Creation and Authority

Senate Bill 408, which was introduced as a modified version of the NAIC exchange model, creates a new article in the WV Code, 33-16G, to establish a health benefit exchange. This bill authorizes the establishment of an exchange within the Offices of the Insurance Commissioner as a governmental agency.
The bill also requires the exchange to pursue federal funds and promulgate rules to achieve federal certification.
If the ACA were to be invalidated or repealed, the exchange Board will issue recommendations to the Legislature for amendments to this article as necessary.

Exchange Board
The exchange board shall be composed of the following member:

  • Four voting ex officio members:
    • The Insurance Commissioner;
    • The Commissioner of the West Virginia Bureau for Medical Services;
    • Director of the West Virginia Children’s Health Insurance Program;
    • Chair of the West Virginia Health Care Authority
  • Four persons appointed by the Governor with advice and consent of the Senate, each to represent the interests of one of the following groups:
    • Individual health care consumers;
    • small employers;
    • organized labor;
    • insurance producers
  • One person to represent the interests of payers who is selected by majority vote of an advisory group
  • One person to represent the interests of health care providers selected by the majority vote of an advisory group

The Governor appoints the chair of the board.

Exchange Duties

The specified duties outlined by the legislation require the exchange to:

  • Provide access to qualified health plans for individuals and employers
  • Provide consumer assistance via a toll-free hotline
  • Maintain a website that provides information on plans and allows for consumer comparison
  • Other obligations has required by State and Federal regulations

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