{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-326.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-326.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-326.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-326.html"}],"law_id":55944,"edition_id":1,"section_id":55944,"structure_id":13680,"section_number":"38.2-326","catch_line":"Plan management functions","history":"2013, cc. 670, 679; 2020, cc. 916, 917.","full_text":"A\n\nAs used in this section:\n\t\t\t“Exchange” means either the (i) federal health benefit exchange established by the Secretary of the U.S. Department of Health and Human Services pursuant to § 1321 of the Patient Protection and Affordable Care Act codified as 42 U.S.C. § 18041(c) in the Commonwealth or (ii) state-based exchange established pursuant to Chapter 65 (§ 38.2-6500 et seq.) and § 1311(b) of the Patient Protection and Affordable Care Act codified as 42 U.S.C. § 18031.\n\t\t\t“Plan management functions” means analyses and reviews necessary to support the certification, decertification, and recertification of qualified health plans and stand-alone dental plans for the participation in an exchange and the collection of data necessary to perform the above functions.B\n\nThe Commission’s Bureau of Insurance, with the assistance of the Virginia Department of Health, shall perform plan management functions required to certify health benefit plans and stand-alone dental plans for participation in the exchange, provided that: (i) full funding is available; (ii) the technology infrastructure, including integration with federal, state, and other necessary entities, is made available to the Commission in order for it to carry out the plan management functions authorized in this section; and (iii) there are no other impediments that effectively prevent the Commission from performing any required plan management functions.C\n\nThe Commission’s Bureau of Insurance may contract and enter into memoranda of understanding to carry out its plan management functions.D\n\nThe Commission shall not use any special fund revenues dedicated to its other functions and duties unrelated to exchange operations, including revenues from utility consumer taxes or fees from licensees or registrants regulated by the Commission or fees paid to the Clerk’s Office, to fund the plan management functions.E\n\nTechnology resources provided by the Commission in carrying out the plan management functions shall be limited to existing Commission technology support functions such as desktop support, network administration support, web services support, or other similar support functions.F\n\nThe Commission shall make available to the public on its website a written report on the implementation and performance of its plan management functions during the preceding fiscal year, including, at a minimum, the manner in which all funds utilized for its plan management functions were expended.","order_by":null,"text":{"0":{"id":204926,"text":"As used in this section:\n\t\t\t“Exchange” means either the (i) federal health benefit exchange established by the Secretary of the U.S. Department of Health and Human Services pursuant to § 1321 of the Patient Protection and Affordable Care Act codified as 42 U.S.C. § 18041(c) in the Commonwealth or (ii) state-based exchange established pursuant to Chapter 65 (§ 38.2-6500 et seq.) and § 1311(b) of the Patient Protection and Affordable Care Act codified as 42 U.S.C. § 18031.\n\t\t\t“Plan management functions” means analyses and reviews necessary to support the certification, decertification, and recertification of qualified health plans and stand-alone dental plans for the participation in an exchange and the collection of data necessary to perform the above functions.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":204927,"text":"The Commission’s Bureau of Insurance, with the assistance of the Virginia Department of Health, shall perform plan management functions required to certify health benefit plans and stand-alone dental plans for participation in the exchange, provided that: (i) full funding is available; (ii) the technology infrastructure, including integration with federal, state, and other necessary entities, is made available to the Commission in order for it to carry out the plan management functions authorized in this section; and (iii) there are no other impediments that effectively prevent the Commission from performing any required plan management functions.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":204928,"text":"The Commission’s Bureau of Insurance may contract and enter into memoranda of understanding to carry out its plan management functions.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":204929,"text":"The Commission shall not use any special fund revenues dedicated to its other functions and duties unrelated to exchange operations, including revenues from utility consumer taxes or fees from licensees or registrants regulated by the Commission or fees paid to the Clerk’s Office, to fund the plan management functions.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":204930,"text":"Technology resources provided by the Commission in carrying out the plan management functions shall be limited to existing Commission technology support functions such as desktop support, network administration support, web services support, or other similar support functions.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"5":{"id":204931,"text":"The Commission shall make available to the public on its website a written report on the implementation and performance of its plan management functions during the preceding fiscal year, including, at a minimum, the manner in which all funds utilized for its plan management functions were expended.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E"}},"ancestry":[{"id":13680,"edition_id":1,"name":"Provisions Relating to Insurance Policies and Contracts","identifier":"3","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:45:32","date_modified":"2026-06-26 03:45:32","permalink":{"id":214203,"object_type":"structure","relational_id":13680,"identifier":"3","token":"38.2\/3","url":"\/38.2\/3\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":67920,"structure_id":13680,"section_number":"38.2-300","catch_line":"Scope of chapter","url":"\/38.2-300\/","token":"38.2\/3\/38.2-300","metadata":false},{"id":66037,"structure_id":13680,"section_number":"38.2-301","catch_line":"Insurable interest required; life, accident and sickness insurance","url":"\/38.2-301\/","token":"38.2\/3\/38.2-301","metadata":false},{"id":76812,"structure_id":13680,"section_number":"38.2-302","catch_line":"Life, accident, and sickness insurance; application required","url":"\/38.2-302\/","token":"38.2\/3\/38.2-302","metadata":false},{"id":58792,"structure_id":13680,"section_number":"38.2-303","catch_line":"Insurable interest required; property insurance","url":"\/38.2-303\/","token":"38.2\/3\/38.2-303","metadata":false},{"id":79372,"structure_id":13680,"section_number":"38.2-304","catch_line":"Contracts of temporary insurance; duration; what deemed to include","url":"\/38.2-304\/","token":"38.2\/3\/38.2-304","metadata":false},{"id":68773,"structure_id":13680,"section_number":"38.2-305","catch_line":"Contents of policies","url":"\/38.2-305\/","token":"38.2\/3\/38.2-305","metadata":false},{"id":76860,"structure_id":13680,"section_number":"38.2-306","catch_line":"Additional contents","url":"\/38.2-306\/","token":"38.2\/3\/38.2-306","metadata":false},{"id":84098,"structure_id":13680,"section_number":"38.2-307","catch_line":"Charter and bylaw provisions in policies","url":"\/38.2-307\/","token":"38.2\/3\/38.2-307","metadata":false},{"id":69279,"structure_id":13680,"section_number":"38.2-308","catch_line":"Contingent liability provisions in policies issued by certain mutual insurers","url":"\/38.2-308\/","token":"38.2\/3\/38.2-308","metadata":false},{"id":65281,"structure_id":13680,"section_number":"38.2-309","catch_line":"When answers or statements of applicant do not bar recovery on policy","url":"\/38.2-309\/","token":"38.2\/3\/38.2-309","metadata":false},{"id":67536,"structure_id":13680,"section_number":"38.2-310","catch_line":"All fees, charges, etc., to be stated in policy","url":"\/38.2-310\/","token":"38.2\/3\/38.2-310","metadata":false},{"id":72176,"structure_id":13680,"section_number":"38.2-311","catch_line":"Type size in which conditions and restrictions to be printed","url":"\/38.2-311\/","token":"38.2\/3\/38.2-311","metadata":false},{"id":75172,"structure_id":13680,"section_number":"38.2-312","catch_line":"Provisions limiting jurisdiction, or requiring construction of contracts by law of other states, prohibited","url":"\/38.2-312\/","token":"38.2\/3\/38.2-312","metadata":false},{"id":74805,"structure_id":13680,"section_number":"38.2-313","catch_line":"Where certain contracts deemed made","url":"\/38.2-313\/","token":"38.2\/3\/38.2-313","metadata":false},{"id":56872,"structure_id":13680,"section_number":"38.2-314","catch_line":"Limitation of action and proof of loss","url":"\/38.2-314\/","token":"38.2\/3\/38.2-314","metadata":false},{"id":69924,"structure_id":13680,"section_number":"38.2-315","catch_line":"Intervening breach","url":"\/38.2-315\/","token":"38.2\/3\/38.2-315","metadata":false},{"id":60466,"structure_id":13680,"section_number":"38.2-316","catch_line":"Policy forms to be filed with Commission; notice of approval or disapproval; exceptions","url":"\/38.2-316\/","token":"38.2\/3\/38.2-316","metadata":false},{"id":85582,"structure_id":13680,"section_number":"38.2-316.1","catch_line":"Premium rates","url":"\/38.2-316.1\/","token":"38.2\/3\/38.2-316.1","metadata":false},{"id":71148,"structure_id":13680,"section_number":"38.2-316.2","catch_line":"Dental carriers; annual actual loss ratio report","url":"\/38.2-316.2\/","token":"38.2\/3\/38.2-316.2","metadata":false},{"id":77188,"structure_id":13680,"section_number":"38.2-317","catch_line":"Delivery and use of certain policies and endorsements","url":"\/38.2-317\/","token":"38.2\/3\/38.2-317","metadata":false},{"id":64949,"structure_id":13680,"section_number":"38.2-318","catch_line":"Validity of noncomplying forms","url":"\/38.2-318\/","token":"38.2\/3\/38.2-318","metadata":false},{"id":67693,"structure_id":13680,"section_number":"38.2-319","catch_line":"Validity of contracts in violation of law","url":"\/38.2-319\/","token":"38.2\/3\/38.2-319","metadata":false},{"id":71052,"structure_id":13680,"section_number":"38.2-320","catch_line":"Insurer to furnish forms for proof of loss","url":"\/38.2-320\/","token":"38.2\/3\/38.2-320","metadata":false},{"id":60210,"structure_id":13680,"section_number":"38.2-321","catch_line":"Payment discharges insurer","url":"\/38.2-321\/","token":"38.2\/3\/38.2-321","metadata":false},{"id":65634,"structure_id":13680,"section_number":"38.2-322","catch_line":"Standardized claims forms","url":"\/38.2-322\/","token":"38.2\/3\/38.2-322","metadata":false},{"id":54659,"structure_id":13680,"section_number":"38.2-323","catch_line":"Repealed","url":"\/38.2-323\/","token":"38.2\/3\/38.2-323","metadata":false},{"id":87300,"structure_id":13680,"section_number":"38.2-324","catch_line":"Disclosure of property damage information","url":"\/38.2-324\/","token":"38.2\/3\/38.2-324","metadata":false},{"id":72048,"structure_id":13680,"section_number":"38.2-325","catch_line":"Electronic delivery","url":"\/38.2-325\/","token":"38.2\/3\/38.2-325","metadata":false},{"id":55944,"structure_id":13680,"section_number":"38.2-326","catch_line":"Plan management functions","url":"\/38.2-326\/","token":"38.2\/3\/38.2-326","metadata":false}],"previous_section":{"id":72048,"structure_id":13680,"section_number":"38.2-325","catch_line":"Electronic delivery","url":"\/38.2-325\/","token":"38.2\/3\/38.2-325","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-326\/","history_text":"

This law was first created in 2013. The record of its establishment is cataloged in chapters 670<\/a> and 679<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 2020, chapters 916<\/a> and 917<\/a>.<\/p>","references":[{"id":64412,"section_number":"32.1-16","catch_line":"State Department of Health","order_by":null,"url":"\/32.1-16\/"},{"id":55347,"section_number":"38.2-4214","catch_line":"Application of certain provisions of law","order_by":null,"url":"\/38.2-4214\/"},{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"},{"id":62548,"section_number":"38.2-4509","catch_line":"Application of certain laws","order_by":null,"url":"\/38.2-4509\/"}],"refers_to":[{"id":75766,"section_number":"38.2-6500","catch_line":"Definitions","order_by":null,"url":"\/38.2-6500\/"}],"permalink":{"id":214317,"object_type":"law","relational_id":55944,"identifier":"38.2-326","token":"38.2\/3\/38.2-326","url":"\/38.2-326\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-326\/","token":"38.2\/3\/38.2-326","dublin_core":{"Title":"Plan management functions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-326","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> As used in this section:\n\t\t\t“Exchange<\/span>” means either the (i) federal health benefit exchange<\/span> established by the Secretary of the U.S. Department of Health and Human Services pursuant to § 1321 of the Patient Protection and Affordable Care Act codified as 42 U.S.C. § 18041(c) in the Commonwealth or (ii) state<\/span>-based exchange<\/span> established pursuant to Chapter 65 (§ 38.2-6500<\/a> et seq.) and § 1311(b) of the Patient Protection and Affordable Care Act codified as 42 U.S.C. § 18031.\n\t\t\t“Plan management functions<\/span>” means analyses and reviews necessary to support the certification, decertification, and recertification of qualified health plans and stand-alone dental plans for the participation in an exchange<\/span> and the collection of data necessary to perform the above functions. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The Commission<\/span>’s Bureau of Insurance<\/span>, with the assistance of the Virginia Department of Health, shall perform plan management functions<\/span> required to certify health benefit plans and stand-alone dental plans for participation in the exchange<\/span>, provided that: (i) full funding is available; (ii) the technology infrastructure, including integration with federal, state<\/span>, and other necessary entities, is made available to the Commission<\/span> in order<\/span> for it to carry out the plan management functions<\/span> authorized in this section; and (iii) there are no other impediments that effectively prevent the Commission<\/span> from performing any required plan management functions<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The Commission<\/span>’s Bureau of Insurance<\/span> may contract<\/span> and enter into memoranda of understanding to carry out its plan management functions<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> The Commission<\/span> shall not use any special fund revenues dedicated to its other functions and duties unrelated to exchange<\/span> operations, including revenues from utility consumer taxes or fees from licensees or registrants regulated by the Commission<\/span> or fees paid to the Clerk’s Office, to fund the plan management functions<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Technology resources provided by the Commission<\/span> in carrying out the plan management functions<\/span> shall be limited to existing Commission<\/span> technology support functions such as desktop support, network administration support, web services support, or other similar support functions. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> The Commission<\/span> shall make available to the public on its website a written report on the implementation and performance of its plan management functions<\/span> during the preceding fiscal year, including, at a minimum, the manner in which all funds utilized for its plan management functions<\/span> were expended. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPLAN MANAGEMENT FUNCTIONS (\u00a7 38.2-326)\n\nA. As used in this section:\n\t\t\t“Exchange” means either the (i) federal health benefit exchange\nestablished by the Secretary of the U.S. Department of Health and Human Services\npursuant to § 1321 of the Patient Protection and Affordable Care Act\ncodified as 42 U.S.C. § 18041(c) in the Commonwealth or (ii) state-based\nexchange established pursuant to Chapter 65 (§ 38.2-6500 et seq.) and\n§ 1311(b) of the Patient Protection and Affordable Care Act codified as 42\nU.S.C. § 18031.\n\t\t\t“Plan management functions” means analyses and reviews necessary\nto support the certification, decertification, and recertification of qualified\nhealth plans and stand-alone dental plans for the participation in an exchange\nand the collection of data necessary to perform the above functions.\n\nB. The Commission’s Bureau of Insurance, with the assistance of the\nVirginia Department of Health, shall perform plan management functions required\nto certify health benefit plans and stand-alone dental plans for participation\nin the exchange, provided that: (i) full funding is available; (ii) the\ntechnology infrastructure, including integration with federal, state, and other\nnecessary entities, is made available to the Commission in order for it to carry\nout the plan management functions authorized in this section; and (iii) there\nare no other impediments that effectively prevent the Commission from performing\nany required plan management functions.\n\nC. The Commission’s Bureau of Insurance may contract and enter into\nmemoranda of understanding to carry out its plan management functions.\n\nD. The Commission shall not use any special fund revenues dedicated to its other\nfunctions and duties unrelated to exchange operations, including revenues from\nutility consumer taxes or fees from licensees or registrants regulated by the\nCommission or fees paid to the Clerk’s Office, to fund the plan management\nfunctions.\n\nE. Technology resources provided by the Commission in carrying out the plan\nmanagement functions shall be limited to existing Commission technology support\nfunctions such as desktop support, network administration support, web services\nsupport, or other similar support functions.\n\nF. The Commission shall make available to the public on its website a written\nreport on the implementation and performance of its plan management functions\nduring the preceding fiscal year, including, at a minimum, the manner in which\nall funds utilized for its plan management functions were expended.\n\nHISTORY: 2013, cc. 670, 679; 2020, cc. 916, 917.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}