insurance
West Virginia sets rules for add-on wellness reimbursements
The law covers programs sold alongside individual or group coverage and says they need their own license. It also makes clear that health plans already offering wellness benefits are not swept into the new article.
West Virginia lawmakers would set separate standards for wellness reimbursement programs. The proposal says the Insurance Commissioner would oversee them, while leaving regular health coverage alone.
- Wellness reimbursement programs would come under state oversight.
- The plans would be treated as add-ons, not insurance replacements.
- The bill leaves the underlying health plan outside the new rules.
- For anyone offered an extra health-coverage product on top of an insurance policy, the distinction matters
- A proposal in West Virginia would bring wellness reimbursement programs under the Insurance Commissioner’s supervision and treat them as add-on products, not replacements for regular coverage
Anyone buying an add-on wellness reimbursement plan with health insurance in West Virginia will now face a separate set of rules. The new law puts those products under the state Insurance Commissioner and leaves regular health coverage alone.
That means the state would be watching the reimbursement program itself, while making clear the underlying individual or group health plan stays separate.
A line between the add-on and the policy
The bill describes these programs as self-insured medical reimbursement plans, or wellness integrated medical plan expense reimbursement plans, created under Sections 105 and 125 of the Internal Revenue Code. They are meant to reimburse qualified medical expenses.
But the proposal draws a bright line. It says the new article would not apply to the underlying individual or group health plan, or to a self-insured group health plan.