Virginia HB 795: Health insurance; association health plans.

Bill Text

Bill Tracking - 2020 session > Legislation 

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2020 SESSION

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VIRGINIA ACTS OF ASSEMBLY -- CHAPTER 

An Act to amend and reenact �� 38.2-3431, 38.2-3437, and 
38.2-3521.1 of the Code of Virginia, relating to health insurance; association 
health plans. 

[H 795] 

Approved 

�

Be it enacted by the General Assembly of Virginia:

1. That �� 38.2-3431, 38.2-3437, and 38.2-3521.1 of the Code 
of Virginia are amended and reenacted as follows:

� 38.2-3431. Application of article; definitions.

A. This article applies to group health plans and to health 
insurance issuers offering group health insurance coverage, and individual 
policies offered to employees of small employers.

Each insurer proposing to issue individual or group accident 
and sickness insurance policies providing hospital, medical and surgical or 
major medical coverage on an expense incurred basis, each corporation providing 
individual or group accident and sickness subscription contracts, and each 
health maintenance organization or multiple employer welfare arrangement 
providing health care plans for health care services that offers individual or 
group coverage to the small employer market in this Commonwealth shall be 
subject to the provisions of this article. Any issuer of individual coverage to 
employees of a small employer shall be subject to the provisions of this 
article if any of the following conditions are met:

1. Any portion of the premiums or benefits is paid by or on 
behalf of the employer;

2. The eligible employee or dependent is reimbursed, whether 
through wage adjustments or otherwise, by or on behalf of the employer for any 
portion of the premium;

3. The employer has permitted payroll deduction for the 
covered individual and any portion of the premium is paid by the employer, 
provided that the health insurance issuer providing individual coverage under 
such circumstances shall be registered as a health insurance issuer in the 
small group market under this article, and shall have offered small employer 
group insurance to the employer in the manner required under this article; or

4. The health benefit plan is treated by the employer or any 
of the covered individuals as part of a plan or program for the purpose of � 
106, 125, or 162 of the United States Internal Revenue Code.

B. For the purposes of this article:

"Actuarial certification" means a written statement 
by a member of the American Academy of Actuaries or other individual acceptable 
to the Commission that a health insurance issuer is in compliance with the 
provisions of this article based upon the person's examination, including a 
review of the appropriate records and of the actuarial assumptions and methods 
used by the health insurance issuer in establishing premium rates for 
applicable insurance coverage.

"Affiliation period" means a period which, under the 
terms of the health insurance coverage offered by a health maintenance 
organization, must expire before the health in