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West Virginia Code 33-48-7 - Funding of the plan

West Virginia Code > Chapter 33 > Article 48 > § 33-48-7 - Funding of the plan


Current as of: 2010

(a) Premiums. --

(1) The plan shall establish premium rates for plan coverage as provided in subdivision (2) of this subsection. Separate schedules of premium rates based on age, sex and geographical location may apply for individual risks. Premium rates and schedules shall be submitted to the commissioner for approval prior to use.

(2) The plan, with the assistance of the commissioner, shall determine a standard risk rate by considering the premium rates charged by other insurers offering health insurance coverage to individuals. The standard risk rate shall be established using reasonable actuarial techniques and shall reflect anticipated experience and expenses for such coverage. Initial rates for plan coverage shall not be less than one hundred twenty-five percent of rates established as applicable for individual standard risks. Subject to the limits provided in this subdivision, subsequent rates shall be established to provide fully for the expected costs of claims including recovery of prior losses, expenses of operation, investment income of claim reserves and any other cost factors subject to the limitations described herein. In no event shall plan rates exceed one hundred fifty percent of rates applicable to individual standard risks.

(b) Notwithstanding the provisions of subsection (c), section eight, article twenty-nine-b, chapter sixteen of this code and not to be construed as in conflict therewith, the health care authority is authorized to increase the assessment obligation of hospitals in an amount not to exceed a maximum of twenty-five percent above the one tenth of one percent specified in said subsection and the entire assessment, including the additional assessment, shall be collected as specified in said subsection. Upon receipt of the additional assessment, the health care authority shall transfer all proceeds generated from the additional assessment collected to the special revenue account established in section seven-a of this article.

(c) The plan is authorized to receive and expend any federal grant.

(d) With the consent of the board, the commissioner is authorized to utilize his or her administrative staff and resources in administering this article. The board shall reimburse the commissioner for all costs of administrative and actuarial services, supplies and other costs incurred by the commissioner in implementing the provisions of this article.

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West Virginia Laws: Health Insurance

West Virginia Code > Chapter 16 > Article 29F - Uninsured And Underinsured Pilot Programs
West Virginia Code > Chapter 33 > Article 15 - Accident And Sickness Insurance
West Virginia Code > Chapter 33 > Article 15B - Uniform Health Care Administration Act
West Virginia Code > Chapter 33 > Article 15C - Diabetes Insurance
West Virginia Code > Chapter 33 > Article 15E - Discount Medical Plan Organizations And Discount Prescription Drug Plan Organizations Act
West Virginia Code > Chapter 33 > Article 16 - Group Accident And Sickness Insurance
West Virginia Code > Chapter 33 > Article 16A - Group Health Insurance Conversion
West Virginia Code > Chapter 33 > Article 16B - Accident And Sickness Rates
West Virginia Code > Chapter 33 > Article 16D - Marketing And Rate Practices For Small Employer Accident And Sickness Insurance Policies
West Virginia Code > Chapter 33 > Article 16F - Group Limited Health Benefits Plans
West Virginia Code > Chapter 33 > Article 25D - Prepaid Limited Health Service Organization Act
West Virginia Code > Chapter 33 > Article 25E - Patients' Eye Care Act
West Virginia Code > Chapter 33 > Article 25F - Coverage For Patient Cost Of Clinical Trials
West Virginia Code > Chapter 33 > Article 28 - Individual Accident And Sickness Insurance Minimum Standards
West Virginia Code > Chapter 33 > Article 48 - Model Health Plan For Uninsurable Individuals Act

U.S. Code Provisions: Health Insurance

U.S. Code Title 26 > Subtitle D > Chapter 47 - Certain Group Health Plans
U.S. Code > Title 26 > Subtitle K - Group Health Plan Requirements

Federal Regulations: Health Insurance

U.S. Code Title 26 > Subtitle D > Chapter 47 - Certain Group Health Plans
U.S. Code > Title 26 > Subtitle K - Group Health Plan Requirements
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