The proposed bill aims to dissolve the Public Employees Insurance Agency (PEIA) and establish a new entity, the Public Employees Mutual Insurance Company, to provide health insurance for public employees in West Virginia. Key changes include the transfer of responsibilities, rights, and assets from the PEIA to the new mutual insurance company, which will operate under a governance structure that includes a board of directors and oversight from the Insurance Commissioner. The bill outlines the financial responsibilities of employers and employees regarding insurance premiums, mandates comprehensive health coverage, and introduces provisions for the management of funds associated with the transition. Additionally, it allows for the retention of excess revenues to offset future premium increases and establishes a cost-sharing structure for premiums.

The legislation also includes specific amendments to health insurance regulations, mandating coverage for certain medical conditions and procedures, such as colorectal cancer screenings and breast reconstruction following mastectomies. It emphasizes the importance of stabilizing emergency medical conditions and outlines the responsibilities of the new insurance company in managing claims. Furthermore, the bill clarifies the conditions under which insurance rates may be deemed inadequate or unfairly discriminatory, ensuring that the new company operates with financial viability while providing equitable access to necessary medical services. Overall, the bill seeks to modernize and enhance the public employees' insurance framework in West Virginia through a privatized model.

Statutes affected:
Introduced Version: 5-16-1, 5-16-2, 5-16-3, 5-16-4, 5-16-5, 5-16-7, 5-16-7a, 5-16-7c, 5-16-7d, 5-16-8, 5-16-9, 5-16-10, 5-16-11, 5-16-12, 5-16-12a, 5-16-13, 5-16-15, 5-16-16, 5-16-17, 5-16-18, 5-16-24, 5-16A-1, 5-16A-2, 5-16A-3, 5-16A-4, 5-16A-5, 5-16A-6, 5-16A-7, 5-16A-8, 5-16A-9, 5-16A-10, 5-16A-11, 5-16A-12, 5-16A-13, 5-16A-14, 5-16A-15, 5-16A-16, 5-16A-17, 5-16A-18, 5-16A-19, 5-16A-20, 5-16-7e