WEST virginia legislature

2019 regular session

Introduced

House Bill 3052

BY Delegates Fleischauer, Pushkin, N. Brown, Hill, Hartman, Sponaugle, C. Thompson, Miley, Lavender-Bowe, Estep-Burton and Walker

[Introduced February 12, 2019; Referred
to the Committee on Banking and Insurance then the Judiciary.]

A BILL to amend the Code of West Virginia,1931, as amended, by adding thereto a new section, designated §33-15-4s, relating to ensuring coverage for residents with preexisting conditions.

Be it enacted by the Legislature of West Virginia:

ARTICLE 15. GENERAL PROVISIONS.

§33-15-4s. Preexisting condition coverage.

(a) Notwithstanding any provision of any policy, contract, plan or agreement applicable to this article, no health insurance policy issued on, or after, the passage of this section may be issued in this state establishing a preexisting condition limitation: Provided, That the underwriting of such constricts may utilize “community rated” limitations and conditions as defined in this section.

(b) Once accepted for coverage, an individual or small group cannot be terminated by the insurer due to claims experience. Termination of coverage for individuals or small groups may be based only on one or more of the reasons set forth in §33-15-2b of this code.

(c) For the purposes of this section, “community rated” means a rating methodology in which the premium for all persons covered by a policy or contract form is the same, based on the experience of the entire pool of risks of all individuals or small groups covered by the corporation without regard to sex, age, health status, tobacco usage or occupation excluding those individuals or small groups covered by Medicare supplemental insurance.

(d) Coverage required under this section may not be subject to exclusions or limitations including costs which are not applied to other policies of coverage.

 

NOTE: The purpose of this bill is to ensure coverage for residents with preexisting conditions and to ensure that their costs are the same as the general population.

Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.