Bill > HB5527

This bill establishes new regulations for "wellness reimbursement programs," which are plans offered to employers or employees that provide reimbursements or benefits to promote health and wellness, often as an add-on to existing health insurance. The bill requires administrators of these programs to be licensed by the West Virginia Insurance Commissioner, a process that involves submitting applications, financial statements, and potentially IRS or Department of Labor approval, and paying fees. Licensed administrators must maintain records, be subject to examinations, and provide a surety bond. The Commissioner can revoke or suspend licenses and impose civil penalties for violations, and criminal penalties, including fines and jail time, are established for those operating without a license or violating other provisions. The bill also clarifies that licensed "brokers," who are independent health insurance agents, are not required to be licensed as wellness program administrators to receive commissions, but they must still act in good faith and avoid misleading advertising. Importantly, these new regulations do not apply to existing individual or group health insurance plans or self-insured group health plans themselves. Finally, the Insurance Commissioner will report to the Legislature every three years on the implementation of these new rules.

Budget and Finance, Government Affairs

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=5527&year=2026&sessiontype=RS&btype=bill