reglab/statecodes huggingface dataset:
2023 West Virginia Code › Chapter 33. Insurance › Article 46. Third-Party Administrator Act › §33-46-9. Compensation to the Administrator

(a) An administrator may not enter into an agreement or understanding with an insurer in which the effect is to make the amount of the administrator's commissions, fees or charges contingent upon savings effected in the adjustment, settlement and payment of losses covered by the insurer's obligations. This provision shall not prohibit an administrator from receiving performance-based compensation for providing hospital or other auditing services.
(b) This section shall not prevent the compensation of an administrator from being based on premiums or charges collected or the number of claims paid or processed.
2023 West Virginia Code › Chapter 33. Insurance › Article 46. Third-Party Administrator Act › §33-46-10. Notice to Covered Individuals; Disclosure of Charges and Fees

(a) When the services of an administrator are used, the administrator shall provide a written notice approved by the insurer to covered individuals advising them of the identity of, and relationship among, the administrator, the policyholder and the insurer.
(b) When an administrator collects funds, the reason for collection of each item shall be identified to the insured party and each item shall be shown separately from any premium. Additional charges may not be made for services to the extent the services have been paid for by the insurer.
(c) The administrator shall disclose to the insurer all charges, fees and commissions received from all services in connection with the provision of administrative services for the insurer, including any fees or commissions paid by insurers providing reinsurance.
2023 West Virginia Code › Chapter 33. Insurance › Article 46. Third-Party Administrator Act › §33-46-13. Registration Requirement

A person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, in connection with life, annuity or accident and sickness coverage provided by a self-funded plan other than a governmental or church plan shall register with the commissioner annually, verifying its status as in this article described.
2023 West Virginia Code › Chapter 33. Insurance › Article 46. Third-Party Administrator Act › §33-46-15. Fees and Charges

Except where it is otherwise specially provided, the commissioner shall assess third-party administrators the following fees: For annual fee for each license, $200; for receiving and filing annual reports, $100; for filing a certified copy of articles of incorporation, $50; for filing a copy of its charter, $50; for filing statements preliminary to admission, $100; for filing any additional paper required by law or furnishing copies of the additional paper, $1; and for every copy of a report or certificate of condition of administrator to be filed in any other state, $25. The commissioner may by rule set reasonable charges for printed forms for the annual statements required by law. He or she may sell at cost publications purchased by, or printed on behalf of the commissioner. All fees and moneys collected shall be used for the purposes set forth in section thirteen, article three of this chapter.
2023 West Virginia Code › Chapter 33. Insurance › Article 46. Third-Party Administrator Act › §33-46-16. Annual Report and Filing Fee

(a) Each administrator licensed under section twelve of this article shall file an annual report for the preceding calendar year with the commissioner on or before July 1, of each year or within an extension of time granted by the commissioner for good cause. The annual report shall include an audited financial statement performed by an independent certified public accountant. An audited financial/annual report prepared on a consolidated basis shall include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:
(1) Amounts shown on the consolidated audited financial report;
(2) Amounts for each entity stated separately; and
(3) Explanations of consolidating and eliminating entries.
The report shall be in the form and contain any matters prescribed by the commissioner and shall be verified by at least two officers of the administrator.
(b) The annual report shall include the complete names and addresses of all insurers with which the administrator had agreements during the preceding fiscal year.
(c) At the time of filing its annual report, the administrator shall pay the filing fee provided in section fifteen of this article.
(d) The commissioner shall review the most recently filed annual report of each administrator on or before September 1, of each year. Upon completion of its review, the commissioner shall either:
(1) Issue a certification to the administrator that the annual report shows that the administrator has a positive net worth as evidenced by audited financial statements and is currently licensed and in good standing, or noting any deficiencies found in that annual report and financial statements; or
(2) Update any electronic database maintained by the national association of Insurance Commissioners, its affiliates or subsidiaries, indicating the annual report shows that the administrator has a positive net worth as evidenced by audited financial statements and is in compliance with existing law, or noting any deficiencies found in the annual report.
2023 West Virginia Code › Chapter 33. Insurance › Article 46. Third-Party Administrator Act › §33-46-18. Exemption for Administrators of Public Health Programs

Programs supervised by the Department of Health and Human Resources, pursuant to chapter nine of this code; the Public Employees Insurance Agency, pursuant to articles sixteen and sixteen-c, chapter five of this code; and the Department of Administration, pursuant to article sixteen-b, chapter five of this code, are exempted from the provisions of this article. Third-party administrators who administer the above-referenced programs are exempt from the provisions of this article with respect to these specific programs only.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-1. Purpose and Intent

The Legislature hereby finds that:
(1) Professional Employer Organizations (hereinafter "PEOs") provide a valuable service to commerce and the citizens of this state by increasing the opportunities of employers to develop cost-effective methods of satisfying their personnel requirements and providing employees with access to certain employment benefits which might otherwise not be available to them;
(2) PEOs operating in this state should be properly recognized and regulated by the Insurance Commissioner; and
(3) Any allocation of employer duties and responsibilities between a PEO and a client-employer pursuant to this article should preserve all rights to which covered employees would be entitled under a traditional employment relationship.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-2. Definitions

(a) "Administrative fee" means the amount charged to a client-employer by a PEO for professional employer services. It does not include amounts paid by a client-employer to the PEO for wages and salaries, benefits, payroll taxes, withholding or assessments paid by the PEO to or on behalf of covered employees under the professional employer agreement.
(b) "Client-employer" means an employer who enters into a professional employer agreement with a PEO.
(c) "Covered employee" means a person employed by a client-employer for whom certain employer responsibilities are shared or allocated pursuant to a PEO agreement. Persons who are officers, directors, shareholders, partners and managers of the client-employer and who perform day-to-day operational services for the client-employer will be covered employees only to the extent expressly set forth in the professional employer agreement.
(d) "PEO group" means two or more PEOs that are majority owned or commonly controlled by the same entity, parent or controlling persons.
(e) "Person" means a natural person or a legal entity, including, without limitation, a sole proprietorship, firm, partnership, limited liability company, association, trust or corporation.
(f) "Professional employer agreement" means a written contract by and between a client-employer and a PEO under which a PEO contracts to provide professional employer services for an administrative fee.
(g) "Professional employer organization" or "PEO" means a person engaged in the business of providing professional employer services, regardless of its use of the term, or conducting business as a "staff leasing company," "registered staff leasing company," "employee leasing company," "administrative employer," or any other name. For purposes of this article, the following is not a PEO:
(1) A person who shares employees with a commonly-owned company within the meaning of section 414(b) and (c) of the Internal Revenue Code of 1986, as amended;
(2) A person who neither holds itself out as a PEO, nor enters into professional employer agreements as its principal business activity;
(3) An independent contractor who assumes responsibility for the product produced or service performed by a person or his or her agents and who retains and exercises primary direction and control over the work performed; or
(4) A person who provides temporary help services.
(h) "Professional employer services" means functions that are:
(1) Allocated to a PEO in a PEO agreement;
(2) Customarily exercised by an employer with respect to its employees, including, but not limited to, hiring, firing and disciplining employees, paying wages, withholding and paying payroll taxes, maintaining employee benefit plans, and providing for mandatory workers' compensation coverage;
(3) Exercised with respect to a majority of the employees of a client-employer; and
(4) Intended to be of a continuing rather than a temporary or seasonal nature.
(j) "Worksite employees" means persons employed by a PEO and not by a client-employer.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-3. Rights, Duties and Obligations Unaffected by This Article

(a) Nothing in this article or in any professional employer agreement affects, modifies or amends any collective bargaining agreement, or the rights or obligations of a client-employer, PEO or covered employee under the Federal National Labor Relations Act, the Federal Railway Labor Act or article one-a, chapter twenty-one of this code.
(b) Notwithstanding any other provision of this article, nothing in this article or in any professional employer agreement:
(1) Diminishes, abolishes or removes rights of covered employees as to a client-employer or obligations of a client-employer to covered employees, including but not limited to rights and obligations arising from civil rights laws guaranteeing nondiscrimination in employment practices;
(2) Affects, modifies, or amends any contractual relationship or restrictive covenant between a covered employee and a client-employer in effect at the time a professional employer agreement becomes effective; or
(3) Prohibits or amends or any contractual relationship or restrictive covenant that is entered into subsequent to the effective date of a professional employer agreement between a client-employer and a covered employee.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-4a. Operation of a Peo Without a License; Enforcement; Penalties; Fraud Unit May Investigate

(a) Any person who operates a PEO without a license issued in accordance with this article is subject to the all of the injunctive, criminal, civil and administrative relief and criminal penalties as provided in article forty-four of this chapter for the unauthorized transaction of insurance.
(b) In addition to the other investigative authority granted to the commissioner in this chapter, the insurance fraud unit created pursuant to the provisions of section eight, article forty-one of this chapter may investigate suspected violations of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-5. Examinations; Costs; Confidentiality of Information

(a) The commissioner may examine or investigate the business and affairs of any PEO plan he or she considers necessary. The examination or investigation is subject to and shall be performed in accordance with the provisions of section nine, article two of this chapter.
(b) The commissioner shall assess the costs of an examination to the PEO.
(c) All working papers, recorded information, documents and copies thereof produced by, obtained by or disclosed to the commissioner or any other person in the course of an examination made under this section are subject to the confidentiality provisions of subdivision (4), subsection (l), section nine, article two of this chapter.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-6. Requirements for Provisions of Peo Agreements

(a) Each professional employer agreement shall, at a minimum, allocate the responsibility to:
(1) Arrange for the payment of wages to covered employees;
(2) Withhold, collect, report and remit payroll-related and unemployment taxes;
(3) Make payments for employee benefits on behalf of covered employees; and
(4) Provide for mandatory workers' compensation coverage.
(b) Each professional employer agreement shall provide that the client-employer shall retain the right to hire, discipline, and terminate a covered employee: Provided, That every professional employment agreement may provide that the PEO has the right to terminate the professional employment agreement if a client-employer refuses without good cause a request from the PEO that the client-employer discipline or terminate a covered employee as may be necessary to fulfill the PEO's responsibilities under this article and the professional employer agreement.
(c) Except as otherwise provided by law:
(1) A client-employer is solely responsible for the quality, adequacy or safety of the goods or services produced or sold in client-employer's business;
(2) A client-employer is solely responsible for directing, supervising, training and controlling the work of a covered employee, and is solely responsible for the acts, errors or omissions of a covered employee, when the covered employee is engaged in the business activities of the client-employer;
(3) A PEO is not liable for the acts, errors or omissions of a client-employer or of a covered employee of the client-employer when the covered employee is acting under the express direction and control of the client-employer.
(d) Within twenty days of its execution, every professional services agreement shall be filed with the commissioner. Such agreements are confidential by law and privileged, are not subject to the provisions of chapter twenty-nine-b of this code, and are not open to public inspection.
(e) A covered employee is not, solely as the result of being a covered employee, an employee of the PEO for purposes of general liability insurance, fidelity bonds, surety bonds, wage bonds or liquor liability insurance carried by the PEO, unless the covered employee is included by specific reference in the professional employer agreement and applicable prearranged employment contract, insurance contract or bond.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-9. Health Benefit Plans; Self-Funded Plans Permitted Under Certain Circumstances

(a) A professional employer organization that sponsors a health benefit plan shall be considered the employer of all of its covered employees, and all covered employees of one or more client employers participating in a health benefit plan sponsored by a single professional employer organization shall be considered employees of that professional employer organization. For purposes of state law, such health benefit plans shall be treated as a single employer welfare benefit plan.
(b) If a professional employer organization offers to its covered employees any health benefit plan which is not fully insured by an authorized insurer, the professional employer organization must comply with the provisions of article thirty-one of this chapter. The Insurance Commissioner of West Virginia is authorized to promulgate and adopt rules with respect to professional employer organizations sponsoring health benefit plans in accordance with this section.
2023 West Virginia Code › Chapter 33. Insurance › Article 46A. Professional Employer Organizations › §33-46A-10. Rule-Making Authority; Fees

(a) In addition to the authority to propose rules as provided in section seven of this article, the commissioner may propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code, to implement the provisions of this article, including but not limited to:
(1) Requirements for the issuance and renewal of licenses;
(2) Requirements for denying, suspending, revoking, reinstating or limiting the practice of a licensee;
(3) Requirements for activating inactive or revoked licenses;
(4) Special financial and other licensing requirements for small, start-up PEOs; and
(5) A schedule of fees.
(b) The commissioner may promulgate emergency rules pursuant to the provisions of section fifteen, article three, chapter twenty-nine-a of this code, for any purposes set forth for legislative rules in subsection (a) of this section.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-1. Purposes

Pursuant to terms and conditions of this article, the State of West Virginia seeks to join with other states and establish the interstate insurance product regulation compact and thus become a member of the interstate insurance product regulation commission. The Insurance Commissioner is hereby designated to serve as the representative of this state to the commission.
The purposes of this compact are, through means of joint and cooperative action among the compacting states:
(1) To promote and protect the interest of consumers of individual and group annuity, life insurance, disability income and long-term care insurance products;
(2) To develop uniform standards for insurance products covered under the compact;
(3) To establish a central clearinghouse to receive and provide prompt review of insurance products covered under the compact and, in certain cases, advertisements related thereto, submitted by insurers authorized to do business in one or more compacting states;
(4) To give appropriate regulatory approval to those product filings and advertisements satisfying the applicable uniform standard;
(5) To improve coordination of regulatory resources and expertise between state insurance departments regarding the setting of uniform standards and review of insurance products covered under the compact;
(6) To create the interstate insurance product regulation commission; and
(7) To perform these and such other related functions as may be consistent with the state regulation of the business of insurance.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-2. Definitions

For purposes of this compact:
(a) "Advertisement" means any material designed to create public interest in a product, or induce the public to purchase, increase, modify, reinstate, borrow on, surrender, replace or retain a policy as more specifically defined in the rules and operating procedures of the commission.
(b) "Bylaws" mean those bylaws established by the commission for its governance or for directing or controlling the commission's actions or conduct.
(c) "Compacting state" means any state which has enacted this compact legislation and which has not withdrawn pursuant to subsection (a), section fourteen of this article or been terminated pursuant to subsection (b) of said section.
(d) "Commission" means the "interstate insurance product regulation commission" established by this compact.
(e) "Commissioner" means the Insurance Commissioner of the State of West Virginia.
(f) "Domiciliary state" means the state in which an insurer is incorporated or organized; or, in the case of an alien insurer, its state of entry.
(g) "Insurer" means any entity licensed by a state to issue contracts of insurance for any of the lines of insurance covered by this article.
(h) "Member" means the person chosen by a compacting state as its representative to the commission or his or her designee.
(i) "Noncompacting state" means any state which is not at the time a compacting state.
(j) "Operating procedures" mean procedures promulgated by the commission implementing a rule, uniform standard or a provision of this compact.
(k) "Product" means the form of a policy or contract, including any application, endorsement or related form which is attached to and made a part of the policy or contract and any evidence of coverage or certificate, for an individual or group annuity, life insurance, disability income or long-term care insurance product that an insurer is authorized to issue.
(l) "Rule" means a statement of general or particular applicability and future effect promulgated by the commission, including a uniform standard developed pursuant to section seven of this article, designed to implement, interpret or prescribe law or policy or describing the organization, procedure or practice requirements of the commission, which shall have the force and effect of law in the compacting states.
(m) "State" means any state, district or territory of the United States of America.
(n) "Third-party filer" means an entity that submits a product filing to the commission on behalf of an insurer.
(o) "Uniform standard" means a standard adopted by the commission for a product line, pursuant to section seven of this article and shall include all of the product requirements in aggregate: Provided, That each uniform standard shall be construed, whether express or implied, to prohibit the use of any inconsistent, misleading or ambiguous provisions in a product and the form of the product made available to the public shall not be unfair, inequitable or against public policy as determined by the commission.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-3. Establishment of the Commission and Venue

(a) The compacting states hereby create and establish a joint public agency known as the "Interstate Insurance Product Regulation Commission." Pursuant to section four of this article, the commission will have the power to develop uniform standards for product lines, receive and provide prompt review of products filed therewith and give approval to those product filings satisfying applicable uniform standards: Provided, That it is not intended for the commission to be the exclusive entity for receipt and review of insurance product filings. Nothing herein shall prohibit any insurer from filing its product in any state wherein the insurer is licensed to conduct the business of insurance; and any such filing shall be subject to the laws of the state where filed.
(b) The commission is a body corporate and politic and an instrumentality of the compacting states.
(c) The commission is solely responsible for its liabilities except as otherwise specifically provided in this article.
(d) Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-6. Meetings and Acts of the Commission

(a) The commission shall meet and take such actions as are consistent with the provisions of this compact and the bylaws.
(b) Each member of the commission shall have the right and power to cast a vote to which that compacting state is entitled and to participate in the business and affairs of the commission. A member shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for members' participation in meetings by telephone or other means of communication.
(c) The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-9. Dispute Resolution

The commission shall attempt, upon the request of a member, to resolve any disputes or other issues that are subject to this compact and which may arise between two or more compacting states, or between compacting states and noncompacting states, and the commission shall promulgate an operating procedure providing for resolution of such disputes.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-10. Product Filing and Approval

(a) Insurers and third-party filers seeking to have a product approved by the commission shall file the product with, and pay applicable filing fees to, the commission. Nothing in this article shall be construed to restrict or otherwise prevent an insurer from filing its product with the insurance department in any state wherein the insurer is licensed to conduct the business of insurance, and such filing shall be subject to the laws of the states where filed.
(b) The commission shall establish appropriate filing and review processes and procedures pursuant to commission rules and operating procedures. Notwithstanding any provision herein to the contrary, the commission shall promulgate rules to establish conditions and procedures under which the commission will provide public access to product filing information. In establishing such rules, the commission shall consider the interests of the public in having access to such information, as well as protection of personal, medical and financial information and trade secrets, that may be contained in a product filing or supporting information.
(c) Any product approved by the commission may be sold or otherwise issued in those compacting states for which the insurer is legally authorized to do business.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-11. Review of Commission Decisions Regarding Filings

(a) Not later than thirty days after the commission has given notice of a disapproved product or advertisement filed with the commission, the insurer or third-party filer whose filing was disapproved may appeal the determination to a review panel appointed by the commission. The commission shall promulgate rules to establish procedures for appointing such review panels and provide for notice and hearing. An allegation that the commission, in disapproving a product or advertisement filed with the commission, acted arbitrarily, capriciously, or in a manner that is an abuse of discretion or otherwise not in accordance with the law, is subject to judicial review in accordance with subsection (d), section three of this article.
(b) The commission shall have authority to monitor, review and reconsider products and advertisements subsequent to their filing or approval upon a finding that the product does not meet the relevant uniform standard. Where appropriate, the commission may withdraw or modify its approval after proper notice and hearing, subject to the appeal process in subsection (a) of this section.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-12. Finance

(a) The commission shall pay or provide for the payment of the reasonable expenses of its establishment and organization. To fund the cost of its initial operations, the commission may accept contributions and other forms of funding from the national association of Insurance Commissioners, compacting states and other sources. Contributions and other forms of funding from other sources shall be of such a nature that the independence of the commission concerning the performance of its duties shall not be compromised.
(b) The commission shall collect a filing fee from each insurer and third party filer filing a product with the commission to cover the cost of the operations and activities of the commission and its staff in a total amount sufficient to cover the commission's annual budget.
(c) The commission's budget for a fiscal year shall not be approved until it has been subject to notice and comment as set forth in section seven of this article.
(d) The commission shall be exempt from all taxation in and by the compacting states.
(e) The commission shall not pledge the credit of any compacting state, except by and with the appropriate legal authority of that compacting state.
(f) The commission shall keep complete and accurate accounts of all its internal receipts, including grants and donations, and disbursements of all funds under its control. The internal financial accounts of the commission shall be subject to the accounting procedures established under its bylaws. The financial accounts and reports including the system of internal controls and procedures of the commission shall be audited annually by an independent certified public accountant. Upon the determination of the commission, but no less frequently than every three years, the review of the independent Auditor shall include a management and performance audit of the commission. The commission shall make an annual report to the Governor and Legislature of the compacting states, which shall include a report of the independent audit. The commission's internal accounts shall not be confidential and such materials may be shared with the commissioner of any compacting state upon request: Provided, That any work papers related to any internal or independent audit and any information regarding the privacy of individuals and insurers' proprietary information, including trade secrets, shall remain confidential.
(g) No compacting state shall have any claim to or ownership of any property held by or vested in the commission or to any commission funds held pursuant to the provisions of this compact.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-13. Compacting States, Effective Date and Amendment

(a) Any state is eligible to become a compacting state.
(b) The compact shall become effective and binding upon legislative enactment of the compact into law by two compacting states: Provided, That the commission shall become effective for purposes of adopting uniform standards for, reviewing and giving approval or disapproval of, products filed with the commission that satisfy applicable uniform standards only after twenty-six states are compacting states or, alternatively, by states representing greater than forty percent of the premium volume for life insurance, annuity, disability income and long-term care insurance products, based on records of the national association of Insurance Commissioners for the prior year. Thereafter, it shall become effective and binding as to any other compacting state upon enactment of the compact into law by that state.
(c) Amendments to the compact may be proposed by the commission for enactment by the compacting states. No amendment shall become effective and binding upon the commission and the compacting states unless and until all compacting states enact the amendment into law.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-15. Severability and Construction

(a) The provisions of this compact shall be severable; and if any phrase, clause, sentence or provision is deemed unenforceable, the remaining provisions of the compact shall be enforceable.
(b) The provisions of this compact shall be liberally construed to effectuate its purposes.
2023 West Virginia Code › Chapter 33. Insurance › Article 47. Interstate Insurance Product Regulation Compact › §33-47-16. Binding Effect of Compact and Other Laws

(a) Other laws. --
(1) Nothing herein prevents the enforcement of any other law of a compacting state, except as provided in subdivision (2) of this subsection.
(2) For any product approved or certified to the commission, the rules, uniform standards and any other requirements of the commission shall constitute the exclusive provisions applicable to the content, approval and certification of such products. For advertisements that are subject to the commission's authority, any rule, uniform standard or other requirement of the commission which governs the content of the advertisements shall constitute the exclusive provision that a commissioner may apply to the content of the advertisement. Notwithstanding the foregoing, no action taken by the commission shall abrogate or restrict: (i) The access of any person to state courts; (ii) remedies available under state law related to breach of contract, tort or other laws not specifically directed to the content of the product; (iii) state law relating to the construction of insurance contracts; or (iv) the authority of the Attorney General of the state, including, but not limited to, maintaining any actions or proceedings, as authorized by law.
(3) All insurance products filed with individual states shall be subject to the laws of those states.
(b) Binding effect of this compact. --
(1) All lawful actions of the commission, including all rules and operating procedures promulgated by the commission, are binding upon the compacting states.
(2) All agreements between the commission and the compacting states are binding in accordance with their terms.
(3) Upon the request of a party to a conflict over the meaning or interpretation of commission actions and upon a majority vote of the compacting states, the commission may issue advisory opinions regarding the meaning or interpretation in dispute.
(4) In the event any provision of this compact exceeds the Constitutional limits imposed on the Legislature of any compacting state, the obligations, duties, powers or jurisdiction sought to be conferred by that provision upon the commission shall be ineffective as to that compacting state and those obligations, duties, powers or jurisdiction shall remain in the compacting state and shall be exercised by the agency thereof to which those obligations, duties, powers or jurisdiction are delegated by law in effect at the time this compact becomes effective.
2023 West Virginia Code › Chapter 33. Insurance › Article 48. Model Health Plan for Uninsurable Individuals Act › §33-48-5. Unfair Referral to Plan

It shall constitute an unfair trade practice for the purposes of article eleven of this chapter for an insurer, insurance agent or insurance broker to refer an individual employee to the plan, or arrange for an individual employee to apply to the plan, for the purpose of separating that employee from group health insurance coverage provided in connection with the employee's employment.
2023 West Virginia Code › Chapter 33. Insurance › Article 48. Model Health Plan for Uninsurable Individuals Act › §33-48-7. Funding of the Plan

(a) Premiums. --
(1) The plan shall establish premium rates for plan coverage as provided in subdivision (2) of this subsection. Separate schedules of premium rates based on age, sex and geographical location may apply for individual risks. Premium rates and schedules shall be submitted to the commissioner for approval prior to use.
(2) The plan, with the assistance of the commissioner, shall determine a standard risk rate by considering the premium rates charged by other insurers offering health insurance coverage to individuals. The standard risk rate shall be established using reasonable actuarial techniques and shall reflect anticipated experience and expenses for such coverage. Initial rates for plan coverage shall not be less than one hundred twenty-five percent of rates established as applicable for individual standard risks. Subject to the limits provided in this subdivision, subsequent rates shall be established to provide fully for the expected costs of claims including recovery of prior losses, expenses of operation, investment income of claim reserves and any other cost factors subject to the limitations described herein. In no event shall plan rates exceed one hundred fifty percent of rates applicable to individual standard risks.
(b) Notwithstanding the provisions of subsection (c), section eight, article twenty-nine-b, chapter sixteen of this code and not to be construed as in conflict therewith, the Health Care Authority is authorized to increase the assessment obligation of hospitals in an amount not to exceed a maximum of twenty-five percent above the one tenth of one percent specified in said subsection and the entire assessment, including the additional assessment, shall be collected as specified in said subsection. Upon receipt of the additional assessment, the Health Care Authority shall transfer all proceeds generated from the additional assessment collected to the special revenue account established in section seven-a of this article.
(c) The plan is authorized to receive and expend any federal grant.
(d) With the consent of the board, the commissioner is authorized to utilize his or her administrative staff and resources in administering this article. The board shall reimburse the commissioner for all costs of administrative and actuarial services, supplies and other costs incurred by the commissioner in implementing the provisions of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 48. Model Health Plan for Uninsurable Individuals Act › §33-48-7a. Special Revenue Account Created

(a) There is hereby created a special revenue account in the state Treasury, designated the "West Virginia Health Insurance Plan Fund", which shall be an interest-bearing account and may be invested in the manner permitted by article six, chapter twelve of this code, with the interest income a proper credit to the fund, unless otherwise designated in law. The fund shall be administered by the commissioner, under the supervision and control of the board, and used to pay all proper costs incurred in implementing the provisions of this article, all administrative costs of the plan, all claims and all proper ongoing costs of the plan. Moneys deposited into this account are available for expenditure as the commissioner may direct in accordance with the provisions of this article.
(b) The following funds shall be paid into this account:
(1) All premium payments received from individuals insured by the plan;
(2) All other payments, gifts or income from any source; and
(3) Transfers from the Health Care Authority of all proceeds generated from the additional assessment collected pursuant to subsection (b), section seven of this article at any time after July 1, 2004.
2023 West Virginia Code › Chapter 33. Insurance › Article 48. Model Health Plan for Uninsurable Individuals Act › §33-48-7b. Surplus Available to Subsidize Premiums

Whenever the board determines that the account created pursuant to section seven-a of this article contains a surplus above those amounts necessary to provide fully for the expected costs of claims and other expenses listed in subsection (a), section seven of this article, the plan may use such surpluses to subsidize the premium of enrollees with an annual average household income at or below four hundred percent of the federal poverty level. The board may propose emergency rules and shall propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code to establish eligibility criteria for enrollees who are eligible for premium subsidy pursuant to this section.
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-2. Definitions

(a) As used in this article, the term "flood" means a general and temporary condition of partial or complete inundation of two acres or more of normally dry land area or of two or more properties, at least one of which is the policyholder's property, from:
(1) Overflow of waters;
(2) Unusual and rapid accumulation or runoff of surface waters from any source;
(3) Mudflow; or
(4) Collapse or subsidence of land along the shore of a lake or similar body of water as a result of erosion or undermining caused by waves or currents of water exceeding anticipated cyclical levels which result in a flood.
(b) As used in this article, the term "insurer" means an insurer that is subject to the provisions of this chapter and is offering flood insurance pursuant to this article: Provided, That a surplus lines insurer offering flood insurance pursuant to this article is exempt from the requirements of this chapter but subject to laws and rules applicable to surplus lines insurers.
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-3. Issuance of Flood Insurance

(a) Subject to the requirements of this article, an insurer may issue an insurance policy, contract or endorsement providing coverage for the peril of flood on any structure or on the contents of personal property on a form that has been filed with and approved by the commissioner pursuant to section eight, article six of this chapter and that may be substantially similar to the form used by the National Flood Insurance Program (NFIP).
(b) A surplus lines agent may export a contract or endorsement providing flood coverage of $1 million or more to an eligible surplus lines insurer without making a diligent effort to seek such coverage from three or more authorized insurers as provided in article twelve-c of this chapter. This subsection expires on July 1, 2019.
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-4. Content of Flood Insurance

(a) At a minimum, coverage for the peril of flood must cover a flood as defined in this article. Coverage for the peril of flood may also include water intrusion, as defined by the policy, which originates from outside the structure and is not otherwise covered under the definition of flood.
(b) An insurer may offer a flood coverage policy, contract or endorsement:
(1) That has a flood deductible based on a stated dollar amount or a percentage of the coverage amount. At a minimum, an insurer must offer deductible amounts applicable to flood losses that equal the standard deductibles offered under the National Flood Insurance Program;
(2) That provides that any flood loss will be adjusted on the basis of:
(A) The actual cash value of the property; or
(B) Replacement costs up to the policy limits in the same manner as provided under section nine, article seventeen of this chapter;
(3) That restricts flood coverage to the principal building, as defined in the applicable policy;
(4) In an agreed-upon amount, including coverage limited to the amount of all outstanding mortgages applicable to the covered property. However, if a policy, contract or endorsement does not limit flood coverage to the replacement cost of the covered property, the contract or endorsement may not include a provision penalizing the policyholder for not insuring the covered property up to replacement cost; or
(5) That, as to the peril of flood, does not cover:
(A) Additional living expenses;
(B) Personal property or contents; or
(C) Law and ordinance coverage. However, an insurer must offer law and ordinance coverage that is comparable to the law and ordinance coverage offered in the standard National Flood Insurance Program policy. A policy, endorsement, or contract that includes the law and ordinance coverage that must be offered under this paragraph must include the following disclosure in uppercase bold lettering of at least 12-point type:
"LAW AND ORDINANCE COVERAGE UNDER THIS POLICY MIGHT HAVE LIMITATIONS ON WHAT IS COVERED IN THE EVENT OF A LOSS. YOU SHOULD CONSULT WITH YOUR AGENT IF YOU HAVE QUESTIONS ABOUT THE COVERAGE OFFERED UNDER THIS POLICY."
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-5. Notice of Availability and Limits of Flood Insurance

(a) A policy, endorsement or contract providing coverage for the peril of flood must provide notice that flood insurance coverage is available from the National Flood Insurance Program.
(b) Any limitations on flood coverage or policy limits as to the peril of flood, including, but not limited to, flood deductibles or flood coverage limited to the amount of all outstanding mortgages, must be prominently disclosed on the declarations page or face page of the policy in uppercase bold lettering of at least 12-point type and be sufficiently clear so as to be readily understandable by both the agent and the property owner.
(c) A policy that limits flood coverage to an amount less than the full replacement cost of the property must include the statement:
"THIS POLICY LIMITS FLOOD COVERAGE TO LESS THAN THE FULL COST OF REPLACEMENT FOR THE PROPERTY, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU AND MAY PUT YOUR EQUITY IN THIS PROPERTY AT RISK."
(d) A policy that insures a dwelling on the basis of actual cash value must include the statement:
"THIS POLICY PAYS YOU THE DEPRECIATED VALUE OF YOUR PROPERTY THAT IS DAMAGED BY FLOOD, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU IF YOUR PROPERTY NEEDS TO BE REPAIRED OR REPLACED."
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-6. Notice of Cancellation or Nonrenewal

A policy, endorsement or contract providing coverage for the peril of flood must require the insurer to give 45-days' prior written notice of cancellation or nonrenewal to the insured and any regulated lending institution or federal agency that is a mortgagee. An insurer or insured may cancel during the term of the policy or upon renewal if the cancellation is for a valid reason under the National Flood Insurance Program.
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-7. Additional Requirements

(a) In addition to any other applicable requirements, an insurer providing flood coverage in this state must:
(1) Notify the office at least thirty days before writing flood insurance in this state; and
(2) File a plan of operation and financial projections or revisions to such plan, as applicable, with the commissioner.
2023 West Virginia Code › Chapter 33. Insurance › Article 49. Flood Insurance › §33-49-10. Rule-Making Authority

(a) The commissioner may propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code to implement the provisions of this article, including but not limited to:
(1) Establishing and refining definitions;
(2) Requirements for ratemaking, forms and other requirements under this chapter;
(3) Clarifying minimum coverage requirements for flood insurance policies;
(4) Determining whether a policy meets the definition of "private flood insurance" or other certain standards and requirements; and
(5) Solvency and market conduct operations.
(b) The commissioner may promulgate emergency rules pursuant to the provisions of section fifteen, article three, chapter twenty-nine-a of this code for any purposes set forth for legislative rules in subsection (a) of this section.