Relating to modify group accident and sickness insurance requirements
Impact
With the proposed changes set to take effect on July 1, 2023, the bill will significantly alter the landscape of group insurance offerings in West Virginia. By reducing the five-year establishment requirement and the mandate for a minimum of 100 members, the bill is anticipated to foster growth in association health plans. Employers and associations can expect more accessible options for providing health benefits to their employees, and the allowed self-insured arrangements can be tailored to specific member needs, potentially increasing coverage options for small businesses and self-employed individuals.
Summary
House Bill 3079 seeks to amend existing requirements surrounding group accident and sickness insurance in West Virginia. Specifically, the bill modifies stipulations related to ‘bona fide associations’, which can now sponsor and operate self-insured multiple employer welfare arrangements if they meet new criteria. This includes relaxing the previous waiting period and the minimum membership requirements, thus encouraging wider participation in such associations. The proposed changes reflect updates allowed under federal guidelines designed to enhance flexibility in group insurance options for employers and associations.
Sentiment
The sentiment around HB 3079 appears to be largely positive among proponents who view the bill as a progressive step towards increasing health coverage options and affordability for groups that have previously been marginalized due to stringent regulatory frameworks. However, concerns were raised by some stakeholders regarding the implications of self-insuring and the potential risks associated with financial stability and claims management within these newly formed arrangements.
Contention
Notable points of contention include the concerns regarding the financial oversight of these self-insured arrangements, as critics argue that relaxed regulations could lead to insufficient protections for employees seeking claims. Opponents contend that while flexibility may increase access, it could also result in varying levels of coverage quality and the potential for inadequacies in safeguarding member interests amidst the new operating freedoms granted to associations.
Provides for licensing and regulation of individuals and entities as health insurance navigators for a health benefit exchange (RR1 +$44,000 SG EX See Note)