West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-44 - Minimum Reserve Standards For Individual And Group Health Insurance Contracts
Section 114-44-3 - Scope

3.1. When an insurer determines that the adequacy of its health insurance reserves requires reserves in excess of the minimum standards specified in this rule, the increased reserves shall be held and shall be considered the minimum reserves for that insurer.

3.2. With respect to any block of contracts, or with respect to an insurer's health business as a whole, a prospective gross premium valuation is the ultimate test of reserve adequacy as of a given valuation date. The gross premium valuation shall take into account, for contracts in force, in a claims status, or in a continuation of benefits status on the valuation date, the present value as of the valuation date of: all expected benefits unpaid, all expected expenses unpaid, and all unearned or expected premiums, adjusted for future premium increases reasonably expected to be put into effect.

3.3. The insurer is to perform a gross premium valuation whenever a significant doubt exists as to reserve adequacy with respect to any major block of contracts, or with respect to the insurer's health business as a whole. In the event inadequacy is found to exist, immediate loss recognition shall be made and the reserves restored to adequacy. Adequate reserves (inclusive of claim, premium and contract reserves, if any) shall be held with respect to all contracts, regardless of whether contract reserves are required for the contracts under the standards in this rule.

3.4. Whenever minimum reserves, as defined in this rule, exceed reserve requirements as determined by a prospective gross premium valuation, the minimum reserves remain the minimum requirement under this rule.