Health Care

Wyo. Stat. Ann. tit. 26, ch. 43
in effect

Wyo. Stat. Ann. § 26-43-101 Definitions.

(a) As used in this act: (i) "Account" means the account provided by W.S. 26-43-112; (ii) "Administrator" means the insurer, insurers or third party administrator or administrators selected pursuant to W.S. 26-43-104(a) to administer the pool; (iii) "Board" means the board of directors of the pool; (iv) "Commissioner" means the insurance commissioner; (v) "Department" means the insurance department; (vi) "Health insurance" means any public health benefit plan, private health benefit plan, hospital and medical expense incurred policy, Medicare supplement policy, nonprofit health care service plan contract and health maintenance organization subscriber contract. The term does not include any hospital or medical service plan which by contract or product design is intended to provide coverage for six (6) months or less, fixed indemnity, limited benefit or credit insurance, coverage issued as a supplement to liability insurance, insurance arising from a workers' compensation or similar law, automobile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance; (vii) "Health maintenance organization" means as defined by W.S. 26-34-102; (viii) "Hospital" means a facility licensed as a hospital by the department of health; (ix) "Insurance arrangement" means any plan, program, contract or any other arrangement under which one (1) or more employers, unions or other organizations provide to their employees or members, either directly or indirectly through a trust or third party administrator, health care services or benefits other than through an insurer. For purposes of assessments under this act "insurance arrangement" does not include any plan, program, contract or other arrangement under which the state of Wyoming, its political subdivisions or school districts provide health care services or benefits pursuant to the authority granted under W.S. 9-3-201; (x) "Insured" means any individual resident of this state who is eligible to receive benefits from any insurer or insurance arrangement; (xi) "Insurer" means any insurance company authorized to transact disability insurance business in this state, Medicare supplement insurance issuer, health maintenance organization or health service plan operation under W.S. 26-22-301; (xii) "Medicare" means coverage under both Part A and B of Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq.; (xiii) "Member" means all insurers and insurance arrangements participating in the pool; (xiv) "Plan of operation" means the plan of operation of the pool, including articles, bylaws and operating rules adopted by the board pursuant to W.S. 26-43-102; (xv) "Pool" means the Wyoming health insurance pool created by W.S. 26-43-102; (xvi) Repealed by Laws 2019, ch. 16, § 2. (xvii) "Creditable coverage" means, with respect to an individual, coverage of the individual provided under any private health benefit plan or public health benefit plan; (xviii) "Federally defined eligible individual" means an individual: (A) For whom, as of the date on which the individual seeks coverage under this act, the aggregate of the periods of creditable coverage, is eighteen (18) or more months; (B) Whose most recent prior creditable coverage was under a group private or public health benefit plan; (C) Who is not eligible for coverage under a group health plan, part A or part B of Medicare or Medicaid, and who does not have other health insurance coverage; (D) With respect to whom the most recent coverage within the period of aggregate creditable coverage was not terminated based on a factor relating to nonpayment of premiums or fraud; (E) Who, if offered the option of continuation coverage under a COBRA continuation provision or under a similar state program, elected such coverage; and (F) Who has exhausted such continuation coverage under such provision or program, if the individual elected the continuation coverage described in subparagraph (E) of this paragraph. (xix) "Eligibility level" means a percentage of the federal poverty guideline for level of coverage under the plan of operation; (xx) "This act" means W.S. 26-43-101 through 26-43-114.

Wyo. Stat. Ann. § 26-43-102 Operation of the pool; board membership; board powers and duties.

(a) There is created a nonprofit entity known as the Wyoming health insurance pool. All insurers issuing health insurance in this state and to the extent not preempted by federal law, insurance arrangements providing health plan benefits in this state on and after July 1, 1990, are members of the pool. The commissioner shall give notice to all member insurers and insurance arrangements of the time and place for the initial meeting of the board appointed pursuant to W.S. 26-43-102(b). (b) The board shall consist of seven (7) members including the commissioner or his designated representative. The commissioner shall appoint three (3) members from participating insurers and three (3) members from the general public. Terms of office for the appointed board members are four (4) years except initial terms shall be less than four (4) years and staggered as determined by the commissioner. The commissioner shall establish procedures for filling vacancies on the board. (c) Members of the board shall serve without compensation but shall receive travel expenses and per diem from pool funds in the same manner and amount as state employees for services incurred for the board. (d) The board shall: (i) Select an administrator of the pool; (ii) Submit to the commissioner a plan of operation for the pool and any amendments to the plan necessary or suitable to assure the fair, reasonable and equitable administration of the pool. The commissioner shall approve the plan of operation after notice and hearing provided the plan is determined suitable to assure the fair, reasonable and equitable administration of the pool and provides for the sharing of pool gains or losses on an equitable proportionate basis. The plan of operation is effective upon approval in writing by the commissioner. If the board at any time thereafter fails to submit suitable amendments to the plan, the commissioner shall adopt reasonable rules after notice and hearing as necessary or advisable to effectuate the provisions of this section. The rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the board and approved by the commissioner; (iii) Have the general powers and authority granted under the laws of this state to insurance companies licensed to transact health insurance; (iv) Establish for each eligibility level appropriate rates, rate schedules, rate adjustments, expense allowances, agents' referral fees, claim reserve formulas and any other actuarial functions appropriate to the operation of the pool. Rates and rate schedules may be adjusted for appropriate risk factors such as age and area variation in claim cost and shall take into consideration appropriate risk factors in accordance with established actuarial and underwriting practices; (v) Assess members of the pool in accordance with the provisions of this act; (vi) Issue policies of insurance in accordance with the requirements of this act; (vii) Repealed by Laws 2019, ch. 16, § 2. (e) The plan of operation provided by paragraph (d)(ii) of this section shall: (i) Establish procedures for the handling, investing and accounting of assets and monies of the pool; (ii) Identify the administrator in accordance with W.S. 26-43-104; (iii) Establish procedures for the collection of assessments to provide for claims paid under the plan and for administrative expenses incurred or estimated to be incurred during the period for which the assessments are made; (iv) Establish the level of assessment payments pursuant to W.S. 26-43-105; (v) Develop and implement a program to publicize and to maintain public awareness of the existence of the plan, the eligibility requirements and procedures for enrollment; (vi) Establish procedures for termination of pool coverage of any person who ceases to meet the eligibility requirements provided by W.S. 26-43-103; (vii) Provide as necessary for audits of the pool and the administration of the pool; (viii) Allow every insurance agent licensed to sell insurance in Wyoming to sell the policy. (f) The board may: (i) Enter into contracts as necessary or proper to carry out the provisions and purposes of this act, including but not limited to the authority, with the approval of the insurance commissioner, to enter into contracts with similar pools of other states for the joint performance of common administrative functions or with persons or other organizations for the performance of administrative functions; (ii) Sue or be sued, including but not limited to taking any legal actions necessary or proper for recovery of any assessments for, on behalf of, or against pool members; (iii) Take legal action as necessary to avoid the payment of improper claims against the pool or the coverage provided by or through the pool; (iv) Appoint from among members appropriate legal, actuarial and other committees as necessary to provide technical assistance in the operation of the pool, policy and other contract design and any other function within the authority of the board; (v) Repealed by Laws 2019, ch. 16, § 2.

Wyo. Stat. Ann. § 26-43-103 Eligibility.

(a) Except as provided in subsections (b) and (e) of this section, any individual person who is a resident of this state is eligible for pool coverage under eligibility level one (1) or eligibility level two (2) if evidence of the following is provided: (i) Rejection of or refusal to issue health insurance for health reasons by one insurer; (ii) Refusal to issue health insurance except at a rate exceeding the applicable pool rate for the coverage applied for under the pool; or (iii) Refusal to issue health insurance except with a reduction or exclusion of coverage for a preexisting health condition which reduction or exclusion is more restrictive than the reduction or exclusion provided by the applicable pool coverage for which application is being made. (b) The following persons are not eligible for pool coverage: (i) Persons who have coverage under health insurance or an insurance arrangement on the issue date of pool coverage; (ii) Any person who is at the time of pool application eligible for Medicaid health care benefits or any person who is eligible for Medicare by reason of age; (iii) Any person who terminated coverage in the pool unless twelve (12) months have elapsed from the termination date; (iv) Any person on whose behalf the pool has paid two hundred fifty thousand dollars ($250,000.00) in benefits. The board shall adjust these amounts annually to reflect the effects of inflation. The adjustment shall not be less than the annual change in the medical component of the "Consumer Price Index for All Urban Consumers" of the department of labor, bureau of statistics, unless the board proposes and the commissioner approves a lower adjustment factor; (v) Inmates of public institutions; (vi) Persons who are eligible for group health insurance or a group health insurance arrangement provided in connection with a policy, plan or program sponsored by an employer and subject to regulation as a group health plan under federal or state law, even though the employer coverage is declined, unless: (A) The cost to insure the individual is offered at a rate to the individual or his employed family member exceeding the applicable pool rate by at least twelve and one-half percent (12.5%) for the coverage applied for under the pool; and (B) At the time of enrollment, plan enrollment does not exceed ninety-five percent (95%) of maximum enrollment capacity as determined under W.S. 26-43-114. (c) Repealed by Laws 2019, ch. 16, § 2. (d) For purposes of catastrophic health insurance pursuant to W.S. 26-43-106(b)(vi), in addition to the requirements of subsection (a) of this section, eligibility shall be limited to those individuals whose total household income does not exceed four hundred percent (400%) of the federal poverty level. (e) Notwithstanding subsection (a) of this section, the commissioner shall have authority to terminate eligibility and disenroll from coverage under the pool some or all of the individuals who are enrolled in the plan as of July 1, 2015, subject to the following: (i) The commissioner has determined that all individuals or groups of individuals who are to be disenrolled have reasonable access to health insurance; (ii) All individuals who are to be disenrolled shall receive prior notice of disenrollment at least ninety (90) days prior to the effective date of the disenrollment; (iii) The commissioner shall have authority to reenroll any individual or group who were disenrolled pursuant to this subsection if it is demonstrated that the individual or group cannot otherwise be insured at reasonable expense.

Wyo. Stat. Ann. § 26-43-104 Administrator.

(a) The board shall select an insurer, insurers or a third party administrator or administrators through a competitive bidding process to administer the pool. The board shall evaluate bids based on criteria established by the board which shall include but are not limited to: (i) The proven ability of the administrator to handle individual accident and health insurance; (ii) The efficiency of the claim paying procedures of the administrator; (iii) An estimate of total charges for administering the plan; (iv) The ability of the administrator to administer the pool in a cost efficient manner. (b) The administrator shall serve for a period determined by the board of not less than three (3) years and not more than five (5) years and is subject to removal for cause. At least one (1) year prior to the expiration of the period of service by an administrator, the board shall invite all insurers, including the current administrator to submit bids to serve as the administrator for the succeeding period. Selection of the administrator for the succeeding period shall be made at least six (6) months prior to the end of the current period. (c) The administrator shall: (i) Perform all eligibility and administrative claims payment functions relating to the pool; (ii) Establish a premium billing procedure for collection of premiums from insureds. Billings shall be made periodically as determined by the board; (iii) Perform all necessary functions to assure timely payment of benefits to covered persons under the pool including but not limited to: (A) Making available information relating to the proper manner of submitting a claim for benefits to the pool and distributing forms upon which submission is made; (B) Evaluating the eligibility of each claim for payment by the pool. (iv) Submit regular reports to the board regarding the pool operation. The board shall determine the frequency, content and form of the report; (v) Determine net written and earned premiums, the expense of administration and the paid and incurred losses for the year and report the information to the board and the department on a form and in the manner prescribed by the commissioner; (vi) Receive payment as provided in the plan of operation for its expenses incurred in the performance of its services.

Wyo. Stat. Ann. § 26-43-105 Assessments; premium tax credit.

(a) After each calendar year, the administrator shall determine the pool net premiums which are premiums less administrative expense allowances, the pool administrative expenses and the pool incurred losses for the calendar year considering investment income and other appropriate gains and losses. (b) Each insurer's assessment shall be determined by multiplying the total cost of pool operation by a fraction the numerator of which equals the insurer's premium and subscriber contract charges for health insurance written in the state during the preceding calendar year and the denominator of which equals the total of all premiums, subscriber contract charges written in the state and to the extent not preempted by federal law, one hundred ten percent (110%) of all claims paid by insurance arrangements in the state during the preceding calendar year. To the extent not preempted by federal law, each insurance arrangement's assessment shall be determined by multiplying the total cost of pool operation by a fraction the numerator of which equals one hundred ten percent (110%) of the benefits paid by the insurance arrangement on behalf of insureds in this state during the preceding calendar year and the denominator of which equals the total of all premiums, subscriber contract charges and one hundred ten percent (110%) of all benefits paid by insurance arrangements made on behalf of insureds in the state during the preceding calendar year. Health insurance premiums and benefits paid by an insurance arrangement that are less than an amount determined by the board to justify the cost of collection shall not be considered for purposes of determining assessments. To the extent not preempted by federal law, insurance arrangements shall report to the board on an annual basis on a form prescribed by the commissioner. Members shall file with the board annual reports and other reports deemed necessary by the board to determine each member's proportion of participation. (c) On or before March 1 of each year, the board shall determine each member's proportion of participation in the pool for the calendar year based on annual statements and other reports deemed necessary by the board and filed by the member with the board. Any deficit incurred by the pool shall be recouped by assessments apportioned under subsection (b) of this section by the board among members. Notification of assessments shall be mailed by the board not later than March 1 of each year. Assessments are due and payable within thirty (30) days after receipt of the assessment notice. (d) For the total amount of assessments due from all members in any one (1) calendar year pursuant to this section up to four million dollars ($4,000,000.00), eighty percent (80%) of each member's proportionate contribution to the first two million dollars ($2,000,000.00) and fifty percent (50%) of the next two million dollars ($2,000,000.00) shall be allowed as a credit against any premium tax owed by the member under this code in the year for which the assessment is payable. The board shall not make a total assessment against all members of more than six million dollars ($6,000,000.00) in any one (1) fiscal year. Assessments received shall be used to defray the total cost of level one (1) pool operations first. Assessment amounts not required to support level one (1) pool operations will be used to support level two (2) operations before any general fund appropriation is used. The general fund appropriation shall only be used to support level two (2) operations. The board shall ensure that all expenses directly attributable to level one (1) individuals are paid from premiums, assessments and any withdrawals from previous reserves. (e) The board may abate or defer, in whole or in part, the assessment of a member if, in the opinion of the board, payment of the assessment would endanger the ability of the member to fulfill its contractual obligations. In the event an assessment against a member is abated or deferred in whole or in part, the amount by which the assessment is abated or deferred may be assessed against the other members in a manner consistent with the basis for assessments set forth in subsection (b) of this section. The member receiving an abatement or deferment shall remain liable to the pool for the deficiency for four (4) years. (f) If assessments exceed actual losses and administrative expenses of the pool, the excess shall be paid to the state treasurer, credited to the account and used by the board to offset future losses or to reduce pool premiums. As used in this subsection, "future losses" includes reserves for incurred but unreported claims. (g) The board may require initial and interim assessments as reasonable and necessary for the organizational, administrative and interim operating expenses and to pay claims in excess of premiums collected. Any initial or interim assessments shall be credited as offsets against any regular assessments due following the close of the calendar year. (h) Assessments collected pursuant to this act shall be paid to the state treasurer and credited to the account.

Wyo. Stat. Ann. § 26-43-106 Minimum benefits; limitations.

(a) Pool coverage shall be offered to eligible persons subject to the termination and disenrollment provisions of W.S 26-43-103(e). The commissioner shall establish by rule and regulation the pool coverage, its schedule of benefits, exclusions and other limitations consistent with this act and taking into consideration the advice and recommendations of the board. The commissioner and the board annually shall review the pool coverage, its schedule of benefits, exclusions and limitations and make changes to reflect the levels of health insurance coverage provided in this state. (b) In establishing the pool coverage, the commissioner shall: (i) Consider the levels of health insurance provided in the state, medical economic factors deemed appropriate and the advice and recommendations of the board; (ii) Promulgate benefit levels, deductibles, coinsurance factors, exclusions and limitations determined to be generally reflective of and commensurate with health insurance plans marketed in the state and required by this act. The commissioner shall offer at least two (2) plans that may include a higher deductible option or a health savings account option in order to provide less expensive coverage alternatives for pool participants; (iii) Repealed by Laws 2005, ch. 57, § 2. (iv) Repealed By Laws 2005, ch. 57, § 2. (v) Design and employ cost containment measures and controls which may include but are not limited to, preadmission certification, concurrent inpatient review, case management, utilization reviews, exclusions or limitations concerning treatment and services, and member deductibles; (vi) Offer for those individuals described in W.S. 26-43-103(d) a catastrophic health plan having a deductible level of twenty-five thousand dollars ($25,000.00), subject to the termination and disenrollment provisions of W.S. 26-43-103(e). (c) Pool coverage shall not include medical costs associated with: (i) Repealed by Laws 2019, ch. 16, § 2. (ii) Cosmetic surgery; (iii) Other procedures as determined by the board. (d) Repealed by Laws 2019, ch. 16, § 2.

Wyo. Stat. Ann. § 26-43-107 Premiums; standard risk rate.

(a) Separate schedules of premium rates based on plan coverage under the pool, age, sex and geographical location may apply for individual risks. (b) The board shall determine the standard risk rate by calculating the average individual standard rate charged by the five (5) largest insurers offering coverages in the state comparable to each plan coverage under the pool. If five (5) insurers do not offer comparable coverage, the standard risk rate shall be established using reasonable actuarial techniques and shall reflect anticipated experience and expenses for the applicable coverage. (c) Initial rates for pool coverage in the first year coverage is provided pursuant to this act shall not be less than one hundred fifty percent (150%) of rates established as applicable for individual standard risks. Subsequent rates may provide for the expected costs of claims including recovery of prior losses, expenses of operation, investment income of claim reserves, and any other costs factors subject to the limitations provided by this subsection. Beginning July 1, 2007, except as provided in subsection (e) of this section, there shall be two (2) levels of eligibility. Level one (1) eligibility applies to persons with income equal to or greater than two hundred fifty percent (250%) of the federal poverty guideline. Level two (2) eligibility applies to persons with income below two hundred fifty percent (250%) of the federal poverty guideline. Premium rates for level one (1) eligibility shall be set at one hundred fifty percent (150%) to two hundred five percent (205%) of rates applicable to individual standard risks. Premium rates for level two (2) eligibility shall be set at one hundred percent (100%) to one hundred forty percent (140%) of rates applicable to individual standard risks. All rates and rate schedules shall be submitted to the commissioner for approval. The rates shall be set as close as practical to the lower end of the range provided. (d) Premiums collected pursuant to this section shall be paid to the state treasurer and credited to the account. (e) Repealed by Laws 2019, ch. 16, § 2.

Wyo. Stat. Ann. § 26-43-108 Preexisting conditions.

(a) Pool coverage shall not exclude charges or expenses incurred for longer than the first twelve (12) months following the effective date of coverage as to any condition for which during the six (6) month period immediately preceding the effective date of coverage medical advice, care or treatment was recommended or received. The preexisting coverage limitation set forth in this section shall not apply to a federally defined eligible individual. (b) Preexisting condition exclusions shall be waived to the extent to which similar exclusions, if any, have been satisfied under any prior health insurance coverage which was terminated and coverage in the pool is effective from the date on which the prior coverage was terminated if application for pool coverage is made not later than ninety (90) days following the termination.

Wyo. Stat. Ann. § 26-43-109 Benefit payments reduction.

(a) Benefits otherwise payable under pool coverage are reduced by: (i) All amounts paid or payable through any other health insurance or insurance arrangement; (ii) All hospital and medical expense benefits paid or payable under any workers' compensation coverage or automobile medical payment or liability insurance whether provided on the basis of fault or nonfault; and (iii) Any hospital or medical benefits paid or payable under or provided pursuant to any state or federal law or program except Medicaid. (b) The administrator or the board has a cause of action against an eligible person for the recovery of the amount of benefits paid which are not for covered expenses. Benefits due from the pool may be reduced or refused as a setoff against any amount recoverable under this section.

Wyo. Stat. Ann. § 26-43-110 Immunity.

The participation in the pool as members, the establishment of rates, forms or procedures or any other joint or collective action required by this act shall not be the basis of any legal action, criminal or civil liability or penalty against the board, the pool or pool members.

Wyo. Stat. Ann. § 26-43-112 Account created; payments; investment.

There is created an account within the trust and agency fund in which all money received, earned or collected pursuant to this act shall be credited and continuously appropriated for the purposes of this act. All claims, costs of administration and other necessary expenses incurred pursuant to this act shall be paid from the account. All money in the account not immediately necessary for the purposes of this act, which amount is certified by the board to the state treasurer, shall be invested and any interest earned shall be credited to the account.

Wyo. Stat. Ann. § 26-43-114 Enrollment capacity planning.

The board shall annually estimate the funds available to the plan through premiums, assessments and legislative appropriations for the subsequent fiscal year and shall determine the maximum number of individuals who may be enrolled for that year without incurring total costs of operation in excess of estimated available funds. The board shall take steps necessary to assure that plan enrollment does not exceed the maximum enrollment capacity determined for that year. In determining enrollment capacity for purposes of this section, the board shall provide for the enrollment in the pool of all federally eligible individuals.

Wyo. Stat. Ann. § 26-43-301 Definitions; applicability.

(a) As used in this article, "air ambulance membership organization" means an entity that, in exchange for fees, dues, charges or other consideration, provides: (i) Discounts to members for the cost of services the organization provides as an air ambulance service company; or (ii) Access for members to providers of air ambulance services and the right to receive air ambulance services from those providers. For purposes of this paragraph, "air ambulance membership organization" means the entity that contracts with health care providers, individuals, employees, groups, provider networks or other air ambulance membership organizations to offer access to air ambulance services and that determines the fees, dues, or charges to air ambulance membership organization members. (b) The registration requirements of this article shall not apply to: (i) An air ambulance membership organization that is otherwise subject to the provisions of this title and is required to be licensed under this title; (ii) A health care provider who provides discounts to patients without any cost or fee of any kind to the patient.

Wyo. Stat. Ann. § 26-43-302 Air ambulance membership organizations; certificate of registration; application.

(a) An air ambulance membership organization shall obtain a certificate of registration from the commissioner before operating as an air ambulance membership organization in Wyoming. (b) An air ambulance membership organization seeking a certificate of registration from the commissioner shall apply on a form created and prescribed by the commissioner. The application shall include: (i) An application fee not to exceed five hundred dollars ($500.00); (ii) Information regarding whether a previous application for a certificate of registration under this article or for a substantially similar certificate under the laws of another state has been denied, revoked, suspended or terminated; (iii) Information regarding whether the applicant is currently under investigation or the subject of any pending action and whether the applicant has been found in violation of any statute or regulation in any jurisdiction in the last five (5) years; (iv) Information sufficient for the commissioner to determine whether the applicant has adequate expertise and experience to operate an air ambulance membership organization and is of good character; (v) Certification that the applicant has established a dedicated toll-free telephone number for its customers and an internet website that makes available the names and addresses of all current air ambulance providers with which the applicant has contracted directly or through a provider network; (vi) Proof that the applicant has posted a surety bond and has established a reserve fund as required by W.S. 26-43-305(f). (c) Upon receipt of an application, the commissioner shall review the application and shall notify the applicant of any deficiencies in the application not later than twenty-one (21) days after receiving the application. Not more than ninety (90) days after receipt of an application containing all required information, the commissioner shall issue a certificate of registration to an applicant that has satisfied all requirements imposed by this article. (d) A certificate of registration issued under this section shall be effective for one (1) year after the date of issuance unless renewed as provided by W.S. 26-43-303(a).

Wyo. Stat. Ann. § 26-43-303 Certificate of registration; renewal; suspension; revocation.

(a) Not less than ninety (90) days before a certificate of registration expires, an air ambulance membership organization seeking to maintain its registration shall submit a renewal application on a form prescribed by the commissioner, the annual report required under W.S. 26-43-307(a) and a renewal fee not to exceed three hundred dollars ($300.00). The commissioner shall renew the certificate of registration for any air ambulance membership organization that is in compliance with the provisions of this article and any rules promulgated pursuant to this article. An air ambulance membership organization may renew its registration for up to one (1) year after expiration of its certificate of registration by paying the renewal fee and a late fee equal to the renewal fee. An air ambulance membership organization shall not enroll new members until their registration is renewed in accordance with this section or a new certificate of registration is approved. (b) The commissioner may suspend or revoke a certificate of registration after notice and an opportunity for a hearing held in accordance with this article and the Wyoming Administrative Procedure Act if the commissioner has reasonable cause to believe that the air ambulance membership organization: (i) Is not operating in compliance with the provisions of this article; (ii) Has advertised, merchandized or attempted to merchandise its services in a manner that misrepresents its services or capacity for service; (iii) Has engaged in deceptive, misleading or unfair practices prohibited by the Wyoming Consumer Protection Act; (iv) Is not fulfilling its obligations as an air ambulance membership organization; or (v) Would be hazardous to the members of the air ambulance membership organization if continued operation were permitted. (c) If the commissioner has reasonable cause under subsection (b) of this section, the commissioner shall notify the air ambulance membership organization in writing specifically stating the grounds for suspending or revoking a certificate of registration. The certificate holder may demand a hearing not later than thirty (30) days after receipt of the notice. Any hearing held under this subsection shall be conducted pursuant to the Wyoming Administrative Procedure Act. (d) Upon reasonable cause shown, the commissioner may suspend the authority of the air ambulance membership organization to enroll new members for a specified period of time not to exceed ninety (90) days. Any suspension under this subsection shall specify in writing any conditions the air ambulance membership organization shall meet before reinstatement of its authority to enroll new members. (e) The commissioner may rescind or modify any suspension ordered under this section. Any modification that results in a suspension being extended or additional conditions imposed on an air ambulance membership organization shall not take effect until after notice is given to the air ambulance membership organization with an opportunity for a hearing held in accordance with this article and the Wyoming Administrative Procedure Act. (f) No certificate of registration of an air ambulance membership organization that has been suspended or revoked shall be reinstated unless requested by the air ambulance membership organization. The commissioner shall not grant the request for reinstatement if the commissioner finds by a preponderance of the evidence that the circumstances for which the suspension or revocation occurred still exist or are likely to recur. (g) In lieu of a suspension or revocation of a certificate of registration, the commissioner may: (i) Issue and serve upon an air ambulance membership organization a violation notice that includes the basis for the violation and an order requiring the air ambulance membership organization to cease and desist from engaging in the acts or practices that caused the issuance of the violation notice; (ii) Impose a civil penalty of not more than one thousand dollars ($1,000.00) for each violation. (h) An air ambulance membership organization shall immediately notify the commissioner if a certificate of registration or other substantially similar authorization issued in another jurisdiction has been suspended, revoked or not renewed.

Wyo. Stat. Ann. § 26-43-304 Air ambulance membership organizations; powers and duties of the commissioner; rulemaking; costs.

(a) The commissioner is authorized to: (i) Examine or investigate the affairs of an air ambulance membership organization to ensure compliance with the provisions of this article; (ii) Order any air ambulance membership organization or applicant to produce materials pertaining to air ambulance membership affairs, including any records, books, files, advertising and solicitation materials and any other information necessary to ensure compliance with this article; (iii) Take statements under oath to determine whether the air ambulance membership organization or an applicant is in violation of the provisions of this article. (b) An air ambulance membership organization found to have violated any provision of this article after an examination or investigation under this section shall pay all costs and fees associated with the examination or investigation. (c) The commissioner shall promulgate any rules necessary to carry out the provisions of this article.

Wyo. Stat. Ann. § 26-43-305 Charges authorized; written agreements required; cancellation of memberships; duties.

(a) An air ambulance membership organization may assess a periodic charge and a reasonable one-time application processing fee to its members. (b) All terms and conditions for memberships of an air ambulance membership organization shall be provided in writing to each member. An air ambulance membership organization meeting the definition specified in W.S. 26-43-301(a)(ii) shall have an agreement in writing with each air ambulance provider offering air ambulance services to its members. The written provider agreement may be entered into directly with the provider or with an entity that hires or represents the provider. (c) A member of an air ambulance membership organization's plan shall have the right to cancel his membership in the plan at any time. If the member cancels his membership not later than thirty (30) days after purchasing a plan, the air ambulance membership organization shall refund to the member any one-time charges that exceed thirty dollars ($30.00) and all periodic charges. For purposes of this subsection, cancellation occurs when notice of cancellation is mailed or otherwise delivered to the air ambulance membership organization. (d) If an air ambulance membership organization cancels a membership for any reason other than nonpayment of charges by a member, the air ambulance membership organization shall issue a pro rata refund of all periodic charges to the member. (e) An air ambulance membership organization or an agent, broker or marketer who sells memberships for an air ambulance membership organization shall disclose all charges for each air ambulance membership organization membership to all prospective members. (f) An air ambulance membership organization shall: (i) Post a surety bond with one (1) or more surety companies approved by the commissioner in the amount of five thousand dollars ($5,000.00) for every one thousand (1,000) members of the organization who are residents of the state of Wyoming or portion thereof; (ii) Establish a reserve fund at any financial institution approved by the commissioner in the amount of three dollars ($3.00) for each member currently part of a plan that the air ambulance membership organization offers. The reserve fund shall be for the benefit of the members and to guarantee that any plan the air ambulance membership organization offers continues until all memberships or plans are terminated. No amount shall be required to be deposited for any family members of the plan member's household unless the family members are separately participating or subscribed to the organization's plan. No further deposits shall be required under this paragraph after the total amount of the reserve fund and surety bond required under paragraph (i) of this subsection exceeds two hundred thousand dollars ($200,000.00). (g) An air ambulance membership organization shall pay any costs of collection upon a judgment in favor of a plan member and attorney fees in any successful action brought by a plan member.

Wyo. Stat. Ann. § 26-43-306 Violations; unfair trade practices; penalties.

In addition to any penalties and other enforcement of this article, any person who willfully violates any provision of this article may be subject to a civil penalty not to exceed one thousand dollars ($1,000.00) for each willful violation.

Wyo. Stat. Ann. § 26-43-307 Reporting requirements; notice to commissioner; penalties.

(a) Not less than ninety (90) days before expiration of a certificate of registration, an air ambulance membership organization seeking renewal of its certificate of registration shall submit an annual report to the commissioner in a form prescribed by the commissioner. The report shall include: (i) An updated list of the names and addresses of all air ambulance providers or air ambulance service providers responsible for the conduct of the air ambulance membership organization's affairs along with disclosure of the extent and nature of any contracts or arrangements with those persons, including any possible conflicts of interest; (ii) The number of members in Wyoming who are enrolled in any membership offered by the air ambulance membership organization; (iii) A list of any membership agreements currently active or entered into with a governmental entity in Wyoming that provides membership of the air ambulance membership organization to all residents of that governmental entity. As used in this paragraph, "governmental entity" means the governing body of a county or municipality in Wyoming; (iv) Any other information related to the air ambulance membership organization as required by the commissioner to ensure compliance with the provisions of this article. (b) An air ambulance membership organization seeking renewal that fails to file an annual report in the form or before the deadline specified in subsection (a) of this section shall be ineligible for renewal until any deficiency is remedied. (c) Upon notice by the commissioner, an air ambulance membership organization failing to comply with subsection (a) of this section shall lose its authority to enroll new members or to do business in Wyoming if the violation continues beyond a time specified by the commissioner. (d) An air ambulance membership organization shall provide the commissioner notice of any change in the organization's name, address, telephone number, address for the principal place of business, mailing address or internet website address not less than thirty (30) days before making the change.

Wyo. Stat. Ann. § 26-43-308 Advertisements; marketing; required disclosures.

(a) All advertisements, marketing materials, brochures, air ambulance membership cards, presentations and any other communications of an air ambulance membership organization shall be truthful and not misleading in fact or in implication. (b) An air ambulance membership organization advertising or marketing its memberships to Wyoming residents shall: (i) Submit all written advertisements and marketing materials to the commissioner for review for compliance with this article; (ii) Not use language in its advertisements or marketing that could reasonably mislead a person into believing that the air ambulance membership plan is insurance; (iii) Not use language in its advertisements, marketing materials, brochures or presentations with respect to being licensed or registered by a state insurance department or with respect to being provided by a governmental entity in a manner that could reasonably mislead an individual into believing that the air ambulance membership plan is insurance or has been endorsed by the state or any Wyoming governmental entity; (iv) Not have restrictions on access to air ambulance membership organizations, including waiting periods and notification periods. (c) An air ambulance membership organization shall make the following general disclosures in writing in bold and not less than twelve (12) point font on the first content page of any advertisement, marketing material or brochure made available to prospective members or the public: (i) The plan is a membership plan and is not insurance coverage; (ii) For air ambulance membership organizations as defined by W.S. 26-43-301(a)(ii), that the range of discounts for air ambulance services provided under the membership will vary depending on the provider and the services offered; (iii) The toll-free number and internet website address for the air ambulance membership organization where prospective members can obtain additional information about the services offered by the air ambulance membership organization. (d) An air ambulance membership organization shall provide the disclosures required by subsection (c) of this section orally to any person who makes initial contact with an air ambulance membership organization by telephone. (e) Before a person purchases a membership from an air ambulance membership organization, the air ambulance membership organization shall mail, give or, with the consent of the person, email to the person a separate document printed in bold and not less than twelve (12) point font that contains the following disclosures: (i) That the air ambulance membership is not insurance coverage; (ii) That, if eligible and covered under Medicare, the prospective member may consult with a representative of the Medicare program to determine the extent of applicable Medicare coverage and what the member's payment obligations will be if transported by air ambulance; (iii) That the prospective member may be covered by an air ambulance membership organization under a membership provided by a governmental entity; (iv) A detailed list of all one-time and periodic fees that are and will be charged to the prospective member to join the air ambulance membership organization; (v) The Wyoming counties served by the air ambulance membership organization; (vi) That, in an emergency and if the prospective member is outside of the air ambulance membership organization's service area, air ambulance services may be provided by another air ambulance provider or air ambulance membership organization, and the benefits of the air ambulance membership organization that the prospective member is joining may not apply to the services provided by another air ambulance provider, and in such case the prospective member may be responsible for the entire bill; (vii) That if the member cancels the membership not later than thirty (30) days after purchasing a plan, the air ambulance membership organization will refund to the member any one-time charges paid by the member that exceed thirty dollars ($30.00) and all periodic charges paid by the member; (viii) That the air ambulance membership organization may not be the company called in the event of an emergency and that the member may be responsible for the entire bill if a different air ambulance service company provides the service.
Source: WY Statutes (Official Site)URL: https://wyoleg.gov/statutes/compress/title26.pdfFetched: 10/4/2026

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