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

Executive Summary
This report to the Governor of West Virginia provides detail about the structure and activities of the
West Virginia Offices of the Insurance Commissioner for the preceding year. The report is divided
into three major sections. Each section is detailed below.
Section 1 of this report highlights the organization of our office and provides detail for its $187.2M in
total revenue collected from the previous year. It includes an interdepartmental organizational chart,
historical list of insurance commissioners, and then proceeds to identify the individual revenue streams
managed by this agency.
Section 2 of this report further identifies the functional divisions of this office, and enumerates each
division’s individual activities during the past year. A summarization of those activities follows:
AccessWV-(West Virginia Health Insurance Plan.), known as the state high-risk health
insurance pool, increased its membership from 576 to 734 during 2009 and provided insurance
to 846 members during the year. It ended the year with an operational gain of $335,000.
The Agents Licensing and Education Division presides over processing and maintaining
records on individual producers licensed to transact insurance business in WV, and issued over
11,014 new licenses in 2009, while handling over 136,000 company appointments and
appointment cancellations.
The Workers’ Compensation Board of Review handles appeals of Workers’ Compensation
claims and during 2009 they maintained their goal of operating without a backlog. They
received 157 new appeals per month with average dispositions of 174.
The Claims Services Division, which oversees management of the workers’ compensation
“Old Fund”, successfully transitioned 47,000 active workers’ compensation claims from
BrickStreet Mutual Insurance to three independent Third Party Administrators: Sedgwick
Claims Management Services, Wells Fargo Disability Management, and American Mining
Claims Services. Since that time, through proper claims handling utilizing accepted industry
standards and a focused settlement initiative, approximately 48% of the active caseload has
been closed.
The Office of Consumer Advocacy assisted consumers in 47 complaints during 2009 and also
participated in the review of 35 Certificate of Need applications and 34 Hospital Rate Review
Applications.
The Consumer Service Division assists our insurance consumers with questions and
complaints. The division received a total of 2,322 written complaints from insurance
consumers in 2009. Over the course of the year, the Division responded to an average of 135
consumer inquiries per day.
The Employer Coverage Unit reviews and grants requests for exemptions from statutory
Workers’ Compensation Coverage as well as serving as the contact point for employee
claimants of uninsured employers. The Unit reviewed 2,938 applications for exemption during
2009, and approved 2,269 of the same.
The Financial Accounting Unit is responsible for the preparation of audited financial
statements, monthly financial reports, and the budget. In 2009, the unit received a fourth
consecutive “clean” opinion on the Audited Financial Statements.
The Financial Conditions Division monitors insurance company financial stability and
collects premium taxes and surcharges. They oversaw a total of 2,256 separate insurance
entities transacting business in West Virginia during 2009 (up from 2,115 in 2008).