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West Virginia · Through as of 2026-08-03; contains at least the enactments of the 2026 Regular Session · Newer source version available

W. Va. Code § 33-16F-5: Eligibility of individuals and groups.

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Where this section sits in the code
  1. CHAPTER 33. INSURANCE.
  2. ARTICLE 16F. GROUP LIMITED HEALTH BENEFITS PLANS.

(a) Individuals. –- Eligibility to enroll in an individual West Virginia affordable health care plan is limited to any resident of this state who:

(1) Is not covered by a private insurance policy and is not eligible for coverage under an employer-sponsored group plan or through a public health insurance program, such as Medicare, Medicaid or the state Children's Health Insurance Program; and

(2) Has not been covered by any health insurance program at any time during the past six months, unless coverage under a health insurance program was terminated within the previous six months due to loss of a job that provided an employer-sponsored health benefit plan or death of, or divorce from, a spouse who was provided an employer-sponsored health benefit plan or, with respect to a public health insurance program, eligibility for such program was lost due to an inability to meet income or categorical requirements: Provided, That an individual may not be excluded from enrollment in a West Virginia affordable health care plan on the ground that he or she is eligible for or is enrolled in a COBRA plan.

(b) Group. -– An otherwise eligible group may not obtain coverage under a West Virginia affordable health care plan unless the group has not had coverage under any health insurance plan at any time during the previous six months.

Collected 2026-09-06T00:28:35Z. Source file · JSON

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