The West Virginia Health Benefit Plan Network Access and Adequacy Act requires insurers that maintain a network of health care providers for its insureds to ensure that the network is sufficient in numbers and has appropriate types of providers in order for all covered services to be accessible without unreasonable travel or delay.   The Act is applicable for plans beginning January 1, 2022, and the Rule with updated standards is applicable for plans beginning on or after January 1, 2025. All plans must file updated network information by July 1st, 2024.

West Virginia Network Access Plan forms need to be filed.  Please read Legislative Rule 114-100.

If you should have any questions you may contact us at OICNetworkAdequacy@wv.gov

1. 1- All documentation and templates should be submitted to OICNetworkAdequacy@wv.gov. 
2. 2- An explanatory cover letter is required with each submission/resubmission.
3. 3- Attach the completed templates in excel format (do not change to PDF).
4. 4- Attach the sample contracts.
5. 5- Please choose the Health, Dental only or Vision only forms below.

• Attach required information and submit to OICNetworkAdequacy@wv.gov.
• Forms to complete:
  • 1- List of Health Plans
  • 2- Provider Locations List
  • 3- Certification of Access Plan for Each Network
  • 4- Providers by County
  • 5- Network Deficiency Template
  • Also, attach copies of Sample Contracts as specified

• Attach required information and submit to OICNetworkAdequacy@wv.gov.
• Forms to complete:
• • 1- List of Dental Plans
  • 2- Dental Providers Locations List
  • 3- Dental Network by County
  • 4- Certification of Dental Access Plan
  • Also, attach copies of Sample Contracts as specified

• Attach required information and submit to OICNetworkAdequacy@wv.gov.
• Forms to complete:
• • 1- List of Vision Plans
  • 2- Vision Providers Locations List
  • 3- Vision Network by County
  • 4- Certification of Vision Access Plan
  • Also, attach copies of Sample Contracts as specified