West Virginia Code § 33-25-7

Licenses
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(a) Before it may issue any contract to a subscriber, a corporation desiring to establish,
maintain and operate a direct health care plan must first obtain from the commissioner a
license as provided in this section.
(b) Applications for an original license shall be made on forms prescribed and furnished by
the commissioner and shall be accompanied by the following documents and information: (1)
Certificate of incorporation; (2) bylaws; (3) list of names and residence addresses of all
officers and board of directors of the corporation; (4) contracts between the corporation and
persons, firms, corporations or associations to render direct heaulth care services; (5)
proposed contracts to be issued to subscribers setting forth in detail the direct health care
services to which subscribers are entitled and the table of rattes to be charged for such
services; (6) financial statement showing the assets and liabilities of the corporation, the
amount of contributions paid, or agreed to be paid, to the corporation for working capital,
the names or name of each contributor and the terms of each contribution; and (7) any
additional information as the commissioner may require.
(c) Within thirty days after receipt of an application, the commissioner shall, upon payment
to him of a license fee of $200, issue a license authorizing the corporation to transact
business in this state in the area to bge served by it, if he is satisfied (1) that the applicant is
incorporated in this state under the provisions of article one, chapter thirty-one of the Code
of West Virginia as a bona fidee, nonprofit corporation, (2) that the health care plan which the
corporation proposes to operate, as well as the forms of all contracts which it proposes to
issue under such healthL care plan, are based upon sound business principles and will be in
every respect equitable, just and fair to the subscriber, (3) that the working capital available
to the corporation will be sufficient to pay all operating expenses during the subscription
period, (4) that the proposed plan will adequately serve the best interests of all the people of
the area in which the corporation intends to operate, regardless of their race, color or
religion, and (5) that the corporation shall have and maintain statutory surplus funds of at
leasWt $2,000,000: Provided, That corporations duly licensed under this article in West
Virginia prior to the effective date of this section whose surplus requirements are increased
by virtue of this section shall have until January 1, 1994, to meet such increased
requirements.
(d) The commissioner may refuse to license a corporation when he determines that such
corporation has not complied with the laws of this state, or that it is not in the best interest
of the people of the state that such corporation be licensed, or that such corporation would
transact business in this state in an improper, illegal or unjust manner. In such event, the
commissioner shall enter an order refusing such license and the applicant therefor may have
a hearing and judicial review in accordance with the applicable provisions of article two of
this chapter relating to hearings before and judicial review of orders entered by the
commissioner.
(e) All licenses issued under the provisions of this article shall expire at midnight on the
thirty-first day of March next following the date of issuance. The commissioner shall renew
annually the license of all corporations which qualify and make applications therefor upon a
form prescribed by the commissioner upon payment to the commissioner of a renewal fee of
$200.
(f) The commissioner shall, after notice and hearing, refuse to renew or shall revoke or
suspend the license of a corporation, if the corporation: (1) Violates any proevision of this
article; (2) fails to comply with any lawful rule, regulation or order of the commissioner; (3)
is transacting its business in an illegal, improper or unjust manner, or irs operating in
contravention of its articles of incorporation or any amendments thereto, of its bylaws, or of
its health care plan; (4) is found by the commissioner to be in an unsound condition or in
such condition as to jeopardize its obligations to subscribers and those with whom it has
contracted; (5) compels subscribers to its health care progratm to accept less than the
obligation due them under their contracts or agreements with the corporation; (6) refuses to
be examined or to produce its accounts, records and files for examination by the
commissioner when required; (7) fails to pay any final judgment rendered against it in West
Virginia within thirty days after the judgment became final or time for appeal expired,
whichever is later; (8) fails to pay when due to the State of West Virginia any fees, charges
or penalties required by this chapter.
In those cases where the commissiogner has the right to revoke, suspend or terminate the
license or any renewal thereof of said corporation, the commissioner shall, by order, require
the corporation to pay to the Setate of West Virginia a penalty in the sum not exceeding
$1,000, and on the failure of the corporation to pay the penalty within thirty days after
notice thereof, the commLissioner shall revoke or suspend the license of the corporation.
When any license has been revoked, suspended or terminated, the commissioner may
reinstate the license when he is satisfied that the conditions causing the revocation,
suspension or termination have ceased to exist and are unlikely to recur.
In tWhe event the commissioner revokes, suspends or terminates a license, the corporation
may demand a hearing in the manner provided in article two of this chapter.

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