§5-16-5b. Creation of Trust for Retirees Hired on or After July 1, 2010
There is hereby created a special revenue account in the State Treasury, designated the Post-July 1, 2010, Employee Trust Fund, which shall be an interest-bearing account and may be invested in accordance with the provisions of article six, chapter twelve of this code, with the interest income a proper credit to the fund. The fund […]
§5-16-7. Authorization to Establish Group Hospital and Surgical Insurance Plan, Group Major Medical Insurance Plan, Group Prescription Drug Plan, and Group Life and Accidental Death Insurance Plan; Rules for Administration of Plans; Mandated Benefits; What Plans May Provide; Optional Plans; Separate Rating for Claims Experience Purposes
(a) The agency shall establish a group hospital and surgical insurance plan or plans, a group prescription drug insurance plan or plans, a group major medical insurance plan or plans, and a group life and accidental death insurance plan or plans for those employees herein made eligible and establish and promulgate rules for the administration […]
§5-16-7a. Additional Mandated Benefits; Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
(a) Notwithstanding any provision of any policy, provision, contract, plan or agreement applicable to this article, reimbursement or indemnification for colorectal cancer examinations and laboratory testing may not be denied for any nonsymptomatic person fifty years of age or older, or a symptomatic person under fifty years of age, when reimbursement or indemnity for laboratory […]
§5-16-7b. Coverage for Telehealth Services
(a) The following terms are defined: (1) “Distant site” means the telehealth site where the health care practitioner is seeing the patient at a distance or consulting with a patient’s health care practitioner.
§5-16-7c. Required Coverage for Reconstruction Surgery Following Mastectomies
(a) The plan shall provide, in a case of a participant or beneficiary who is receiving benefits in connection with a mastectomy and who elects breast reconstruction in connection with such mastectomy, coverage for: (1) All stages of reconstruction of the breast on which the mastectomy has been performed;
§5-16-7d. Coverage for Patient Cost of Clinical Trials
(a) The provisions of this section and section seven-e of this article apply to the health plans regulated by this article. (b) This section does not apply to a policy, plan or contract paid for under Title XVIII of the Social Security Act. (c) A policy, plan or contract subject to this section shall provide […]
§5-16-7e. Definitions
For purposes of section seven-d of this article: (a) A "clinical trial" is a study that determines whether new drugs, treatments or medical procedures are safe and effective on humans. To determine the efficacy of experimental drugs, treatments or procedures, a study is conducted in four phases including the following: Phase II: The experimental drug […]
§5-16-1. Short Title; Legislative Intent
The short title by which this article may be referred to is "West Virginia Public Employees Insurance Act" and it is the express intent of the Legislature to encourage and promote a uniform partnership relation between all employers and employees participating in the insurance plan or plans formulated under the provisions of this article and […]
§5-16-2. Definitions
The following words and phrases as used in this article, unless a different meaning is clearly indicated by the context, have the following meanings: (1) “Agency” means the Public Employees Insurance Agency created by this article.
§5-16-3. Composition of Public Employees Insurance Agency; Appointment, Qualification, Compensation and Duties of Director of Agency; Employees; Civil Service Coverage
(a) The Public Employees Insurance Agency consists of the director, the Finance Board, the Advisory Board and any employees who may be authorized by law. The director shall be appointed by the Governor, with the advice and consent of the Senate, and serves at the will and pleasure of the Governor. The director shall have […]