§ 33-50-1 — Definitions

For the purposes of this article, the following words and terms mean the following:

(1) "Commissioner" means the West Virginia Insurance Commissioner.

(2) "Consumer" means an individual or family purchasing insurance coverage through the exchange.

(3) "Exchange" means the West Virginia Health Benefit Exchange or an exchange website operated by the federal government.

(4) "Health care provider" means a provider of medical or health services and any other person or organization who furnishes, bills or is paid for health care in the normal course of business.

(5) "Health carrier" means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health services.

(6) "Network" means a group of health care providers that have contracted with a health plan to provide care at a discounted rate.

(7) "Qualified health plan" means a health plan certified to be offered for sale through the exchange.

(8) "West Virginia Health Benefit Exchange" means the government-regulated marketplace of qualified health plans with multiple levels of coverage established pursuant to article sixteen-g of this chapter.

Legislative History

2015 Reg. Sess., SB366