Bill > HB5527

This bill establishes a new regulatory framework in West Virginia for "wellness reimbursement programs," which are defined as self-insured medical reimbursement plans or wellness integrated medical plan expense reimbursement plans that are designed to be ancillary products to existing health coverage and comply with specific federal tax codes. The key provisions require any entity managing these programs, known as a "wellness reimbursement program administrator," to obtain a license from the West Virginia Insurance Commissioner, a process that involves fees, financial reporting, and demonstrating competence and trustworthiness, with the possibility of license revocation or suspension and civil penalties for violations. The bill also mandates that these administrators defend employers and their employees against claims arising from these programs if they result in a taxable event, and clarifies the roles and responsibilities of "brokers" (licensed health insurance agents) in marketing these programs, prohibiting them from making deceptive statements. Importantly, these new regulations explicitly do not apply to the underlying individual or group health insurance plans themselves, and the Insurance Commissioner is required to report to the Legislature every three years on the implementation of this article.

Budget and Finance

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