V.I. Code tit. 3, § 633 (2019)
2019 US Virgin Islands Code|Title 3 - Executive|Chapter 25 - Personnel Merit System, Compensation, Expenses and Miscellaneous Benefits|Subchapter VIII - Insurance|§ 633. Contract for health insurance

 (a) The Board, with the approval of the Governor and the Legislature, is hereby authorized and directed to establish a self-funded health insurance plan or to purchase a contract or contracts to provide benefits under a health insurance plan in accordance with the provisions of this subchapter. Such self-funded health insurance plan may be contracted with a third party administrator and the contract or contracts shall be purchased from one or more corporations licensed to transact insurance business in the Virgin Islands. All the benefits to be provided under this subchapter shall be included in the self-funded health insurance plan or may be included in one or more contracts, or the benefits may be classified into different types with each type included under one or more contracts issued by the same or different companies. However, the Board in any case shall require, under the contract, that the health insurance contractor at least establish and maintain: (1) a paperless claims system or a claims system that does not require paper forms to be used; (2) a claims office located in the Virgin Islands; (3) a toll free telephone number so that plan participants can have questions answered concerning covered claims and the cost of services; and (4) a contract with a Preferred Provider Organization (PPO) in the Virgin Islands. (b) The Board shall assess the Government insurance programs on an annual basis and may recommend continuation of a self-funded health insurance plan or renewal of the contracts in force subject to approval by the Governor and the Legislature and appropriation of any increase in funds by the Legislature. At least once every five years, however, the Board shall invite proposals from all interested and qualified insurers desiring to provide insurance coverage authorized by this subchapter at least 180 days prior to the termination of the existing contract. The Board shall enter into an agreement to purchase a contract with such an insurer(s) and submit the agreement to the Governor and the Legislature not less than 120 days before the termination of the existing contract. The Governor shall review the agreement and approve or disapprove the same. If approved, the Governor shall submit the agreement to the Legislature not less than 60 days before the termination of the existing contract and the Board shall appear and present the agreement and furnish to the Legislature or any of its committees, such information, records, and documents as the Legislature or any committee may consider necessary or proper to carry out the Legislature's mandate under section 632(a). If disapproved, the Governor shall return the agreement to the Board with recommendations for renegotiation not more than 30 days after his receipt of the agreement and shall so notify the Legislature. The Board may at its discretion invite proposals on a more frequent basis, but any recommendation to change insurer(s) will be done in conformance with the procedures and time frames listed above. Nothing herein shall be construed as requiring the Government to change its insurance carrier if, as a result of the proposals, the Government determines to renew the existing contracts. (c) The Board, with the approval of the Governor and the Legislature, may arrange with any corporation, licensed to transact insurance business in the United States Virgin Islands, issuing any such contract to reinsure portions of such contract with any other such corporation which elects to be a reinsurer and is legally competent to enter into a reinsurance agreement. (d) The Board, with the approval of the Governor and the Legislature, may designate one or more of such corporations as the administering corporation or corporations. (e) Each employee who is covered under any such contract or contracts shall receive a certificate setting forth the benefits to which the employee and his dependents are entitled thereunder, to whom such benefits shall be payable, to whom claims should be submitted, and summarizing the provisions of the contract principally affecting the employee and his dependents. Such certificate shall be in lieu of the certificate which the corporation or corporations issuing such contract or contracts would otherwise issue. (f) The corporations eligible to participate as reinsurers, and the amount of coverage under the contract or contracts to be allocated to each issuing corporation or reinsurer, may be redetermined by the Board for and in advance of any contract year after the first year on a basis consistent with subsection (c) of this section, and with any modifications thereof it deems appropriate to carry out the intent of such subsection. (g) The Board shall not approve any contract or contracts for the fiscal year commencing July 1, 1970, which would require an expenditure by the Government in excess of the amount appropriated for that purpose. (h) The Board, with the approval of the Governor and the Legislature, may, on June 30, 1971, or anytime thereafter, discontinue any contract or contracts it has purchased from any corporation or corporations and replace it or them with a contract or contracts in any other corporation or corporations meeting the requirements of this section.