reglab/statecodes huggingface dataset:
2023 West Virginia Code › Chapter 33. Insurance › Article 50. Patient Protection and Transparency Act › §33-50-1. Definitions

For the purposes of this article, the following words and terms mean the following:
(1) "Commissioner" means the West Virginia Insurance Commissioner.
(2) "Consumer" means an individual or family purchasing insurance coverage through the exchange.
(3) "Exchange" means the West Virginia Health Benefit Exchange or an exchange website operated by the federal government.
(4) "Health care provider" means a provider of medical or health services and any other person or organization who furnishes, bills or is paid for health care in the normal course of business.
(5) "Health carrier" means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health services.
(6) "Network" means a group of health care providers that have contracted with a health plan to provide care at a discounted rate.
(7) "Qualified health plan" means a health plan certified to be offered for sale through the exchange.
(8) "West Virginia Health Benefit Exchange" means the government-regulated marketplace of qualified health plans with multiple levels of coverage established pursuant to article sixteen-g of this chapter.
2023 West Virginia Code › Chapter 33. Insurance › Article 50. Patient Protection and Transparency Act › §33-50-2. Information Available to the Public and Disclosures Required of Health Carriers

(a) The commissioner shall on his or her website provide information regarding the qualified health plans being offered for sale through the exchange in a format easily found by a consumer on such website. Information may be provided through links to specific information, including through links to the website of each health carrier offering a qualified health plan for sale through the exchange.
(b) Information to be made available to consumers for each qualified health plan offered for sale through the exchange include:
(1) The names of the physicians, hospitals and other health care providers that are in network;
(2) A list of the types of specialists that are in network;
(3) Exclusions from coverage by category of benefits;
(4) Restrictions on use or quantity of covered items and services by category of benefits;
(5) The dollar amount of copayments;
(6) The percentage of coinsurance by item and service;
(7) Required cost-sharing;
(8) Information sufficient to determine whether a specific drug is available on formulary;
(9) Clinical prerequisites or authorization requirements for coverage of specific drugs;
(10) A description of how medications will be included in or excluded from the deductible;
(11) A description of out-of-pocket costs that may not apply to the deductible for a medication;
(12) Information sufficient to determine whether a specific drug is covered when furnished by a physician or clinic;
(13) An explanation of the amount of coverage for out-of-network providers or noncovered services;
(14) The process for a patient to appeal a health plan decision; and
(15) Contact information for the qualified health plan.
(c) The commissioner may require a qualified health plan to make the information listed in subsection (b) of this section available, including for website usage, and to provide for the reasonable updating of such information.
(d) The commissioner's website should provide general information concerning the exchange, qualified health plans, health insurance terminology and other information consumers may need to assist them in making informed decisions concerning the purchase of a qualified health plan through the exchange.
2023 West Virginia Code › Chapter 33. Insurance › Article 51. Pharmacy Audit Integrity Act › §33-51-6. Limitations

(a) The provisions of this article do not apply to an investigative audit of pharmacy records when:
(1) Fraud, waste, abuse or other intentional misconduct is indicated by physical review or review of claims data or statements; or
(2) Other investigative methods indicate a pharmacy is or has been engaged in criminal wrongdoing, fraud or other intentional or willful misrepresentation.
(b) This article does not supersede any audit requirements established by federal law.
2023 West Virginia Code › Chapter 33. Insurance › Article 51. Pharmacy Audit Integrity Act › §33-51-7. Pharmacy Benefits Manager and Auditing Entity Registration

(a) Prior to conducting business in the State of West Virginia, except as provided in subsection (d) of this section, an auditing entity shall register with the Insurance Commissioner. The commissioner shall make an application form available on its publicly accessible Internet website that includes a request for the following information:
(1) The identity, address, and telephone number of the applicant;
(2) The name, business address, and telephone number of the contact person for the applicant; and
(3) When applicable, the federal employer identification number for the applicant.
(b) Term and fee. —
(1) The term of registration shall be two years from the date of issuance.
(2) The Insurance Commissioner shall determine the amount of the initial application fee and the renewal application fee for the registration. Such fee shall be submitted by the applicant with an application for registration. An initial application fee is nonrefundable. A renewal application fee shall be returned if the renewal of the registration is not granted.
(3) The amount of the initial application fees and renewal application fees must be sufficient to fund the Insurance Commissioner's duties in relation to its responsibilities under this article, but a single fee may not exceed $1,000.
(c) Registration. —
(1) The Insurance Commissioner shall issue a registration, as appropriate, to an applicant when the Insurance Commissioner determines that the applicant has submitted a completed application and paid the required registration fee.
(2) The registration may be in paper or electronic form, is nontransferable, and shall prominently list the expiration date of the registration.
(d) Duplicate registration. —
(1) A licensed insurer or other entity licensed by the commissioner pursuant to this chapter shall comply with the standards and procedures of this article but is not required to separately register as an auditing entity.
(2) A pharmacy benefits manager that is registered as a third-party administrator pursuant to §33-46-1 et seq. of this code shall comply with the standards and procedures of this article but is not required to register separately as an auditing entity.
2023 West Virginia Code › Chapter 33. Insurance › Article 51. Pharmacy Audit Integrity Act › §33-51-13. Effective Date

Notwithstanding any other effective date to the contrary, the amendments to this article enacted during the 2022 regular legislative session shall apply to all policies, contracts, plans, or agreements subject to this section that are delivered, executed, amended, adjusted, or renewed on or after January 1, 2023.
2023 West Virginia Code › Chapter 33. Insurance › Article 52. Corporate Governance Annual Disclosure Act › §33-52-1. Short Title, Purpose and Scope of Article

(a) This article may be cited as the "Corporate Governance Annual Disclosure Act".
(b) The purpose of this article is to:
(1) Provide the commissioner a summary of an insurers or insurance groups corporate governance structure, policies and practices to permit the commissioner to gain and maintain an understanding of the insurers corporate governance framework;
(2) Outline the requirements for completing a corporate governance annual disclosure with the commissioner;
(3) Set forth the procedures for filing the corporate governance annual disclosure; and
(4) Provide for the confidential treatment of the corporate governance annual disclosure and related information that will contain confidential and sensitive information related to an insurer or insurance groups internal operations and proprietary and trade secret information which, if made public, could potentially cause the insurer or insurance group competitive harm or disadvantage.
(c) Nothing in this article limits the commissioners examination authority, or the rights or obligations of third parties, under §33-2-9 of this code.
(d) The requirements of this article apply to all licensed insurers domiciled in this state.
2023 West Virginia Code › Chapter 33. Insurance › Article 52. Corporate Governance Annual Disclosure Act › §33-52-2. Definitions

As used in this article:
(1) "Board" means the board of directors of an insurer or insurance group.
(2) "Corporate Governance Annual Disclosure" or "CGAD" means a confidential report filed by the insurer or insurance group made in accordance with the requirements of this article.
(3) "Insurance group" means those insurers and affiliates included within an insurance holding company system as defined in §33-27-2 of this code.
(4) "Insurer" means every person engaged in the business of making contracts of insurance, except that it shall not include agencies, authorities or instrumentalities of the United States, its possessions and territories, the Commonwealth of Puerto Rico, the District of Columbia, or a state or political subdivision of a state.
(5) "ORSA summary report" means the report filed in accordance with §33-40B-5 of this code.
(6) "Senior management" means any corporate officer responsible for reporting information to the board at regular intervals or providing this information to shareholders or regulators and shall include, for example and without limitation, the chief executive officer (CEO), chief financial officer (CFO), chief operations officer (COO), chief procurement officer (CPO), chief legal officer (CLO), chief information officer (CIO), chief technology officer (CTO), chief revenue officer (CRO), chief visionary officer (CVO), or any other "C" level executive.
2023 West Virginia Code › Chapter 33. Insurance › Article 52. Corporate Governance Annual Disclosure Act › §33-52-5. Filing Procedures

(a) An insurer, or the insurance group of which the insurer is a member, required to file a CGAD by §33-52-3 of this code, shall, no later than June 1 of each calendar year, submit to the commissioner a CGAD that contains the information described in §33-52-4 of this code.
(b) The insurer or insurance group has discretion regarding the appropriate format for providing the information required by this article and is permitted to customize the CGAD to provide the most relevant information necessary to permit the commissioner to gain an understanding of the corporate governance structure, policies and practices utilized by the insurer or insurance group.
(c) Notwithstanding subsection (a) of this section, and as outlined in §33-52-3 of this code, if the CGAD is completed at the insurance group level, then it must be filed with the lead state of the group as determined by the procedures outlined in the most recent financial analysis handbook adopted by the National Association of Insurance Commissioners. In these instances, a copy of the CGAD must also be provided to the chief regulatory official of any state in which the insurance group has a domestic insurer, upon request.
(d) An insurer or insurance group may comply with this section by referencing other existing documents, including, but not limited to, ORSA summary report, holding company Form B or F filings, Securities and Exchange Commission (SEC) proxy statements or foreign regulatory reporting requirements, if the documents provide information that is comparable to the information described in §33-52-4 of this code. The insurer or insurance group shall clearly reference the location of the relevant information within the CGAD and attach the referenced document if it is not already filed or available to the commissioner.
(e) Each year following the initial filing of the CGAD, the insurer or insurance group shall file an amended version of the previously filed CGAD indicating where changes have been made. If no changes were made in the information or activities reported by the insurer or insurance group, the filing should so state.
2023 West Virginia Code › Chapter 33. Insurance › Article 52. Corporate Governance Annual Disclosure Act › §33-52-8. Sanctions

Any insurer failing, without just cause, to timely file the CGAD as required in this article shall be required, after notice and hearing, to pay a penalty of up to $1,000 for each days delay, to be recovered by the commissioner. Any penalty so recovered shall be paid into the General Revenue Fund of this state. The commissioner may reduce the penalty if the insurer demonstrates to the commissioner that the imposition of the penalty would constitute a financial hardship to the insurer.
2023 West Virginia Code › Chapter 33. Insurance › Article 53. Certificates of Insurance › §33-53-2. Definitions

For purposes of this article:
"Certificate of insurance" means a document or instrument, regardless of how titled or described, that is prepared or issued by an insurer or insurance producer as evidence or confirmation of the existence of property or casualty insurance coverage. The term does not include a statement of declaration, policy of insurance, insurance binder, policy endorsement, or automobile insurance identification or information card.
"Insurance producer" means a person required to be licensed under the laws of this state to sell, solicit, or negotiate property or casualty insurance.
"Insurer" means any organization that issues property or casualty insurance.
"Person" means any individual, partnership, corporation, association, or other legal entity, including any government or governmental subdivision or agency.
2023 West Virginia Code › Chapter 33. Insurance › Article 53. Certificates of Insurance › §33-53-3. Certificate Forms

(a) The Commissioner of Insurance shall prohibit the use of a certificate of insurance form if the form:
(1) Is unfair, misleading, or deceptive, or violates public policy; or
(2) Violates any law, including any rule promulgated by the commissioner.
(b) A certificate of insurance is not a policy of insurance and does not affirmatively or negatively amend, extend, or alter the coverage afforded by the policy to which the certificate of insurance makes reference. A certificate of insurance does not confer to any person new or additional rights beyond what the referenced policy of insurance expressly provides.
2023 West Virginia Code › Chapter 33. Insurance › Article 53. Certificates of Insurance › §33-53-4. Limitations on Use

(a) A person may not:
(1) Prepare, issue, or request or require the issuance of a certificate of insurance that contains any false or misleading information concerning the policy of insurance to which the certificate of insurance refers; or
(2) Prepare, issue, or request or require the issuance of a certificate of insurance that purports to affirmatively or negatively alter, amend, or extend the coverage provided by the policy of insurance to which the certificate of insurance refers.
(b) A certificate of insurance may not warrant that the policy of insurance referenced in the certificate comply with the insurance or indemnification requirements of a contract and the inclusion of a contract number or description within a certificate of insurance may not be interpreted as doing such.
2023 West Virginia Code › Chapter 33. Insurance › Article 53. Certificates of Insurance › §33-53-5. Notice Requirements

A person is entitled to notice of cancellation, nonrenewal, or any material change, and to any similar notice concerning a policy of insurance only if the person has such notice rights under the terms of the policy of insurance or any endorsement to the policy. The terms and conditions of the notice are governed by the policy of insurance or endorsement and may not be altered by a certificate of insurance.
2023 West Virginia Code › Chapter 33. Insurance › Article 53. Certificates of Insurance › §33-53-6. Applicability

(a) The provisions of this article apply to all certificates of insurance issued in connection with a property or casualty insurance policy issued or renewed on or after July 1, 2020, and in connection with property, operations, or risks located in this state, regardless of where the policyholder, insurer, insurance producer, or person requesting or requiring the issuance of a certificate of insurance is located.
(b) A certificate of insurance or any other document or correspondence prepared, issued, requested, or required in violation of this article is void.
2023 West Virginia Code › Chapter 33. Insurance › Article 53. Certificates of Insurance › §33-53-7. Enforcement, Penalties and Rulemaking

(a) The Commissioner of Insurance shall examine and investigate the activities of any person that the commissioner reasonably believes has been or is engaged in an act or practice prohibited by this article.
(b) The commissioner may enforce the provisions of this article by any means permissible in this chapter, including by issuing orders to cease and desist. Any person who violates a provision of this article may, after notice and hearing pursuant to 33-2-13 of this code, be fined by the commissioner a sum not to exceed $1,000 per violation.
(c) The commissioner may propose rules for legislative approval in accordance with the provisions of 29A-3-1
et seq.
of this code, necessary or reasonable to carry out the provisions of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 54. Requiring Accountable Pharmaceutical Transparency, Oversight, and Reporting Act › §33-54-3. Drug Manufacturer Reporting Requirements

(a) Not later than January 15 of each calendar year, a drug manufacturer shall submit a report to the Auditor stating the following information for each brand-name, specialty, and generic drug manufactured by the drug manufacturer and sold in the state directly by the drug manufacturer or a wholesale drug distributor:
Provided
, That the requirements of this section only apply to:
(1) Generic, brand-name, or specialty drugs with a wholesale acquisition cost of at least $100 for a 30-day supply; and
(2) A generic, brand-name, or specialty drug manufactured by a drug manufacturer that recognizes a wholesale acquisition cost increase of 40 percent or greater over the preceding three calendar years, or 15 percent or greater in the previous calendar year.
(b) The report shall include:
(1) The name of the drug;
(2) Whether the drug is a brand-name drug or generic drug;
(3) The effective date of any change or any reportable change in the wholesale acquisition cost price;
(4) The introductory price of the prescription drug when it was approved for marketing by the United States Food and Drug Administration;
(5) The national drug code for the specific drug;
(6) Aggregate company-level research and development costs for the most recent calendar year for which final audit data is available;
(7) The name and annual U.S. sales/revenue of each drug manufacturers prescription drugs that lost patent exclusivity in the United States in the previous three calendar years; and
(8) A statement regarding the factor or factors that caused any increase in the wholesale acquisition cost.
(c) If the drug manufacturer is subject to reporting requirements established by the Securities and Exchange Commission, the quality and types of information submitted to the Auditor under this section must be consistent with the information that the drug manufacturer includes in the drug manufacturers annual report submitted on Form 10-K to the Securities and Exchange Commission.
2023 West Virginia Code › Chapter 33. Insurance › Article 54. Requiring Accountable Pharmaceutical Transparency, Oversight, and Reporting Act › §33-54-4. Health Benefit Plan Issuer Reporting Requirements

No later than March 1 of each calendar year, each health benefit plan issuer shall submit to the Auditor a report providing the following information for the immediately preceding calendar year:
Provided
, That nothing in this article should be construed as to requiring a health benefit plan issuer to disclose confidential health information protected by the Health Insurance Portability and Accountability Act:
(1) The names of the 25 most frequently prescribed prescription drugs across all plans;
(2) The percent increase in annual net spending for prescription drugs across all plans;
(3) The percent increase in premiums that were attributable to prescription drugs across all plans;
(4) The percentage of specialty drugs with utilization management requirements across all plans; and
(5) The premium reductions that were attributable to specialty drug utilization management.
2023 West Virginia Code › Chapter 33. Insurance › Article 54. Requiring Accountable Pharmaceutical Transparency, Oversight, and Reporting Act › §33-54-5. Auditor S Searchable Pharmaceutical Transparency Website Created

(a) By July 1, 2021, the Auditor shall create a searchable pharmaceutical price transparency website, containing the information specified in §33-54-3 and §33-54-4 of this code, available to the public at no cost, and presented in a consumer-friendly, searchable format.
(b) Effective July 1, 2021, the Auditor shall update the information displayed on the searchable pharmaceutical price transparency website within 30 days of receiving updated or revised information from a drug manufacturer or health benefit plan issuer.
(c) Each drug manufacturer or health benefit plan issuer shall submit to the Auditor in writing contact information for those entities or individuals employed by the health benefit plan issuer or drug manufacturer responsible for complying with reporting requirements specified in §33-54-3 of this code, and shall notify the Auditor within 30 days of any changes to this information.
(d) The Auditor shall publish the identity of any drug manufacturer or health benefit plan issuer who fails to comply with the requirements of this article or who submits false or inaccurate information to the Auditor.
(e) The Auditor shall compile a report regarding information submitted pursuant to the provisions of §33-54-4 of this code and submit this analysis to the Legislative Oversight Commission on Health and Human Resources Accountability created pursuant to §16-29E-1
et seq.
of this code beginning on December 30, 2022, and annually thereafter.
2023 West Virginia Code › Chapter 33. Insurance › Article 55. Health Benefit Plan Network Access and Adequacy Act › §33-55-2. Applicability and Scope

(a) Except as provided in subsection (b) of this section, this article applies to all health carriers that offer network plans.
(b) The following provisions of this article do not apply to health carriers that offer network plans that consist solely of limited scope dental plans or limited scope vision plans:
(1) 33-55-3(a)(2) of this code;
(2) 33-55-3(f)(7)(E), 33-55-3(f)(8)(B) and 33-55-3(f)(11) of this code;
(3) 33-55-4(b)(2) and (3) of this code; and
(4) 33-55-4(c)(1)(A) and (B), 33-55-4(c)(2), 33-55-4(c)(3), 33-55-4(d)(1)(B) and 33-55-4(d)(1)(C) of this code.
2023 West Virginia Code › Chapter 33. Insurance › Article 55. Health Benefit Plan Network Access and Adequacy Act › §33-55-5. Intermediaries

A contract between a health carrier and an intermediary shall satisfy all the requirements contained in this section.
(a) A health carriers statutory responsibility to monitor the offering of covered benefits to covered persons may not be delegated or assigned to the intermediary.
(b) A health carrier has the right to approve or disapprove participation status of a subcontracted provider in its own or a contracted network for the purpose of delivering covered benefits to the carriers covered persons.
(c) A health carrier shall maintain copies of all intermediary health care subcontracts at its principal place of business in the state, or ensure that it has access to all intermediary subcontracts, including the right to make copies to facilitate regulatory review, upon 20 days prior written notice from the health carrier.
(d) If applicable, an intermediary shall transmit utilization documentation and claims-paid documentation to the health carrier. The carrier shall monitor the timeliness and appropriateness of payments made to providers and health care services received by covered persons.
(e) If applicable, an intermediary shall maintain the books, records, financial information, and documentation of services provided to covered persons at its principal place of business in the state and preserve them for two years in a manner that facilitates regulatory review.
(f) An intermediary shall allow the commissioner access to the intermediarys books, records, financial information, and any documentation of services provided to covered persons, as necessary to determine compliance with this article.
(g) A health carrier has the right, in the event of the intermediarys insolvency, to require the assignment to the health carrier of the provisions of a providers contract addressing the providers obligation to furnish covered services. If a health carrier requires assignment, the health carrier remains obligated to pay the provider for furnishing covered services under the same terms and conditions as the intermediary prior to the insolvency.
(h) Notwithstanding any other provision of this section, to the extent the health carrier delegates its responsibilities to the intermediary, the carrier shall retain full responsibility for the intermediarys compliance with the requirements of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 55. Health Benefit Plan Network Access and Adequacy Act › §33-55-6. Filing Requirements and State Administration

(a) At the time a health carrier files its access plan, the health carrier shall file for approval with the commissioner sample contract forms proposed for use with its participating providers and intermediaries.
(b) A health carrier shall submit material changes to a contract that would affect a provision required under this article or implementing regulations to the commissioner for approval at least 30 days prior to use.
(c) The health carrier shall maintain provider and intermediary contracts at its principal place of business in the state, or the health carrier shall have access to all contracts and provide copies to facilitate regulatory review upon 20 days prior written notice from the commissioner.
2023 West Virginia Code › Chapter 33. Insurance › Article 55. Health Benefit Plan Network Access and Adequacy Act › §33-55-7. Contracting

(a) The execution of a contract by a health carrier does not relieve the health carrier of its liability to any person with whom it has contracted for the provision of services, nor of its responsibility for compliance with the law or applicable regulations.
(b) All contracts shall be in writing and subject to review.
(c) All contracts shall comply with applicable requirements of the law and applicable regulations.
2023 West Virginia Code › Chapter 33. Insurance › Article 55. Health Benefit Plan Network Access and Adequacy Act › §33-55-8. Enforcement

(a) If the commissioner determines that a health carrier has not contracted with a sufficient number of participating providers to assure that covered persons have accessible health care services in a geographic area, or that a health carriers network access plan does not assure reasonable access to covered benefits, or that a health carrier has entered into a contract that does not comply with this article, or that a health carrier has not complied with a provision of this article, the commissioner shall require a modification to the access plan or institute a corrective action plan, as appropriate, that shall be followed by the health carrier, or may use any of the commissioners other enforcement powers to obtain the health carriers compliance with this article.
(b) The commissioner will not act to arbitrate, mediate, or settle disputes regarding a decision not to include a provider in a network plan or in a provider network or regarding any other dispute between a health carrier, its intermediaries, or one or more providers arising under or by reason of a provider contract or its termination.
2023 West Virginia Code › Chapter 33. Insurance › Article 56. Health Care Services Provided by Pharmacists › §33-56-1. Services Provided by Pharmacists

(a) For health plans, policies, contracts, or agreements issued, amended, adjusted, or renewed on or after January 1, 2021:
(1) Benefits may not be denied for any health care service performed by a pharmacist licensed under 30-5-1
et seq.
of this code if:
(A) The service performed was within the lawful scope of the pharmacists license;
(B) The plan would have provided benefits if the service had been performed by another health care provider; and
(C) The pharmacist is included in the plans network of participating providers.
(2) The health plan shall include an adequate number of pharmacists in its network of participating health care providers.
(b) The participation of pharmacies in the plan networks drug benefit does not satisfy the requirement that plans include pharmacists in their network of participating health care providers.
(c) Health benefit plans, policies, contracts, or agreements issued, amended, adjusted, or renewed on or after January 1, 2020, but before January 1, 2021, that delegate credentialing agreements to contracted health care facilities shall accept credentialing for pharmacists employed or contracted by those facilities. Health plans shall reimburse facilities for covered services provided by network pharmacists within the pharmacists scope of practice per negotiations with the facility.
(d) For purposes of this section, health plans, policies, contracts, or agreements do not include Medicaid or Children's Health Insurance Program health plans, policies, contracts, or agreements that are approved by the Department of Health and Human Resources Bureau of Medical Services.
2023 West Virginia Code › Chapter 33. Insurance › Article 58. Required Coverage for Health Insurance › §33-58-1. Coverage and Dispensing Birth Control

(a) Notwithstanding a prohibition or limitation contained within the provisions of 33-1-1
et seq.
and 5-16-1 of this code an insurer subject to 5-16-1
et seq.
, 33-15-1
et seq.
, 33-16-1
et seq.
, 33-24-1
et seq.
, 33-25-1
et seq.
, and 33-25A-1 of this code which amends, renews, or delivers a health policy on or after January 1, 2021, that provides coverage for contraceptive drugs, shall provide coverage for a 12-month refill of contraceptive drugs obtained at one time by the insured after the insured has completed the initial supply of the drugs, unless the insured requests a smaller supply or the prescribing provider instructs that the insured must receive a smaller supply. A health benefit plan that provides coverage shall allow the insured to receive the contraceptive drugs on-site at the providers office, if available, and dispensing practices must follow all clinical guidelines for appropriate prescribing and dispensing to ensure the health of the patient while maximizing access to effective contraceptive drugs.
(b) A health benefit plan that provides coverage for hormonal contraceptives, in the absence of clinical contraindications, may not impose utilization controls or other forms of medical management limiting the supply of contraceptive drugs that may be dispensed or furnished by a provider or pharmacy, or at a location licensed or otherwise authorized to dispense drugs or supplies, to an amount that is less than a 12-month supply.
(c) This section does not exclude coverage for contraceptive drugs as prescribed by a provider for reasons other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating symptoms of menopause, or for contraception that is necessary to preserve the life or health of an enrollee.
(d) Nothing in this section requires a health benefit plan to cover contraceptive drugs provided by a provider, pharmacy, or at a location authorized to dispense drugs or supplies, that does not participate in the health benefit plans provider or pharmacy network, as appliable, except as may be otherwise authorized or required by state law or by the plans policies governing out-of-network coverage.
(e) For purposes of this section, the term "contraceptive drugs" means all drugs approved by the United States Food and Drug Administration that are used to prevent pregnancy, including, but not limited to, hormonal drugs administered orally, transdermally, and intravaginally.
2023 West Virginia Code › Chapter 33. Insurance › Article 60. Insurance Innovation › §33-60-4. Limited No-Action Letter

(a) Within 10 days following the timely receipt of an acceptance pursuant to 33-60-3(d)(2)(B) of this code, the commissioner shall issue a limited no-action letter that:
(1) Sets forth terms and conditions for the participant that are the same as those set forth in the notice of acceptance issued under 33-60-3(d)(2) of this code; and
(2) Provides that so long as the participant and any clients of the participant abide by the terms and conditions set forth in the letter, no administrative or regulatory action concerning the compliance of the insurance innovation with West Virginia law will be taken by the commissioner against the participant or any clients during the term of the beta test.
(b) If the application is deemed accepted under 33-60-3(a)(3) of this code, the proposed limited no-action letter included with the application shall be deemed to have the effect of a limited letter issued by the commissioner.
(c) The safe harbor of the limited letter shall persist until the earlier of:
(1) The early termination of the beta test under 33-60-5 of this code;
(2) The issuance of an extended no-action letter; or
(3) The issuance of a notice declining to issue an extended no-action letter.
(d) The commissioner shall publish all limited letters issued pursuant to this section on the commissioners publicly accessible internet website.
2023 West Virginia Code › Chapter 33. Insurance › Article 60. Insurance Innovation › §33-60-5. Time Period of Beta Test; Extension of Time Period; Penalties for Violation of Limited No-Action Letter

(a) The time period for a beta test shall be three years. The time period may be extended by the commissioner in the notice of acceptance for a period that is not longer than one year if a request is made in accordance with 33-60-2(a)(5)(B) of this code.
(b) During the beta test, the participant and any clients of the participant shall:
(1) Comply with all terms and conditions set forth in the limited no-action letter; and
(2) Provide the commissioner with all documents, data, and information requested by the commissioner.
(c) For any violation of the terms or conditions set forth in the limited letter, the commissioner may:
(1) Issue an order terminating the beta test and the safe harbor of the limited letter before the time period set forth in the limited letter has expired; and
(2) Impose a fine of not more than $2,000 per violation.
(d) The commissioner may issue an order under 33-60-5(c) of this code if, following receipt of information or complaints, the commissioner determines the beta test is causing consumer harm.
(e) The commissioner may issue an order requiring a client to cease and desist any activity violating the terms or conditions set forth in the limited letter. The issuance of a cease and desist order to one client shall not otherwise impact the ability of the participant or any other clients to continue activities relating to the innovation in a manner compliant with the requirements of the limited letter.
(f) A participant or client may request a hearing on any order issued under this section pursuant to 33-2-13 of this code.
2023 West Virginia Code › Chapter 33. Insurance › Article 60. Insurance Innovation › §33-60-7. Confidentiality of Information

(a) All documents, materials, or other information in the possession or control of the commissioner that are created, produced, obtained, or disclosed in relation to this article and that relate to the financial condition of any person shall be confidential by law and privileged, are not subject to the provisions of chapter 29B of this code, are not subject to subpoena, and are not subject to discovery or admissible in evidence in any private civil action.
(b) Notwithstanding any law to the contrary, the commissioner may disclose in an extended no-action letter any information relating to the insurance innovation necessary to clearly establish the safe harbor of the extended no-action letter.
2023 West Virginia Code › Chapter 33. Insurance › Article 60. Insurance Innovation › §33-60-8. Reports to the Legislature

(a) On or before September 1 each year during which there was activity pursuant to this article during the prior fiscal year, the commissioner shall submit a written report to the Joint Committee on Government and Finance that meets the requirements of 33-60-8(b) of this code.
(b) The report shall include the following:
(1) The number of:
(A) Applications filed and accepted;
(B) Beta tests conducted; and
(C) Extended no-action letters issued;
(2) A description of the innovations tested;
(3) The length of each beta test;
(4) The results of each beta test;
(5) A description of each safe harbor created under 33-60-6 of this code;
(6) The number and types of orders or other actions taken by the commissioner or any other interested party under this article;
(7) Identification of any statutory barriers for consideration by the Legislature following successful beta tests and the issuance of extended no-action letters; and
(8) Any other information or recommendations deemed relevant by the commissioner.
(c) The commissioner shall also, upon request of any committee of the Legislature, testify and explain any report submitted under this section and any activity pursuant to this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 60. Insurance Innovation › §33-60-9. Reciprocity Agreements

The commissioner may enter into agreements with state, federal, or foreign regulatory agencies to allow persons who make an insurance innovation available in West Virginia through the regulatory sandbox to make their insurance innovation available in other jurisdictions and to allow persons operating in similar regulatory sandboxes in other jurisdictions to make insurance innovations available in West Virginia under the standards of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 60. Insurance Innovation › §33-60-10. Rulemaking

(a) The Insurance Commissioner shall propose rules for legislative approval in accordance with the provisions of 29A-3-1
et seq
. of this code for the purposes of administering this article.
(b) The Insurance Commissioner shall develop all forms, contracts, or other documents to be used for the purposes outlined in this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 61. Mining Mutual Insurance Company › §33-61-3. Definitions

For purposes of this article, the term:
"Commissioner" means the Insurance Commissioner as provided in 33-2-1 of this code.
"Company" means the Mining Mutual Insurance Company created pursuant to the terms of this article.
"Operator" has the same meaning as provided in 22-3-3 of this code and means any person who is granted or who should obtain a permit to engage in any activity covered by 22-3-1,
et seq
. of this code and any rule promulgated pursuant thereto and includes any person who engages in surface mining or surface mining and reclamation operations, or both. The term shall also be construed in a manner consistent with the federal program pursuant to the federal Surface Mining Control and Reclamation Act of 1977, as amended.
2023 West Virginia Code › Chapter 33. Insurance › Article 61. Mining Mutual Insurance Company › §33-61-4. Authorization for Creation of Company; Requirements and Limitations

(a) A Mining Mutual Insurance Company may be created as a domestic, private, nonstock corporation in this state. The company shall remain for the duration of its existence a domestic mutual insurance company owned by its policyholders and may not be converted into a stock corporation or any other entity not owned by its policyholders.
(b) For the duration of its existence, the company shall not be considered a department, unit, agency, or instrumentality of this state for any purpose. All debts, claims, obligations, and liabilities of the company, whenever incurred, are the debts, claims, obligations, and liabilities of the company only and not of this state or of any department, unit, agency, instrumentality, officer, or employee of this state.
(c) The moneys of the company shall not be considered part of the General Revenue Fund of the state. The debts, claims, obligations, and liabilities of the company are not and may not be considered a debt of the state or a pledge of the credit of the state.
(d) The company is not subject to provisions of 6-9A-1
et seq
. of this code or the provisions of 29B-1-1,
et seq
. of this code.
(e) All premiums collected by the company are subject to the premium taxes, additional premium taxes, additional fire and casualty insurance premium taxes and surcharges contained in 33-3-14, 33-3-14a, 33-3-14d, and 33-3-33 of this code to the extent applicable.
2023 West Virginia Code › Chapter 33. Insurance › Article 61. Mining Mutual Insurance Company › §33-61-5. Governance and Organization

(a) The company shall initially be governed by a provisional board of directors consisting of five directors. The provisional board shall act as the incorporators of the company and shall prepare and file articles of incorporation and bylaws in accordance with the provisions of this article and all of the provisions of this code. The provisional board of directors shall be appointed as follows:
(1) The chair shall be appointed by the Governor. The chair shall be an individual with at least five years experience as a CEO and board member of a mutual insurance company.
(2) One member of the board shall be selected by the Secretary of the Department of Environmental Protection. This provisional board member shall have extensive experience in environmental management and shall have at least five years experience in coal mine reclamation.
(3) One member of the provisional board shall be selected by the Insurance Commissioner. This provisional board member shall have insurance experience and shall have served at least five years as an officer of a board of directors of a mutual insurance company.
(4) One member of the provisional board shall be selected by the President of the Senate. This provisional board member shall have experience in coal mine operations, reclamation, and land management.
(5) One member of the provisional board shall be selected by the Speaker of the House of Delegates. This provisional board member shall have experience in coal mine operations, reclamation, and land management.
(b) Upon the filing of the companys articles of incorporation and bylaws, the directors and officers of the company are to be chosen in accordance with such articles of incorporation and bylaws:
Provided
, That the companys articles of incorporation and bylaws shall specifically state that the terms of boards members shall be as follows: (1) Two members shall be for a term of four years; (2) one member shall be for a term of three years; (3) one member shall be for a term of two years; and (4) one member shall be for a term of one year. Thereafter, the directors shall serve staggered terms of four years. If additional directors are added to the board as provided in the companys bylaws, the term shall be for four years.
2023 West Virginia Code › Chapter 33. Insurance › Article 61. Mining Mutual Insurance Company › §33-61-6. Management and Administration of the Company

(a) If the companys board of directors determines that the affairs of the company may be administered suitably and efficiently, the company may enter into a contract with a licensed insurer, licensed health service plan, insurance service organization, third-party administrator, insurance brokerage firm or other firm or company with suitable qualifications and experience to administer some or all of the affairs of the company, subject to the continuing direction of the board of directors as required by the articles of incorporation and bylaws of the company, and the contract. All such contracts shall be awarded by competitive bidding.
(b) The company shall file a true copy of the contract with the commissioner.
2023 West Virginia Code › Chapter 33. Insurance › Article 61. Mining Mutual Insurance Company › §33-61-7. Application for License; Authority of Commissioner

(a) As soon as practical, the company established pursuant to the provisions of this article shall file its corporate charter and bylaws with the commissioner and apply for a license to transact insurance in this state. Notwithstanding any other provision of this code, the commissioner shall act on the documents within 15 days of the filing by the company.
(b) The Legislature authorizes the commissioner to review the documentation submitted by the company and to determine the initial capital and surplus requirements of the company, notwithstanding the provisions of 33-3-5b of this code. The commissioner has the sole discretion to determine the capital and surplus funds of the company and to monitor the economic viability of the company during its initial operation and duration on not less than a monthly basis. The company shall furnish the commissioner with all information and cooperate in all respects necessary for the commissioner to perform the duties set forth in this section and in other provisions of this chapter, including annual audited financial statements required by 33-33-1
et seq
. of this code and fidelity bond coverage for each of the directors of the company.
(c) Subject to the provisions of subsection (d) of this section, the commissioner may waive other requirements imposed on mutual insurance companies by the provisions of this chapter as the commissioner determines is necessary to enable the company to begin issuing performance bonds in this state at the earliest possible date.
(d) Within 40 months of the date of the issuance of its license to transact insurance, the company shall comply with the capital and surplus requirements set forth in 33-3-5b of this code.