HB 5527
Relating to Wellness Reimbursement Programs
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- Passed House of Delegates
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill establishes a framework for wellness reimbursement programs in West Virginia. It allows for the licensing of self-insured medical reimbursement plans and wellness integrated medical plan expense reimbursement plans by the Insurance Commissioner, subject to state and federal regulations. The bill defines key terms, outlines licensing requirements for program administrators, and clarifies that these programs do not apply to individual or group health plans.
Key provisions
- Defines key terms such as ‘Broker,’ ‘Commissioner,’ and ‘Wellness reimbursement program.’
- Requires wellness reimbursement program administrators to be licensed by the Insurance Commissioner.
- Establishes initial and renewal licensing fees for program administrators.
- Mandates compliance with federal ERISA requirements and IRS guidelines.
- Requires program administrators to maintain records and be subject to inspections.
- Prohibits misleading advertisements and offers related to wellness reimbursement programs.
- Clarifies that brokers are not required to be licensed as program administrators.
- Requires program administrators to defend employers and employees against claims arising from the program.
Who is affected
- Insurance Industry
- Healthcare Providers
- Employers
- Employees
- Insurance Agents
Notable changes
- Creates a new regulatory framework for wellness reimbursement programs in West Virginia.
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