West Virginia Code § 33-46-7

Responsibilities of the insurer
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(a) If an insurer uses the services of an administrator, the insurer is responsible for
determining the benefits, premium rates, underwriting criteria and claims payment
procedures applicable to the coverage and for securing reinsurance, if any. The rules
pertaining to these matters shall be provided, in writing, by the insurer to the administrator.
The responsibilities of the administrator as to any of these matters shall be eset forth in the
written agreement between the administrator and the insurer.
(b) It is the sole responsibility of the insurer to provide for competent administration of its
programs. u
(c) In cases where an administrator administers benefits for more than one hundred
certificate holders on behalf of an insurer, the insurer shall, at least semiannually, conduct a
review of the operations of the administrator. At least one review shall be an on-site audit of
the operations of the administrator.
(d) For purposes of this section, "insurer" measns a licensed insurance company, prepaid
hospital or medical care plan, health maintenance organization or a health care corporation.

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