reglab/housing_qa huggingface dataset:
VA Code § 38.2-3418.19 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3418.19. Coverage for organ, eye or tissue transplant

A. Notwithstanding the provisions of § 38.2-4319, 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 providing a health care plan for health care services, whose policy, contract, or plan, including any certificate of evidence of coverage issued in connection with such policy, contract, or plan, includes coverage for services related to organ, eye, or tissue transplantation as defined in § 32.1-297.2 shall not:1. Deny coverage to a covered person solely on the basis of the person's disability;2. Deny a person eligibility or continued eligibility to enroll in or to renew coverage under the policy, contract, or plan for the purpose of avoiding the requirements of § 32.1-297.2;3. Penalize a health care provider, reduce or limit the reimbursement of a health care provider, or provide monetary or nonmonetary incentives to a health care provider to induce such health care provider to act in a manner inconsistent with the requirements of § 32.1-297.2; or4. Reduce or limit coverage for services related to organ, eye, or tissue transplant as defined in § 32.1-297.2 for an eligible individual with a disability as defined in § 32.1-297.2.B. The provisions of this section shall apply to any policy, contract, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2021.C. The provisions of this section shall not apply to short-term travel, accident-only, or limited or specified disease policies; contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal government plans; or short-term nonrenewable policies of not more than six months' duration.D. Nothing in this section shall require an insurer to provide coverage for a medically inappropriate organ, eye or tissue transplant.2020, cc. 217, 218, § 38.2-3418.18.
VA Code § 38.2-3418.20 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3418.20. Coverage for hearing aids and related services

A. As used in this section:"Hearing aid" means any wearable, nondisposable instrument or device designed or offered to aid or compensate for impaired human hearing and any parts, attachments, or accessories, including earmolds, but excluding batteries and cords. Hearing aids are not to be considered durable medical equipment."Related services" includes earmolds, initial batteries, and other necessary equipment, maintenance, and adaptation training.B. Notwithstanding the provisions of § 38.2-3419, 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 providing a health care plan for health care services shall provide coverage for hearing aids and related services for children 18 years of age or younger under any policy, contract, or plan delivered, issued for delivery, or renewed in the Commonwealth. The coverage shall include payment of the cost of one hearing aid per hearing-impaired ear every 24 months, up to $1,500 per hearing aid. The insured may choose a higher-priced hearing aid and may pay the difference in cost above $1,500, with no financial or contractual penalty to the insured or to the provider of the hearing aid.C. No insurer, corporation, or health maintenance organization shall impose upon any person receiving benefits pursuant to this section any copayment or fee, and no condition may be applied to the person that is not equally imposed upon all individuals in the same benefit category.D. Coverage shall be available under this section only for services and equipment recommended by an otolaryngologist. Such recommended services and equipment may be provided or dispensed by an otolaryngologist, licensed audiologist, or licensed hearing aid specialist.E. The provisions of this section shall apply to any policy, contract, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2021.F. The provisions of this section shall not apply to short-term travel, accident-only, limited or specified disease policies, or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal governmental plans or to short-term nonrenewable policies of not more than six months' duration.2020, c. 1094, § 38.2-3418.18.
VA Code § 38.2-3419 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3419. Additional mandated coverage made optional to group policy or contract holder

Any new or existing group policy or contract holder for whom coverage under an accident and sickness insurance policy is issued or renewed by an insurer or for whom coverage under a contract is issued or renewed by a corporation licensed pursuant to Chapter 42 (§ 38.2-4200 et seq.) of this title, shall be given the option to purchase any coverage, benefits or services first mandated under this chapter on or after July 1, 1982, provided that all mandated coverages as of June 30, 1982, will not be affected.1982, c. 577, § 38.1-348.14; 1986, c. 562.
VA Code § 38.2-3419.1 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3419.1. Report of costs and utilization of mandated benefits

A. Beginning with the calendar year 1991, every insurer, health services plan, and health maintenance organization from which a report is deemed necessary under regulations adopted by the Commission shall report to the Commission cost and utilization information for each of the mandated benefits and providers set forth in this article. The reporting period shall be as determined by the Commission in its regulations, but not less often than biennially. Each report shall be submitted no later than the next May 1 following the reporting period. The reports shall be in detail and form as required under regulations adopted by the Commission so as to provide the information deemed necessary by the Commission to determine the financial impact of each mandated benefit and provider.B. The Commission shall prepare a consolidation of these reports to provide to the General Assembly such information concerning the costs of mandated benefits, the utilization of services under mandated benefits, and such other information as the Commission or the General Assembly may deem appropriate. Such consolidated reports shall be submitted to the General Assembly no later than the next October 31 following the reporting period.1990, cc. 393, 439; 1994, c. 316.
VA Code § 38.2-3420 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3420. Authority and jurisdiction of Commission; exception

A. Except as provided in subsection B, any person offering or providing coverage in the Commonwealth for health care services, whether the coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the Commission to the extent the person is not regulated by another agency of the Commonwealth, any subdivision of the Commonwealth, or the federal government relating to the offering or providing of coverage for health care services.B. Neither the provisions of this section nor any other provision of this title shall be construed to affect or apply to a multiple employer welfare arrangement (MEWA) comprised only of banks together with their plan-sponsoring organization, and their respective employees, provided the multiple employer welfare arrangement (i) is duly licensed as a MEWA by the insurance regulatory agency of a state contiguous to the Commonwealth, (ii) files with the Commission a copy of its certificate of authority or other proper license from the contiguous state, (iii) has no more than 500 Virginia residents who are employees of its member banks enrolled in or receiving accident and sickness benefits as insureds, members, enrollees, or subscribers of the MEWA, and (iv) is subject to solvency examination authority and reserve adequacy requirements determined by sound actuarial principles by such domiciliary contiguous state. For purposes of this subsection:"Bank" means an institution that has or is eligible for insurance of deposits by the Federal Deposit Insurance Corporation."Plan-sponsoring organization" means an association that (i) sponsors a MEWA comprised only of banks; (ii) has been actively in existence for at least five years; (iii) has been formed and maintained in good faith for purposes other than obtaining insurance; (iv) does not condition membership in the association on any health status-related factor relating to an individual, including an employee of an employer or a dependent of an employee; (v) makes health insurance coverage offered through the association available to all members regardless of any health status-related factor relating to such members or individuals eligible for coverage through a member; (vi) does not make health insurance coverage offered through the association available other than in connection with a member of the association; and (vii) meets such additional requirements as may be imposed under the laws of the Commonwealth, and includes any subsidiary of such an association.1983, c. 417, § 38.1-43.7; 1986, c. 562; 1990, c. 477; 2004, c. 236; 2011, c. 329; 2012, c. 589.
VA Code § 38.2-3421 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3421. How to show jurisdiction of other state agency or federal government

A person may show that it is regulated by another agency of this Commonwealth, any subdivision of this Commonwealth, or the federal government by providing to the Commission the appropriate certificate, license or other document issued by the other governmental agency that permits or qualifies it to provide those services set forth in § 38.2-3420. Provided, however, in lieu of such certificate, license or other documentation, the Commission may determine that such person is not subject to the jurisdiction of the Commission if the Commission is otherwise satisfied that such person is regulated by another agency of this Commonwealth, any subdivision of this Commonwealth or the federal government relating to the offering or providing of coverage for health care services. Any person who has provided such certificate, license, or other document shall immediately notify the Commission if such person ceases to be regulated by the governmental agency as stated in the certificate, license, or other document provided to the Commission. Any other person who is otherwise determined by the Commission not to be subject to the jurisdiction of the Commission shall also notify the Commission of any change in its circumstances which may materially affect such determination of the Commission.1983, c. 417, § 38.1-43.8; 1986, c. 562; 1990, c. 477.
VA Code § 38.2-3422 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3422. Examination

Any person that fails to show that it is regulated by another agency of this Commonwealth, any subdivision of this Commonwealth, or the federal government as provided by § 38.2-3421 shall be subject to an examination by the Commission to determine the organization and solvency of the person and whether or not the person is in compliance with the applicable provisions of this title.1983, c. 417, § 38.1-43.9; 1986, c. 562; 1990, c. 477.
VA Code § 38.2-3423 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3423. When subject to this title

Any person that fails to show that it is regulated by another agency of this Commonwealth, any subdivision of this Commonwealth, or the federal government as provided by § 38.2-3421 shall be subject to all appropriate provisions of this title regarding the operation of its business.1983, c. 417, § 38.1-43.10; 1986, c. 562; 1990, c. 477.
VA Code § 38.2-3424 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3424. Disclosure of extent and elements of coverage

A. Any agent, agency, administrator, or other person that advertises, sells, transacts, or administers coverage for health care services in this Commonwealth where that coverage is provided by any person subject to the provisions of this article shall inform any purchaser, prospective purchaser, or covered person of (i) the lack of insurance or other coverage, unless that coverage is fully insured or otherwise fully covered by an admitted life insurer, accident and sickness insurer, health services plan, dental or optometric services plan, or health maintenance organization and (ii) if the coverage is fully insured or otherwise fully covered, the terms, coverages, limits, and deductibles including the amount of "stop-loss" insurance in effect.B. No person, including an administrator, insurer, agent, or affiliate of an insurer shall make, publish, disseminate, circulate, or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in any newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio station or television station, or in any other way, any advertisement, announcement, or statement soliciting membership, offering coverage, or evidencing coverage in any health care plan or arrangement which is subject to regulation by the Commission under this article and not otherwise regulated by this title, unless such advertisement, announcement, or statement contains the following disclosure:Your plan of coverage is not protected under the Virginia Life, Accident and Sickness Insurance Guaranty Association Act. Therefore:1. In the event of an insolvency of your plan, you may be unable to collect any amount you are owed for covered claims, regardless of the coverage provided under the plan;2. The payment of premiums into your plan does not guarantee payment of claims under your plan, regardless of the coverage provided under the plan.When such disclosure is contained in print, it shall be no smaller than boldfaced ten-point type.1983, c. 417, § 38.1-43.11; 1986, c. 562; 1990, c. 477.
VA Code § 38.2-3424.1 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3424.1. Applicability

Nothing contained in this article shall be construed to apply to any plan for providing health insurance coverage established pursuant to § 2.2-2818.1990, c. 477.
VA Code § 38.2-3425 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3425. Expired

Expired.
VA Code § 38.2-3430.1 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3430.1. Application of article

This article applies to individual health insurance coverage offered, sold, issued, or renewed in this Commonwealth, but shall not apply to any individual health insurance coverage for any of the "excepted benefits" defined in § 38.2-3431. In the event of conflict between the provisions in this article and other provisions of this title, the provisions of this article shall be controlling.1997, cc. 807, 913.
VA Code § 38.2-3430.1:1 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3430.1:1. Health insurance coverage not required

No resident of this Commonwealth, regardless of whether he has or is eligible for health insurance coverage under any policy or program provided by or through his employer, or a plan sponsored by the Commonwealth or the federal government, shall be required to obtain or maintain a policy of individual insurance coverage except as required by a court or the Department of Social Services where an individual is named a party in a judicial or administrative proceeding. No provision of this title shall render a resident of this Commonwealth liable for any penalty, assessment, fee, or fine as a result of his failure to procure or obtain health insurance coverage. This section shall not apply to individuals voluntarily applying for coverage under a state-administered program pursuant to Title XIX or Title XXI of the Social Security Act. This section shall not apply to students being required by an institution of higher education to obtain and maintain health insurance as a condition of enrollment. Nothing herein shall impair the rights of persons to privately contract for health insurance for family members or former family members.2010, cc. 106, 107, 108, 818.
VA Code § 38.2-3430.2 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3430.2. Definitions

A. The terms defined in § 38.2-3431 that are used in this article shall have the meanings set forth in that section.B. For purposes of this article:"Eligible individual" means an individual:1. (i) for whom, as of the date on which the individual seeks coverage under this section, the aggregate of the periods of creditable coverage is 18 or more months and (ii) whose most recent prior creditable coverage was under individual health insurance coverage, a group health plan, governmental plan, church plan, or a state plan under Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.), or health insurance coverage offered in connection with any such plan;2. Who is not eligible for coverage under (i) a group health plan, (ii) part A or part B of Title XVIII of the Social Security Act, or (iii) a state plan under Title XIX of such Act, or any successor program, and does not have other health insurance coverage;3. With respect to whom the most recent coverage within the coverage period described in subdivision 1 was not terminated based on a factor described in subdivision B 1 or B 2 of § 38.2-3430.7 relating to nonpayment of premiums or fraud;4. If the individual had been offered the option of continuation coverage under a COBRA continuation provision or under a similar state program, who elected such coverage;5. Who, if the individual elected such continuation coverage, has exhausted such continuation coverage under such provision or program; and6. In the case where individual health insurance coverage is the most recent creditable coverage, the coverage was nonrenewed by the health insurance issuer under the conditions allowed in subdivision C 2 of § 38.2-3430.7, in which case the aggregate period of creditable coverage required is reduced to 12 months.For the purposes of determining the aggregate of the periods of creditable coverage under subdivision B 1 (i) of this section, a period of creditable coverage shall not be counted with respect to enrollment of an individual under a health benefit plan if, after such period, there was a 63-day period during all of which the individual was not covered under any creditable coverage or was not serving a waiting period for coverage under a group health plan, or for group health insurance coverage or was in an affiliation period. This period shall begin on the day following an individual's termination of coverage and shall continue until the date an individual submits an application for coverage. In those cases where an application is submitted by mail, the date of postmark shall be deemed to be the date the application is submitted.1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.
VA Code § 38.2-3430.3 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3430.3. Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage

A. Guaranteed availability.1. All eligible individuals shall be provided a choice of all individual health insurance coverage currently being offered by a health insurance issuer and the chosen coverage shall be issued.2. The coverage provided as required in subdivision A 1 shall not impose any preexisting condition exclusion or affiliation period with respect to the coverage.B. Health insurance issuers are prohibited from imposing any limitations or exclusions based upon named conditions that apply to eligible individuals.C. Health insurance issuers shall include on all applications for health insurance coverage questions which will enable the health insurance issuer to determine if an applicant is applying for coverage as an eligible individual as defined in § 38.2-3430.2. This requirement shall not apply to applications used in connection with managed health care plans administering and providing care to Medicare beneficiaries in exchange for preestablished compensation from Medicare, as permitted under applicable state and federal guidelines.D. The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.1997, cc. 807, 913; 1999, c. 1004; 2000, c. 136; 2005, c. 335; 2013, c. 751.
VA Code § 38.2-3430.3:1 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3430.3:1. Expired

Expired.
VA Code § 38.2-3430.4 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 34 - Provisions Relating to Accident and Sickness Insurance|§ 38.2-3430.4. Special rules for network plans

A health insurance issuer that offers health insurance coverage in the individual market may:1. Limit the eligible individuals who may be enrolled under such coverage to those who live, reside, or work within the service area for such network plan;2. Within the service area of such plan, deny such coverage to such individuals if the health insurance issuer has demonstrated to the Commission that: (i) it will not have the capacity to deliver services adequately to additional individual enrollees because of its obligations to existing group contract holders, enrollees and enrollees covered under individual contracts; and (ii) it is applying this section uniformly to individuals without regard to any health status-related factor of such individuals and without regard to whether the individuals are eligible individuals;3. A health insurance issuer, upon denying health insurance coverage in any service area in accordance with subdivision 2, may not offer coverage in the individual market within such service area for a period of 180 days after such coverage is denied.1997, cc. 807, 913; 1998, c. 24.