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Group Accident and Sickness Insurance. | Midpage
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West Virginia Code
Chapter 33
16
Group Accident and Sickness Insurance.
33-16-1
Scope of article.
33-16-1a
Definitions.
33-16-1b
Applicability.
33-16-2
Eligible groups.
33-16-3
Required policy provisions.
33-16-3a
Same-mental health.
33-16-3b
Home health care coverage.
33-16-3c
Loss ratio.
33-16-3d
Medicare supplement insurance.
33-16-3e
Policies to cover nursing services.
33-16-3f
Required policy provisions -- Treatment of temporomandibular joint disorder and craniomandibular disorder.
33-16-3g
Third party reimbursement for mammography, pap smear or human papilloma virus testing.
33-16-3h
Third party reimbursement for rehabilitation services.
33-16-3i
Coverage of emergency services.
33-16-3j
Hospital benefits for mothers and newborns.
33-16-3k
Limitations on preexisting condition exclusions for health benefit plans.
33-16-3l
Renewability and modification of health benefit plans.
33-16-3m
Creditable coverage.
33-16-3n
Eligibility for enrollment.
33-16-3o
Third party reimbursement for colorectal cancer examination and laboratory testing.
33-16-3p
Required coverage for reconstruction surgery following mastectomies.
33-16-3q
Required use of mail-order pharmacy prohibited.
33-16-3r
Coverage for patient cost of clinical trials.
33-16-3s
Third-party reimbursement for kidney disease screening.
33-16-3t
Required coverage for dental anesthesia services.
33-16-3u
Special enrollment period under the American Recovery and Reinvestment Act of 2009.
33-16-3v
Required coverage for treatment of autism spectrum disorders.
33-16-3w
Maternity coverage.
33-16-3x
Deductibles, copayments and coinsurance for anti-cancer medications.
33-16-3y
Eye drop prescription refills.
33-16-3z
Deductibles, copayments and coinsurance for abuse-deterrent opioid analgesic drugs.
33-16-3a
a. Step therapy.
33-16-3b
b. Coverage for amino acid-based formulas.
33-16-3c
c. Substance use disorder.
33-16-3d
d. Prior authorization.
33-16-3e
e. Fairness in Cost-Sharing Calculation.
33-16-3f
f. Mental health parity.
33-16-3g
g. Incorporation of the Health Benefit Plan Network Access and Adequacy Act.
33-16-3h
h. Incorporation of the coverage for 12-month refill for contraceptive drugs.
33-16-3r
r. Coverage of emergency medical services to triage and transport to alternative destination or treat in place.
33-16-3z
z. Lyme disease to be covered by all health insurance policies.
33-16-4
Size of type.
33-16-5
Contingencies for which benefits or reimbursement of expenses permitted.
33-16-6
Rider changing individual policy to group policy prohibited.
33-16-7
Hospital indemnity policies not to exclude coverage for confinement in government hospital.
33-16-8
Continuum of care services.
33-16-9
Policies not to terminate coverage because of diagnosis or treatment of acquired immune deficiency syndrome.
33-16-10
Policies discriminating among health care providers.
33-16-11
Group policies not to exclude insured's children from coverage; required services; coordination with other insurance.
33-16-12
Child immunization services coverage.
33-16-13
Equal treatment of state agency.
33-16-14
Coordination of benefits with Medicaid.
33-16-15
Individual medical savings accounts; definitions; ownership; contributions; trustees; regulations.
33-16-16
Insurance for diabetics.
33-16-17
Commissioner to propose rules.
33-16-18
Assignment of certain benefits in dental care insurance coverage.
33-16-19
Copayments for certain services.