WV| West Virginia Insurance Bulletin No. 25-03 summarizes significant legislation from the 2025 Regular Session of the West Virginia Legislature that impacts the insurance industry. Key statutory changes include the introduction of new requirements for insurance holding companies, modifications to prior authorization for medical care, and revisions to reporting and provider definitions related to workers’ compensation.
Summary of 2025 West Virginia Insurance Legislation
- Senate Bill 800 – Insurance Holding Company Systems
- Amends the Insurance Holding Company Systems Act to align with the updated NAIC model.
- Introduces group capital calculation (GCC) filing and liquidity stress test (LST) reporting.
- GCC provides solvency regulators with additional analytical tools for group-wide supervision, offering financial insight and quantifying risk across insurance groups.
- The LST gives regulators deeper understanding of macroprudential risks.
- Aligns state law with U.S. agreements with the EU and UK.
- Effective: January 1, 2026.
- Senate Bill 833 – Prior Authorizations for Medical Care
- Allows insurers to require prior authorization for prescription drugs even if a healthcare practitioner has a “gold card” exemption.
- Gold card exemptions no longer apply to pharmaceutical medication claims.
- Prior authorization for drugs stays under prior law; definition not changed.
- Effective: April 11, 2025.
- Senate Bill 856 – Reporting Requirements
- Repeals or modifies numerous Insurance Commissioner reporting requirements, removing various quarterly, annual, and biennial reports.
- Reduces reporting and publishing mandates related to workers’ compensation, flood insurance, automobile rates, medical malpractice, and related subjects.
- Maintains flood insurance annual notice requirement, which may now be met by posting online.
- Effective: July 11, 2025.
- House Bill 2797 – Post Traumatic Stress Disorder Claims
- Expands the list of professionals who may diagnose PTSD for first responders under workers’ compensation to include certified mental health nurse practitioners and psychiatric physician assistants (must have a master’s degree or higher, terminal license, and qualification to treat PTSD).
- Clarifies mental health treatment for PTSD can be provided by other licensed mental health providers beyond the initial diagnosing professional.
- Removes the previous sunset date of July 1, 2026.
- Effective: July 11, 2025.