West Virginia Offices of the Insurance Commissioner 2009 Annual ...
West Virginia Offices of the Insurance Commissioner 2009 Annual ...
West Virginia Offices of the Insurance Commissioner 2009 Annual ...
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Senate Bill 284 - Relating to Viatical Settlements. (Effective July 6, <strong>2009</strong>)<br />
This bill amends <strong>the</strong> Viatical Settlements Act that was initially enacted in 2008. The first<br />
change allows applicants for a broker’s license to demonstrate evidence <strong>of</strong> financial responsibility<br />
through an errors and omissions policy in <strong>the</strong> sum <strong>of</strong> not less than $100,000 per occurrence and<br />
$300,000 in <strong>the</strong> aggregate for all occurrences within one year; <strong>the</strong> 2008 statute required an applicant to<br />
provide a surety bond in <strong>the</strong> amount <strong>of</strong> $250,000.<br />
The second change corrects a drafting error in <strong>the</strong> criminal provisions <strong>of</strong> <strong>the</strong> Act in which only<br />
a viator (policyholder) could be convicted <strong>of</strong> a fraudulent viatical settlement act; <strong>the</strong> bill expands <strong>the</strong><br />
scope <strong>of</strong> <strong>the</strong> criminal provisions to any “person convicted <strong>of</strong> a fraudulent viatical settlement act.”<br />
Senate Bill 322 - Exempting certain life insurance policies from Medicaid assignment. (Effective<br />
July 10, <strong>2009</strong>)<br />
Submission <strong>of</strong> an application to <strong>the</strong> state Department <strong>of</strong> Health and Human Resources<br />
(“DHHR”) for medical assistance constitutes an assignment <strong>of</strong> <strong>the</strong> right <strong>of</strong> <strong>the</strong> applicant to recover<br />
from personal insurance or o<strong>the</strong>r sources to <strong>the</strong> extent <strong>of</strong> <strong>the</strong> cost <strong>of</strong> medical services paid by <strong>the</strong><br />
Medicaid program. The bill exempts life insurance policies with a death benefit <strong>of</strong> $25,000 or less<br />
from this assignment.<br />
Senate Bill 326 - Mandating certain dental anes<strong>the</strong>sia insurance coverage. (Effective July 10, <strong>2009</strong>)<br />
This bill mandates that most group and individual health insurance policies, including PEIA,<br />
cover general anes<strong>the</strong>sia for certain dental procedures performed on young people or those with certain<br />
developmental disorders.<br />
Senate Bill 408 - Relating to model health plan for uninsurable individuals. (Effective July 8, <strong>2009</strong>)<br />
This bill permits <strong>the</strong> use <strong>of</strong> surplus funds in <strong>the</strong> Model Health Plan for Uninsurable Individuals<br />
fund (<strong>the</strong> State’s high risk pool, commonly known as “AccessWV”) to subsidize premiums <strong>of</strong> lowincome<br />
enrollees. The AccessWV Board <strong>of</strong> Directors must propose legislative rules to establish<br />
eligibility criteria for applicants for <strong>the</strong> subsidies.<br />
Current law imposes a six-month preexisting-condition exclusion on all new enrollees except<br />
those coming from a COBRA plan. The bill grants rulemaking authority to <strong>the</strong> AccessWV Board to<br />
propose additional classes <strong>of</strong> individuals to which <strong>the</strong> preexisting-condition exclusion would not apply.<br />
Senate Bill 414 - Creation <strong>of</strong> <strong>the</strong> Governor’s Office <strong>of</strong> Health Enhancement and Lifestyle Planning.<br />
(Effective August 26, <strong>2009</strong>)<br />
This bill terminates three existing programs – <strong>the</strong> prescription benefit program established in<br />
2000; <strong>the</strong> 2004 pharmaceutical programs (cost management council, etc.), and <strong>the</strong> Interagency Health<br />
Council – and creates in <strong>the</strong>ir stead a new agency, <strong>the</strong> Governor’s Office <strong>of</strong> Health Enhancement and<br />
Lifestyle Planning (“GO HELP”), <strong>the</strong> primary task <strong>of</strong> which is to “coordinate all state health care<br />
system reform initiatives” among all executive agencies. The bill also mandates that <strong>the</strong> GO HELP<br />
director implement four “medical home” pilots in addition to similar pilots now underway through <strong>the</strong><br />
Bureau for Medical Services (“BMS”) and PEIA.<br />
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