…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 40 CREDIT FOR REINSURANCE §114-40-1. Authority. 1.1. Scope. -- This legislative rule establishes the standards and procedural requirements which the commissioner considers necessary to carry out the provision of W. Va. Code…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 41 ACTUARIAL OPINION AND MEMORANDUM RULE §114-41-1. General. 1.1. Scope. -- This legislative rule applies to all life insurance companies and fraternal benefit societies doing business in this State and to all life insuranc…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 41A PROPERTY AND CASUALTY ACTUARIAL OPINION §114-41A-1. General. 1.1. Scope. -- This rule applies to all property and casualty insurance companies and fraternal benefit societies doing business in this State and to all prop…

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 42 CONTINUING EDUCATION FOR INDIVIDUAL INSURANCE PRODUCERS §114-42-1. General. 1.1. Scope. -- This legislative rule establishes standards for continuing insurance education requirements and the sanctions to be imposed for f…

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 (…