Introduced January 23, Senate Bill 395 allows the WV Public Employees Insurance Agency (PEIA) to establish base benefits associated with a bronze, silver, and gold insurance plan equivalent to their current plans. The agency may determine the state’s expense for each covered individual or family associated with each base benefit plan in 2019.
The state may pay any West Virginia licensed provider of health insurance, providing the base benefits required by the board to offer these plans, not less than the base benefits demanded by the board. The qualifying insurance companies shall be subject to a 10 percent loss ratio.
Any profits greater than 10 percent from policies sold to the state on behalf of the agency recipients shall go back to the plan as a combination of improved benefit, price, or refund offerings as determined by the insurance company.