W. Va. Code R. § 114-9-5

Current through Register Vol. XLI, No. 50, December 13, 2024
Section 114-9-5 - Prohibitions
5.1. Producers. -- No person shall act as an insurance agent or an insurance broker in connection with a mass marketing plan for any kind of insurance unless such person is duly licensed, pursuant to the provisions of article twelve, chapter thirty-three of the West Virginia Code of 1931, as amended.
5.2. Fictitious arrangement prohibited. -- No insurer shall, without the approval of the Insurance Commissioner sell insurance pursuant to a mass marketing plan to members of any association or organization formed principally for the purpose of obtaining such insurance.
5.3. Compulsory participation prohibited. -- No insurer shall sell insurance pursuant to a mass marketing plan if it is a condition of employment or of membership in an association, organization or other group that any employee or member purchase insurance pursuant to such plan, or if any employee or member shall be subject to any penalty by reason of his nonparticipation.
5.4. Tie-in sales prohibited. -- No insurer shall sell insurance pursuant to a mass marketing plan if (i) the purchase of insurance available under such plan is contingent upon the purchase of any other insurance, product or service or (ii) the purchase or price of any other insurance, product or service is contingent upon the purchase of insurance available under such plan. This provision shall not be deemed to prohibit the reasonable requirement of safety devices, such as heat detectors, lightning rods, theft prevention equipment and the like.
5.5. Cancellation and nonrenewal.
(a) The failure of an employer, association, organization or other group to remit premiums when due for any reason (including, but not limited to, interruption or termination of employment or membership) shall not be regarded as "Nonpayment of Premium" by any insured under any such plan providing for remittance of premium by such employer, association, organization or other group, unless such insured shall have been given written notice of such failure to remit and shall not himself have paid such premium by the later of (i) twenty (20) days after such notice or (ii) the due date of such premium remittance under the mass marketing plan.
(b) All mass marketing plans shall provide that upon termination of employment or membership or upon the discontinuance of the mass marketing plan, the insured employee or member may maintain his policy in force for at least sixty (60) days in the same amount, upon payment of the premium applicable to the class of risk to which he belongs on an individual basis. The option to maintain the insurance in force shall be exercised within thirty (30) days following the date of termination. Any notice of cancellation or nonrenewal of any policy of an employee or member insured under a mass marketing plan shall be accompanied by a notice to the employee or member that, at his request, the insurer will afford the employer, association, organization or other group a reasonable opportunity to consult with the insured and to present facts in opposition to cancellation or nonrenewal.

W. Va. Code R. § 114-9-5