Title 26 — Title 26 — Insurance Code
56 chapters · 1,242 sections in this title.
W.S. § 26-40-102 (a) Definitions
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(a) Definitions. As used in this chapter: (i) "Health care provider" means any physician, hospital or other person licensed or otherwise authorized in this or another state to furnish to any individual medical or dental care, vision care or hospitalization incident to the furnish…
W.S. § 26-40-103 Payment of claims
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Payment of claims. (a) If any disability insurance policy provides for settlement of a claim for payment of medical services or procedures provided by a health care provider using a usual, customary and reasonable basis the insurer shall: (i) Submit to the department upon request…
W.S. § 26-40-104 Prohibitions
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Prohibitions. (a) No person may make payment on a claim for benefits under an individual, group or blanket disability policy covering residents of this state unless such claim payment is made in compliance with this chapter. (b) Any person who violates any provisions of this chap…
W.S. § 26-40-201 Payment of claims under medical necessity standard; review
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Payment of claims under medical necessity standard; review. (a) As used in this section, "medical necessity or other similar basis" includes, but is not limited to, "medically necessary," "medically necessary care" and "medically necessary and appropriate," as defined in W.S. 26-…
W.S. § 26-41-101 Approval as a domestic insurer
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Approval as a domestic insurer. Any insurer which is organized under the laws of any jurisdiction other than this state and is admitted to do business in this state for the purpose of writing insurance may become a domestic insurer by meeting the substantive requirements of law r…
W.S. § 26-41-102 Conversion to foreign insurer
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Conversion to foreign insurer. Any domestic insurer may, upon the approval of the commissioner, transfer its domicile to any other state in which it is admitted to transact the business of insurance, and upon such a transfer shall cease to be a domestic insurer, and shall be admi…
W.S. § 26-41-103 Effects of redomestication
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Effects of redomestication. (a) The certificate of authority, agent appointments and licenses, rates, and other items which the commissioner of insurance allows, in his discretion, which are in existence at the time any insurer licensed to transact the business of insurance in th…
W.S. § 26-42-101 Short title
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Short title. This chapter is known as the "Wyoming Life and Health Insurance Guaranty Association Act."
W.S. § 26-42-102 (a) Definitions
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(a) Definitions. As used in this act: (i) "Account" means any of the three (3) accounts created by W.S. 26-42-104(a); (ii) "Association" means the Wyoming life and health insurance guaranty association created by W.S. 26-42-104; (iii) "Authorized assessment" or the term "authoriz…
W.S. § 26-42-103 Coverage and limitations
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Coverage and limitations. (a) This act shall provide coverage for the policies and contracts specified in subsection (b) of this section and provide coverage as follows: (i) To persons who are owners, certificate holders or enrollees under the policies or contracts other than str…
W.S. § 26-42-104 Creation of the association
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Creation of the association. (a) There is created a nonprofit legal entity to be known as the Wyoming life and health insurance guaranty association. All member insurers are members of the association as a condition of their authority to transact insurance or health maintenance o…
W.S. § 26-42-105 Board of directors
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Board of directors. (a) The board of directors of the association consists of not less than five (5) nor more than nine (9) member insurers serving terms as established in the plan of operation provided by W.S. 26-42-108. Membership on the board shall be subject to the following:…
W.S. § 26-42-106 Powers and duties of the association
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Powers and duties of the association. (a) If a member insurer is an impaired insurer, the association may in its discretion and subject to any conditions imposed by the association that do not impair the contractual obligations of the impaired insurer, that are approved by the co…
W.S. § 26-42-107 Assessments
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Assessments. (a) For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers separately for each account and at a time and for amounts as the board finds necessary. Assessments are…
W.S. § 26-42-108 Plan of operation
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Plan of operation. (a) The association shall maintain a plan of operation to assure the fair, reasonable and equitable administration of the association. The plan of operation and any amendments to the plan of operation shall be submitted to the commissioner and are effective upo…
W.S. § 26-42-109 Duties and powers of the commissioner
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Duties and powers of the commissioner. (a) In addition to the duties and powers enumerated in other provisions of this act, the commissioner shall: (i) Upon request of the board of directors, provide the association with a statement of the premiums in this and any other appropria…
W.S. § 26-42-110 Prevention of insolvencies
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Prevention of insolvencies. (a) To aid in the detection and prevention of member insurer insolvencies or impairments, the commissioner shall: (i) Notify the commissioners of all the other states, territories of the United States and the District of Columbia by mail within thirty …
W.S. § 26-42-111 Credits for assessments paid; tax offsets
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Credits for assessments paid; tax offsets. (a) A member insurer may offset against its premium tax liability to this state an assessment described in W.S. 26-42-107(k) to the extent of ten percent (10%) of the amount of the assessment for each of the ten (10) calendar years follo…
W.S. § 26-42-112 Assessment liability; records; assets; proceedings against impaired or insolvent insurer
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Assessment liability; records; assets; proceedings against impaired or insolvent insurer. (a) This act shall not be construed to reduce the liability for unpaid assessments of the insureds of an impaired or insolvent insurer operating under a plan with assessment liability. (b) R…
W.S. § 26-42-113 Examination of the association; annual report
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Examination of the association; annual report. The association is subject to examination and regulation by the commissioner. The board of directors shall submit to the commissioner each year not later than one hundred twenty (120) days after the association's fiscal year, a finan…
W.S. § 26-42-114 Tax exemptions
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Tax exemptions. The association is exempt from payment of all fees and all taxes levied by this state or any of its subdivisions except taxes levied on real property.
W.S. § 26-42-115 judgments
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judgments. Stay of proceedings; reopening default All proceedings in which the insolvent insurer is a party in any court in this state shall be stayed one hundred eighty (180) days from the date an order of liquidation, rehabilitation or conservation is final to permit proper leg…
W.S. § 26-42-116 Prohibited advertisement of association chapter in insurance sales; notice
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Prohibited advertisement of association chapter in insurance sales; notice. (a) No person including a member insurer, agent or affiliate of an insurer shall make, publish, disseminate, circulate or place before the public, or cause directly or indirectly to be made, published, di…
W.S. § 26-42-117 Immunity
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Immunity. Except as provided by W.S. 26-42-106(r)(ii), 26-42-109(b) and 26-42-112, there shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer or its agents or employees, the association or its agents or employees, member…
W.S. § 26-42-118 Prospective application
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Prospective application. (a) Except as provided in subsection (b) of this section, this act shall apply to any member insurer which is placed under an order of liquidation with a finding of insolvency on or after July 1, 2014. (b) The amendments provided in the 2014 amendments to…
W.S. § 26-43-101 (a) Definitions
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(a) Definitions. As used in this act: (i) 26-43-112; "Account" means the account provided by W.S. (ii) "Administrator" means the insurer, insurers or third party administrator or administrators selected pursuant to W.S. 26-43-104(a) to administer the pool; (iii) "Board" means the…
W.S. § 26-43-102 Operation of the pool; board membership; board powers and duties
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Operation of the pool; board membership; board powers and duties. (a) There is created a nonprofit entity known as the Wyoming health insurance pool. All insurers issuing health insurance in this state and to the extent not preempted by federal law, insurance arrangements providi…
W.S. § 26-43-103 Eligibility
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Eligibility. (a) Except as provided in subsections (b) and (e) of this section, any individual person who is a resident of this state is eligible for pool coverage under eligibility level one (1) or eligibility level two (2) if evidence of the following is provided: (i) Rejection…
W.S. § 26-43-104 Administrator
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Administrator. (a) The board shall select an insurer, insurers or a third party administrator or administrators through a competitive bidding process to administer the pool. The board shall evaluate bids based on criteria established by the board which shall include but are not l…
W.S. § 26-43-105 Assessments; premium tax credit
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Assessments; premium tax credit. (a) After each calendar year, the administrator shall determine the pool net premiums which are premiums less administrative expense allowances, the pool administrative expenses and the pool incurred losses for the calendar year considering invest…
W.S. § 26-43-106 Minimum benefits; limitations
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Minimum benefits; limitations. (a) Pool coverage shall be offered to eligible persons subject to the termination and disenrollment provisions of W.S 26-43-103(e). The commissioner shall establish by rule and regulation the pool coverage, its schedule of benefits, exclusions and o…
W.S. § 26-43-107 Premiums; standard risk rate
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Premiums; standard risk rate. (a) Separate schedules of premium rates based on plan coverage under the pool, age, sex and geographical location may apply for individual risks. (b) The board shall determine the standard risk rate by calculating the average individual standard rate…
W.S. § 26-43-108 Preexisting conditions
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Preexisting conditions. (a) Pool coverage shall not exclude charges or expenses incurred for longer than the first twelve (12) months following the effective date of coverage as to any condition for which during the six (6) month period immediately preceding the effective date of…
W.S. § 26-43-109 Benefit payments reduction
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Benefit payments reduction. (a) Benefits otherwise payable under pool coverage are reduced by: (i) All amounts paid or payable through any other health insurance or insurance arrangement; (ii) All hospital and medical expense benefits paid or payable under any workers' compensati…
W.S. § 26-43-110 Immunity
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Immunity. The participation in the pool as members, the establishment of rates, forms or procedures or any other joint or collective action required by this act shall not be the basis of any legal action, criminal or civil liability or penalty against the board, the pool or pool …
W.S. § 26-43-111 Tax exemption
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Tax exemption. The pool established pursuant to this act is exempt from insurance premium taxes.
W.S. § 26-43-112 Account created; payments; investment
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Account created; payments; investment. There is created an account within the trust and agency fund in which all money received, earned or collected pursuant to this act shall be credited and continuously appropriated for the purposes of this act. All claims, costs of administrat…
W.S. § 26-43-113 Termination of provisions
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Termination of provisions. This act is not effective after June 30, 2030.
W.S. § 26-43-114 Enrollment capacity planning
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Enrollment capacity planning. The board shall annually estimate the funds available to the plan through premiums, assessments and legislative appropriations for the subsequent fiscal year and shall determine the maximum number of individuals who may be enrolled for that year with…
W.S. § 26-43-201 Repealed by Laws 2010, ch
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Repealed by Laws 2010, ch. 96, § 1.
W.S. § 26-43-202 Repealed by Laws 2010, ch
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Repealed by Laws 2010, ch. 96, § 1.
W.S. § 26-43-203 Repealed by Laws 2010, ch
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Repealed by Laws 2010, ch. 96, § 1.
W.S. § 26-43-204 Repealed by Laws 2010, ch
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Repealed by Laws 2010, ch. 96, § 1.
W.S. § 26-43-205 Repealed by Laws 2010, ch
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Repealed by Laws 2010, ch. 96, § 1.
W.S. § 26-43-206 Repealed by Laws 2010, ch
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Repealed by Laws 2010, ch. 96, § 1.
W.S. § 26-43-207 Repealed by Laws 2021, ch
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Repealed by Laws 2021, ch. 149, § 3.
W.S. § 26-43-301 Definitions; applicability
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Definitions; applicability. (a) As used in this article, "air ambulance membership organization" means an entity that, in exchange for fees, dues, charges or other consideration, provides: (i) Discounts to members for the cost of services the organization provides as an air ambul…
W.S. § 26-43-302 Air ambulance membership organizations; certificate of registration; application
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Air ambulance membership organizations; certificate of registration; application. (a) An air ambulance membership organization shall obtain a certificate of registration from the commissioner before operating as an air ambulance membership organization in Wyoming. (b) An air ambu…
W.S. § 26-43-303 Certificate of registration; renewal; suspension; revocation
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Certificate of registration; renewal; suspension; revocation. (a) Not less than ninety (90) days before a certificate of registration expires, an air ambulance membership organization seeking to maintain its registration shall submit a renewal application on a form prescribed by …
W.S. § 26-43-304 Air ambulance membership organizations; powers and duties of the commissioner; rulemaking; costs
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Air ambulance membership organizations; powers and duties of the commissioner; rulemaking; costs. (a) The commissioner is authorized to: (i) Examine or investigate the affairs of an air ambulance membership organization to ensure compliance with the provisions of this article; (i…