Code of Virginia - Title 38.2 Insurance - Chapter 42 Health Services Plans

38.2-4200 Applicability of chapter
A. Except as otherwise provided by law, no plan shall be organized, conducted or offered in this Commonwealth other than in the manner set forth ...

38.2-4201 Definitions
As used in this chapter: "Contract holder" means a person entering into a subscription contract with a nonstock corporation. "Nonstock corporation" means a foreign or ...

38.2-4202 Hospital services plans
A hospital or a group of hospitals may conduct through a nonstock corporation as agent for them a hospital services plan as defined in § ...

38.2-4203 Medical or surgical services plans
A group of physicians may conduct through a nonstock corporation as agent for them a medical or surgical services plan as defined in § 38.2-4201. ...

38.2-4204 Merger of nonstock corporations
A nonstock corporation operating a hospital services plan pursuant to § 38.2-4202 may be combined with a nonstock corporation operating a medical or surgical services ...

38.2-4204.1 Commission approval of mergers of nonstock corporations operating prepaid hospital, medical and sur...
A. Except as otherwise provided in this chapter, Article 11 (§ 13.1-894 et seq.) of Chapter 10 of Title 13.1 shall apply to mergers involving ...

38.2-4205 Dental and optometric services
Dental services and optometric services may be provided by either subscription contract or endorsement in a plan. (1986, c. 562.) ...

38.2-4206 Nonstock corporation required
Each plan shall be conducted either by or through (i) a nonstock corporation organized pursuant to the laws of this Commonwealth or (ii) a foreign ...

38.2-4207 Existing foreign nonstock corporation
Any foreign nonstock corporation licensed in the Commonwealth as of July 1, 1980, may conduct a plan directly. (1980, c. 682, § 38.1-813.3; 1986, c. ...

38.2-4208 Nonstock corporation not required to act as agent
A. A nonstock corporation may offer or administer a plan without being required to act as an agent for providers of health care services. B. ...

38.2-4209 Preferred provider subscription contracts
A. As used in this section, a "preferred provider subscription contract" is a contract that specifies how services are to be covered when rendered by ...

38.2-4209.1 Pharmacies; freedom of choice
A. Notwithstanding any provision of § 38.2-4209, no corporation providing preferred provider subscription contracts shall prohibit any person receiving pharmaceutical benefits thereunder from selecting, without ...

38.2-4209.2 Description unavailable
Repealed by Acts 1995, c. 467. ...

38.2-4210 Liability of participants
A. All hospitals, persons, nonstock corporations, and physicians participating in a plan shall be jointly and severally liable on all contracts made for the purposes ...

38.2-4211 Change of participants
A. Any participating hospital, person, nonstock corporation or physician may resign from a plan at any time but will continue to be liable on each ...

38.2-4212 Board of directors of nonstock corporation operating plan
A. Notwithstanding the provisions of §§ 13.1-853, 13.1-854 and 13.1-855, a nonstock corporation operating a plan pursuant to §§ 38.2-4202, 38.2-4203, 38.2-4204, or § 38.2-4208 ...

38.2-4213 Liability of participating providers upon merger of nonstock corporation
If two or more nonstock corporations merge, §§ 38.2-4210 and 38.2-4211 shall not apply to the new or surviving nonstock corporation, its plans or its ...

38.2-4214 Application of certain provisions of law
No provision of this title except this chapter and, insofar as they are not inconsistent with this chapter, §§ 38.2-200, 38.2-203, 38.2-209 through 38.2-213, 38.2-218 ...

38.2-4214.1 Rehabilitation, liquidation, conservation
Any rehabilitation, liquidation, or conservation of a health services plan shall be deemed to be the rehabilitation, liquidation, or conservation of an insurer and shall ...

38.2-4215 Payments by nonstock corporation
No payments shall be made by a nonstock corporation to a person included in a subscription contract unless the payment is for breach of contract ...

38.2-4216 Description unavailable
Repealed by Acts 1987, cc. 565, 655. ...

38.2-4216.1 Open enrollment
A. A nonstock corporation licensed under this chapter shall make available to citizens of the Commonwealth an open enrollment program under the terms set forth ...

38.2-4217 Reports
A. In addition to the annual statement required by § 38.2-1300, the Commission shall require each nonstock corporation to file on a quarterly basis any ...

38.2-4218 Subscriber to have free choice of medical practitioners available
A plan shall be organized and operated to assure that any subscriber shall have free choice of the medical practitioners available and participating in the ...

38.2-4219 Subscriber to be advised in writing as to benefits and limitations thereon
A nonstock corporation shall, prior to and during the term of the subscription contract, fully, fairly and currently advise the subscriber in writing of the ...

38.2-4220 Interplan arrangements
A nonstock corporation may enter into contracts with similar nonstock corporations for the interchange of services to those included in subscription contracts and may provide ...

38.2-4221 Services of certain practitioners other than physicians to be covered
A. A nonstock corporation shall not fail or refuse, either directly or indirectly, to allow or to pay to a subscriber for all or any ...

38.2-4222 Licensing of nonstock corporations
A. No person shall deliver or issue for delivery in this Commonwealth a subscription contract without a license issued by the Commission. Each nonstock corporation ...

38.2-4223 Renewal of license
A. Each nonstock corporation shall renew its license with the Commission annually by July 1. The renewal license shall not be issued unless the nonstock ...

38.2-4224 Licensing of agents
Subscription contracts may be solicited only through life and health insurance agents licensed in accordance with Chapter 18 of this title. Home office salaried officers ...

38.2-4225 Description unavailable
Repealed by Acts 1987, cc. 565, 655. ...

38.2-4226 Taxation
Except as provided by Chapter 4 of this title, the license tax paid by a nonstock corporation under Chapter 25 of Title 58.1 shall be ...

38.2-4227 Misleading applications or contracts
In the operation of a plan, no person shall use any misleading subscription applications or contracts. (Code 1950, § 32-195.16; 1956, c. 268, § 38.1-829; ...

38.2-4228 Controversies involving subscription contracts
The Commission shall have no jurisdiction to adjudicate controversies growing out of subscription contracts. A breach of contract shall not be deemed a violation of ...

38.2-4229 Reinsurance
Any nonstock corporation licensed under this chapter may by policy, treaty or other agreement cede to any insurer reinsurance upon the whole or any part ...

38.2-4229.1 Conversion to domestic mutual insurer
A. Any domestic nonstock corporation subject to the provisions of this chapter that has the surplus required by § 38.2-1030 for domestic mutual insurers issuing ...

38.2-4230 Definitions
As used in this article: "Affiliate" of a specific person or a person "affiliated" with a specific person means a person that directly or indirectly, ...

38.2-4231 Registration of nonstock corporations that are members of holding company system
A. Each nonstock corporation licensed under this chapter that is a member of a holding company system shall register with the Commission. Any nonstock corporation ...

38.2-4232 Standards for transactions with affiliates; adequacy of surplus; dividends and other distribution...
A. Transactions by nonstock corporations licensed under this chapter with their affiliates shall be subject to the following standards: 1. The terms shall be fair ...

38.2-4233 Commission approval required for certain transactions
A. Prior written approval of the Commission shall be required for any transaction between a nonstock corporation licensed under this chapter and any of its ...

38.2-4234 Examinations
A. In addition to the powers the Commission has under Article 4 of Chapter 13 (§ 38.2-1317 et seq.) of this title, the Commission shall ...

38.2-4235 Confidential treatment of information and documents
All information, documents and copies obtained by or disclosed to the Commission or any other person in the course of an examination or investigation made ...