West Virginia Public Employees Insurance Act. | MidpageWest Virginia Public Employees Insurance Act.
5-16-1Short title; legislative intent.5-16-2Definitions.5-16-3Composition of Public Employees Insurance Agency.5-16-4Public Employees Insurance Agency Finance Board.5-16-5Powers and duties of the finance board.5-16-5aRetiree premium subsidy from Retiree Health Benefit Trust for hires prior to July 1, 2010.5-16-5bCreation of trust for retirees hired on or after July 1, 2010.5-16-7Authorization to establish plans; mandated benefits; optional plans; separate rating for claims experience purposes.5-16-7aAdditional mandated benefits; third party reimbursement for colorectal cancer examination and laboratory testing.5-16-7bCoverage for telehealth services.5-16-7cRequired coverage for reconstruction surgery following mastectomies.5-16-7dCoverage for patient cost of clinical trials.5-16-7eDefinitions.5-16-7fPrior authorization.5-16-7gCoverage for prescription insulin drugs.5-16-8Conditions of insurance program.5-16-8aAir-ambulance fees.5-16-9Authorization to execute contracts.5-16-10Contract provisions for group hospital and surgical, group major medical, group prescription drug and group life, and accidental death insurance for retired employees, their spouses, and dependents.5-16-11To whom benefits paid.5-16-12Misrepresentation by employer, employee or provider; penalty.5-16-12aInspections; violations and penalties.5-16-12bPrivileges and immunity.5-16-13Payment of costs by employer and employee; spouse and dependent coverage; involuntary employee termination coverage; conversion of annual leave and sick leave authorized for health or retirement benefits; authorization for retiree participation; continuation of health insurance for surviving dependents of deceased employees; requirement of new health plan; limiting employer contribution.5-16-14Program qualifying for favorable federal income tax treatment.5-16-15Optional dental, optical, disability, and prepaid retirement plan, and audiology and hearing-aid service plan.5-16-16Preferred provider plan.5-16-17Preexisting conditions not covered; defined.5-16-18Payment of costs by employer; schedule of insurance; special funds created; duties of Treasurer with respect thereto.5-16-19Authorization to take advantage of acts of congress, accept gifts, grants and matching funds.5-16-20Expense fund.5-16-21No member or employee of public employees insurance agency shall gain directly or indirectly from any contract or contracts provided for hereunder; criminal penalties.5-16-22Permissive participation; exemptions.5-16-23Members of Legislature may be covered if cost of the entire coverage is paid by such members.5-16-24Rules for administration of article; eligibility of certain retired employees and dependents of deceased members for coverage; employees on medical leave of absence entitled to coverage; life insurance.5-16-24aPaper transactions.5-16-25Reserve fund.5-16-26Quarterly report.5-16-28Incorporation of the coverage for 12-month refill for contraceptive drugs.5-16-29Limitation on PEIA participation.5-16-30PEIA solvency.5-16-31PEIA actuarial study.5-16-32Effective date of amendments.