Employers have no obligation under West Virginia law to offer long-term care insurance to their employees. However, if long-term care insurance is among the benefits offered, certain state law requirements under the West Virginia Long-Term Care Insurance Act limit how the plan may be designed (WV Code Sec. 33-15A-1 et seq.).
A long-term care insurance policy in West Virginia may not:
• Be canceled, nonrenewed, or otherwise terminated because of the age or the deterioration of the mental or physical health of the insured individual;
• Contain a provision establishing a new waiting period if existing coverage is converted to or replaced by a new or other policy within the same company (except for an increase in benefits that the insured individual or group policyholder voluntarily selected);
• Provide coverage only for skilled nursing care or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care;
• Condition eligibility for any benefits on prior hospitalization requirement;
• Condition eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
• Condition eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement (WV Code Sec. 33-15A-6).
Group long-term care insurance issued in West Virginia must provide covered individuals with a basis for continuation or conversion of coverage (WV ADC Sec. 114-32-4).