Current through Register Vol. XLI, No. 50, December 13, 2024
Section 114-9-4 - Standards And Requirements4.1. Premium rates. -- Premium rates under a mass marketing plan shall comply with the standards prescribed by the insurance laws of West Virginia, including, but not limited to, the standards that rates not be excessive, inadequate or unfairly discriminatory. Rates shall not be deemed to be unfairly discriminatory because different premiums result for policyholders with like loss exposures but different expense factors, or like expense factors but different loss exposures, so long as the rates reflect the differences with reasonable accuracy. Rates shall not be deemed to be unfairly discriminatory if they are averaged broadly among persons insured under a mass marketing plan.4.2. Statistics. -- An insurer selling insurance pursuant to mass marketing plans shall maintain separate statistics as to loss and expense experience pertinent thereto.4.3. Disclosure required. -- Every insurer, agent or broker selling insurance pursuant to a mass marketing plan shall, prior to sale, make full and fair disclosure to prospective insureds of all features of such plan, whether favorable or unfavorable, including, but not limited to, premium rates, benefits, duration of coverage, policyholder services, conversion privileges available and the financial interests in the plan, if any, of the sponsoring employer, association, organization or the group.4.4. Underwriting standards. -- No insurer shall use underwriting standards for individual risk selection in a mass marketing plan which are, on the whole, more restrictive that the standards used by such insurer for individual risk selection in the sale of the same kind of insurance in West Virginia other than pursuant to mass marketing plans. In the event insurer does not sell such kind of insurance in West Virginia other than pursuant to mass marketing plans, its underwriting standards for individual risk selection in such plans shall, on the whole, be no more restrictive than the standards used by its principal affiliate, if any, for individual risk selection in the sale of such kind of insurance in West Virginia other than pursuant to mass marketing plans.4.5. Compulsory facilities. -- An insurer, agent or broker selling insurance pursuant to a mass marketing plan shall, with respect to any employees or members who apply for but are denied insurance under such plan, assist such persons in obtaining insurance through any other appropriate insurance plan, such as the assigned risk plan.