W. Va. Code R. § 114-87-3

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 114-87-3 - Participation in Pilot Program by Certain Individuals and Employer Groups

3.1. Unless otherwise prohibited by this rule, a participating provider may offer a Plan to an individual if the individual is covered by a high deductible plan and a participating provider may offer a Plan to an employer group if the employer group is covered by a high deductible plan.

3.2. An individual or employer with a high deductible plan may not purchase a Plan from a participating provider unless the subscriber or employer is able to demonstrate that participation in the Plan will not negatively impact the health insurance coverage that is currently offered or will be offered by the employer.

3.3. Any individual who has converted his or her health benefit plan or policy from a low deductible plan to a high deductible plan may not purchase a Plan from a participating provider for three (3) months from date of conversion.

3.4. Any employer who has converted its health benefit plan from a low deductible plan to a high deductible health benefit plan may not purchase a plan from a participating provider for six (6) months from the date of conversion.

W. Va. Code R. § 114-87-3