West Virginia Offices of the Insurance Commissioner 2009 Annual ...

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Audited Financial Results: Fiscal Year 2009 Access WV was included as an enterprise fund in the financial audit of the Offices of the Insurance Commissioner for State Fiscal Year 2009 ending June 30, 2009. No issues were identified for AccessWV. Total net assets were reported as $11.16 million. Net premium revenues of $3.89 million for the fiscal year exceeded operating expenses of $3.53 million. The audit was done by Suttle and Stalnaker, PLLC of Charleston. Financial Results: Calendar Year 2009 Unaudited financial results for Calendar Year 2009 are reported here. An audit of AccessWV Financial Statements for State Fiscal Year 2010 for the period ending June 30, 2010, will be undertaken during 2010. AccessWV ended 2009 with a cash balance of $12.90 million and a calendar year surplus of $1.52 million. The year ended with an operational gain (premiums minus expenses) of $335,000. Calendar Year 2009 revenues were reported as $5.47 million on a cash basis. These revenues came from hospital assessments, premiums and interest. The “Uninsurable Individuals Act” provides for hospital assessments as the interim source of financing for the high risk pool, at a maximum of an additional one quarter of one percent of the assessment by the state Health Care Authority. The additional assessment was levied at a rate half the permitted maximum in 2009 and provided $1,034,772 to support the pool. Premiums contributed $4,287,737 to revenue, and interest earnings came to $39,260. No federal funding was received in 2009. Calendar Year expenditures on a cash basis were $3.95 million, with $3.6 of that amount going to pay claims, including both medical and pharmacy. Administrative expense was $340,686, for an administrative expense ratio of 7.9%. This measure has decreased as Plan enrollment increased. 22
Agents Licensing and Education Division Agents Licensing & Education is responsible for processing and maintaining records on individual producers licensed to transact business in West Virginia. Licensees include residents who must complete educational and testing requirements to obtain a license. Residents of other states who have completed similar requirements in their states of domicile may apply for a West Virginia non-resident license by submitting the appropriate application and documentation for review. In addition to licensing of individual producers, the division oversees the licensing of Adjusters, Surplus Lines Licensees, Business Entities (Agencies), Viatical Settlement Brokers and Viatical Settlement Business Entities. Producers must be appointed to represent each insurance company the producers are transacting business for in West Virginia. Insurance companies are responsible for submitting appointment information and fees to Agents Licensing & Education for processing. Monies generated through licensing and appointment fees, letters of certification and letters of clearance are deposited into the Offices of the Insurance Commissioner’s Special Revenue account. Resident producers must periodically complete continuing education to maintain their licenses. The continuing education program is governed by a six-member board appointed by the Insurance Commissioner. The representatives (all of whom are WV resident insurance producers) of this Board represent various areas of the insurance industry as prescribed by law. Administrative functions for the continuing education program are handled by Prometric. Prometric reviews provider and course applications under guidelines established by the Board of Insurance Agent Education. Additionally, Prometric banks the continuing education credits to the producers’ records and, at compliance time, provides the Insurance Commissioner with data on compliant and noncompliant producers. The current reporting period began 7-1-2010 and will end 6-30-2012. The following are current statistics on the various aspects of Agents Licensing and Education Division. 23
Page 1 and 2: West Virginia Offices of the Insura
Page 3 and 4: Executive Summary This report to th
Page 5 and 6: TABLE OF CONTENTS SECTION 1 GENERAL
Page 7 and 8: Admitted Assets, Liabilities, Commo
Page 9 and 10: Organizational Chart Virgil Helton,
Page 11 and 12: FEES AND TAXES COLLECTED DURING THE
Page 13 and 14: WEST VIRGINIA OFFICES OF THE INSURA
Page 15 and 16: APPROPRIATED APPROPRIATED EXPENDITU
Page 17 and 18: SECTION 2 DIVISIONAL REPORTS 17
Page 19 and 20: An applicant must be a resident of
Page 21: Major Activities in 2009 The Plan
Page 25: Workers’ Compensation Board of Re
Page 28 and 29: The focused settlement initiative h
Page 30 and 31: October 2008 November 2008 December
Page 32 and 33: Offices of the Insurance Commission
Page 34 and 35: January 2009 February 2009 March 20
Page 36 and 37: Representing Consumers in First and
Page 38 and 39: FIRST PARTY COMPLAINTS HANDLED BY T
Page 40 and 41: CERTIFICATE OF NEED - March 2009 FA
Page 42 and 43: Hospital Rate Review The Office of
Page 44 and 45: Consumer Service Division The Consu
Page 46 and 47: CONSUMER SERVICE COMPLAINTS CALENDA
Page 48 and 49: CONSUMER SERVICE COMPLAINTS CALENDA
Page 50 and 51: Employer Coverage Unit The Employer
Page 52 and 53: Financial Accounting Unit The Finan
Page 54 and 55: Financial Conditions Division The p
Page 56 and 57: FINANCIAL CONDITIONS DIVISION West
Page 58 and 59: FINANCIAL CONDITIONS DIVISION West
Page 60 and 61: WEST VIRGINIA ESSENTIAL PROPERTY IN
Page 62 and 63: 2009 Summary of West Virginia Opera
Page 64 and 65: American Retirement Life Insurance
Page 66 and 67: ADP Totalsource, Inc. d/b/a ADP Tot
Page 68 and 69: FINANCIAL CONDITIONS DIVISION Merit
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FINANCIAL CONDITIONS DIVISION Compa
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FINANCIAL CONDITIONS DIVISION Risk
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National Health Club Purchasing Gro
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FINANCIAL CONDITIONS DIVISION Name
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ADA Risk Purchasing Group, Inc. (Am
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FINANCIAL CONDITIONS DIVISION Liqui
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Office of Inspector General—Fraud
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The following chart depicts statist
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James R. Hiroskey Jr., age 25 of Lo
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Ramona Mack, age 40 of Winfield, pl
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Jennifer Jo & Matthew Nichols, ages
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Senate Bill 284 - Relating to Viati
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Senate Bill 537 - Relating to Worke
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Senate Bill 537 -continued §33-2-2
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House Bill 3047 - Clarifying that t
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114 CSR 42 - Continuing Education f
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09-EO-03 - Emergency Order entered
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DISCIPLINARY ACTIONS Individual Ins
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Market Conduct Unit Four (4) “Agr
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Employer Violator System (EVS) The
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MANAGED HEALTH CARE PLANS: The West
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A Client Reporting process was deve
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Non-Workers’ Compensation Matters
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Rates and Forms Division The Rates
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2009 Filings by Product Commercial
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Approved Rate Change History of Top
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Private Passenger Auto Market Share
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2009 West Virginia Market Share Rep
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Total for Top 10 Insurers 76.87% $4
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Admitted Assets, Liabilities, Net W
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Domestic Property Insurers Common P
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Admitted Assets, Liabilities, Capit
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Admitted Assets, Liabilities, Capit
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West Virginia Offices of the Insurance Commissioner 2009 Annual ...

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