West Virginia Code § 33-25D-17

Powers of insurers, hospital service corporations, medical service
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corporations, dental service corporations, health service corporations and health
maintenance organizations.
(a) An insurance company licensed in this state, a hospital, medical, dental or health service
corporation authorized to do business in this state or a health maintenance organization
holding a certificate of authority under article twenty-five-a of this chapter, eafter applying
for and receiving a certificate of authority as a prepaid limited health service organization,
may through a subsidiary or affiliate organize and operate a prepaid limrited health service
organization under the provisions of this article. Notwithstanding any other law to the
contrary, any two or more insurance companies, hospital, medical, dental or health service
corporations, health maintenance organizations or subsidiaries or affiliates thereof, may
jointly organize and operate a prepaid limited health servicet organization. The business of
insurance is considered to include the providing of health care by a prepaid limited health
service organization owned or operated by an insurer or a subsidiary of the insurer.
(b) Notwithstanding any provision of insurance, hospital, medical, dental or health service
corporation or health maintenance organizatiosn laws, an insurer, a hospital, medical, dental
or health service corporation or a health maintenance organization may contract with a
prepaid limited health service organization to provide insurance or similar protection against
the cost of care provided through prepaid limited health service organizations and to provide
coverage in the event of the failure of the prepaid limited health service organization to meet
its obligations. The enrollees oef a prepaid limited health service organization constitute a
permissible group under those laws. Under the contracts, the insurer or hospital, medical,
dental or health serviceL corporation or health maintenance organization may make benefit
payments to prepaid limited health service organizations for limited health services
rendered by provider s.
(c) Notwithstanding any provision of insurance, hospital, medical, dental or health service
corporation or health maintenance organization laws, an insurer, a hospital, medical, dental
or hWealth service corporation or a health maintenance organization may exclude in any
contract or policy issued to a group, any coverage which would duplicate the coverage of a
prepaid limited health service organization, whether for services, supplies or
reimbursement, to the extent that the coverage or service is provided in accordance with
this chapter pursuant to a contract or policy issued to the same group or to a part of that
group by a prepaid limited health service organization.

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