HB 5527: Relating to Wellness Reimbursement Programs - West Virginia

hb5527 s fin am _1 3-11 adopted.htm → Enrolled Committee Substitute · 5 edits · Apr 2, 2026

MODERATE

The document changed from a committee amendment draft to the final enrolled version of the bill, adding full legislative text and official signatures. This version establishes new laws for wellness reimbursement plans, defining them as self-insured medical plans that must be licensed by the Insurance Commissioner. It sets rules for program administrators, including defense of employers against claims, and mandates a report to the Legislature every three years.

Scope change

The bill's scope is now fully defined as applying to self-insured medical wellness reimbursement plans and wellness integrated medical plan expense reimbursement plans in West Virginia, while explicitly excluding individual or group health plans.

SCOPE

Added the complete text of the act, including definitions for wellness reimbursement plans and the requirement that they be licensed by the Insurance Commissioner.

REQUIREMENT

Added requirements for wellness reimbursement program administrators to defend employers and employees against claims or suits in certain circumstances.

ENFORCEMENT

Added provisions for the revocation or suspension of licenses, civil penalties, and criminal penalties for non-compliance.

TIMELINE

Added a requirement for the Insurance Commissioner to file a report with the Legislature every three years on the implementation of the new article.

TECHNICAL

Added official certification signatures from the Clerks of the House and Senate, and the Governor's signature line, finalizing the bill's status.

Engrossed Committee Substitute → hb5527 s fin am _1 3-11 adopted.htm · 3 edits

MINOR

The bill text was updated to reflect a committee amendment that broadens the definition of regulated wellness programs to include various benefit structures, not just specific self-insured plans. The amendment also adds a new confidentiality requirement for records filed with the Insurance Commissioner and updates terminology throughout the document to ensure consistency with the new definition.

Scope change

The scope of the bill was expanded to cover a wider range of wellness benefit arrangements, moving from a narrow definition of 'self-insured medical plans' to a broader category including any plan offering wellness-related benefits intended to promote health.

DEFINITION

The definition of 'Wellness reimbursement program' was expanded to 'Wellness reimbursement program, arrangement, or benefit plan,' now covering any plan offering wellness benefits intended to promote health, rather than just specific self-insured medical reimbursement plans.

REQUIREMENT

A new subsection was added requiring the Insurance Commissioner to treat all proprietary information, records, and filings related to the program as confidential and exempt from public disclosure.

TECHNICAL

Terminology was updated throughout the text to consistently use the new expanded definition (e.g., changing 'Wellness reimbursement program administrator' to 'Wellness reimbursement program, arrangement, or benefit plan administrator').

Committee Substitute → Engrossed Committee Substitute · 2 edits · Mar 14, 2026

MINOR

The bill was updated from a 'Committee Substitute' to an 'Engrossed Version', indicating it has passed further review and is ready for final legislative action. The text includes minor formatting corrections, such as changing 'A used' to 'As used' in the definitions section, but no substantive policy changes regarding wellness reimbursement plans or administrative requirements were identified in the provided excerpt.

TECHNICAL

Corrected a grammatical error in the definitions section by changing 'A used' to 'As used'.

Updated the version history links to reflect the current status as the 'Engrossed Version' instead of the 'Committee Substitute'.

Introduced Version → Committee Substitute · 8 edits

MODERATE

The bill was amended to clarify that it applies to administrators rather than just the programs, updated legal citations to match current federal statutes, and strengthened enforcement by adding civil penalties and requiring administrator defense of employers. The changes also refined the criteria for licensing and criminal penalties to ensure better alignment with regulatory standards.

Scope change

The bill's scope was expanded to explicitly require licensure for wellness reimbursement program administrators and to clarify that brokers are not employees of these administrators.

DEFINITION

Updated the definition of a wellness reimbursement program to include specific references to U.S. Code sections instead of just the Internal Revenue Code.

REQUIREMENT

Added a new section requiring wellness reimbursement program administrators to be licensed, detailing application fees, financial reporting, and compliance with federal ERISA requirements.

Added a new section defining the role of brokers, clarifying they are not employees of the administrator and outlining their duties and restrictions.

Added a requirement for wellness reimbursement program administrators to defend and indemnify employers and employees against claims arising from the program.

ENFORCEMENT

Changed the penalty for failing to obtain a license from a specific misdemeanor fine to a general reference to existing enforcement penalties in the code.

Reduced the maximum jail term for violating the article from two years to one year.

Changed the penalty language from 'administrative monetary penalty' to 'civil penalty' and updated the grounds for license revocation to include crimes with a rational nexus to the licensed activities.

TECHNICAL

Updated the report filing requirement to explicitly state that the commissioner must 'prepare and file' the report.

Relating to Wellness Reimbursement Programs

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