{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3407.2.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3407.2.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3407.2.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3407.2.html"}],"law_id":77646,"edition_id":1,"section_id":77646,"structure_id":12994,"section_number":"38.2-3407.2","catch_line":"Coverage for medical child support","history":"1994, c. 213.","full_text":"A\n\nNo insurer, health services plan, or health maintenance organization shall refuse to enroll a child under a parent’s coverage because (i) the child was born out of wedlock; (ii) the child is not claimed as a dependent on the parent’s federal income tax return; or (iii) the child does not reside with the parent or in the insurer’s, health services plan’s, or health maintenance organization’s service area.B\n\nUpon receipt of proof that a parent eligible for family coverage under an accident and sickness policy, health services plan, or health maintenance organization contract has been required by a court or administrative order to provide health coverage for a child, the insurer, health services plan, or health maintenance organization shall:1\n\nPermit such parent to enroll under such family coverage any such child who is otherwise eligible for such coverage, without regard to any enrollment season restrictions;2\n\nIf such parent is enrolled but fails to make application to obtain coverage for such child, enroll such child upon application by the child’s other parent or by the Department of Social Services; and3\n\nNot disenroll or otherwise eliminate coverage of such child unless the insurer, health services plan, or health maintenance organization is provided satisfactory written evidence that:\n\t\t\t\ta. Such court or administrative order is no longer in effect;\n\t\t\t\tb. Such child is or will be enrolled in comparable health coverage through another insurer, health services plan, or health maintenance organization which will take effect not later than the effective date of termination of the child’s coverage under the policy or contract issued by the insurer, health services plan, or health maintenance organization; or\n\t\t\t\tc. Family health coverage has been eliminated under the insurance policy, health services plan, or health maintenance organization contract.C\n\nAny insurer, health services plan, or health maintenance organization providing coverage to the child of a noncustodial parent shall (i) provide to the custodial parent, upon request, any information that is necessary to obtain benefits for such child under such coverage; (ii) permit the custodial parent, or the provider of health services if approved by the custodial parent, to submit claims for services without the approval of the noncustodial parent; and (iii) make payment on claims submitted pursuant to clause (ii) directly to such custodial parent, provider, or the Department of Medical Assistance Services.","order_by":null,"text":{"0":{"id":278523,"text":"No insurer, health services plan, or health maintenance organization shall refuse to enroll a child under a parent’s coverage because (i) the child was born out of wedlock; (ii) the child is not claimed as a dependent on the parent’s federal income tax return; or (iii) the child does not reside with the parent or in the insurer’s, health services plan’s, or health maintenance organization’s service area.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":278524,"text":"Upon receipt of proof that a parent eligible for family coverage under an accident and sickness policy, health services plan, or health maintenance organization contract has been required by a court or administrative order to provide health coverage for a child, the insurer, health services plan, or health maintenance organization shall:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":278525,"text":"Permit such parent to enroll under such family coverage any such child who is otherwise eligible for such coverage, without regard to any enrollment season restrictions;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":278526,"text":"If such parent is enrolled but fails to make application to obtain coverage for such child, enroll such child upon application by the child’s other parent or by the Department of Social Services; and","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"4":{"id":278527,"text":"Not disenroll or otherwise eliminate coverage of such child unless the insurer, health services plan, or health maintenance organization is provided satisfactory written evidence that:\n\t\t\t\ta. Such court or administrative order is no longer in effect;\n\t\t\t\tb. Such child is or will be enrolled in comparable health coverage through another insurer, health services plan, or health maintenance organization which will take effect not later than the effective date of termination of the child’s coverage under the policy or contract issued by the insurer, health services plan, or health maintenance organization; or\n\t\t\t\tc. Family health coverage has been eliminated under the insurance policy, health services plan, or health maintenance organization contract.","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"C"},"5":{"id":278528,"text":"Any insurer, health services plan, or health maintenance organization providing coverage to the child of a noncustodial parent shall (i) provide to the custodial parent, upon request, any information that is necessary to obtain benefits for such child under such coverage; (ii) permit the custodial parent, or the provider of health services if approved by the custodial parent, to submit claims for services without the approval of the noncustodial parent; and (iii) make payment on claims submitted pursuant to clause (ii) directly to such custodial parent, provider, or the Department of Medical Assistance Services.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B3"}},"ancestry":[{"id":12994,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214889,"object_type":"structure","relational_id":12994,"identifier":"1","token":"38.2\/34\/1","url":"\/38.2\/34\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","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":57593,"structure_id":12994,"section_number":"38.2-3400","catch_line":"Application of chapter","url":"\/38.2-3400\/","token":"38.2\/34\/1\/38.2-3400","metadata":false},{"id":72072,"structure_id":12994,"section_number":"38.2-3401","catch_line":"Forms of insurance authorized","url":"\/38.2-3401\/","token":"38.2\/34\/1\/38.2-3401","metadata":false},{"id":65240,"structure_id":12994,"section_number":"38.2-3402","catch_line":"Certification to accompany application","url":"\/38.2-3402\/","token":"38.2\/34\/1\/38.2-3402","metadata":false},{"id":83988,"structure_id":12994,"section_number":"38.2-3403","catch_line":"Fraudulent procurement of policy","url":"\/38.2-3403\/","token":"38.2\/34\/1\/38.2-3403","metadata":false},{"id":65279,"structure_id":12994,"section_number":"38.2-3404","catch_line":"Commission may establish rules and regulations for simplified and readable accident and sickness insurance policies","url":"\/38.2-3404\/","token":"38.2\/34\/1\/38.2-3404","metadata":false},{"id":62539,"structure_id":12994,"section_number":"38.2-3405","catch_line":"Certain subrogation provisions and limitations upon recovery in hospital, medical, etc., policies forbidden; 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This law was first created in 1994. The record of its establishment is cataloged in chapter 213<\/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.<\/p>","references":[{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"}],"refers_to":false,"permalink":{"id":215055,"object_type":"law","relational_id":77646,"identifier":"38.2-3407.2","token":"38.2\/34\/1\/38.2-3407.2","url":"\/38.2-3407.2\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3407.2\/","token":"38.2\/34\/1\/38.2-3407.2","dublin_core":{"Title":"Coverage for medical child support","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3407.2","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> No insurer<\/span>, health services plan<\/span>, or health maintenance organization shall refuse to enroll a child under a parent’s coverage because (i) the child was born out of wedlock; (ii) the child is not claimed as a dependent on the parent’s federal income tax return; or (iii) the child does not reside with the parent or in the insurer<\/span>’s, health services plan<\/span>’s, or health maintenance organization’s service area. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Upon receipt of proof that a parent eligible for family coverage under an accident and sickness policy, health services plan<\/span>, or health maintenance organization contract<\/span> has been required by a court<\/span> or administrative order<\/span> to provide health coverage for a child, the insurer<\/span>, health services plan<\/span>, or health maintenance organization shall: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Permit such parent to enroll under such family coverage any such child who is otherwise eligible for such coverage, without regard to any enrollment season restrictions; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> If such parent is enrolled but fails to make application to obtain coverage for such child, enroll such child upon application by the child’s other parent or by the Department of Social Services; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Not disenroll or otherwise eliminate coverage of such child unless the insurer<\/span>, health services plan<\/span>, or health maintenance organization is provided satisfactory written evidence<\/span> that:\n\t\t\t\ta. Such court<\/span> or administrative order<\/span> is no longer in effect;\n\t\t\t\tb. Such child is or will be enrolled in comparable health coverage through another insurer<\/span>, health services plan<\/span>, or health maintenance organization which will take effect not later than the effective date of termination of the child’s coverage under the policy or contract<\/span> issued by the insurer<\/span>, health services plan<\/span>, or health maintenance organization; or\n\t\t\t\tc. Family health coverage has been eliminated under the insurance<\/span> policy, health services plan<\/span>, or health maintenance organization contract<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> Any insurer<\/span>, health services plan<\/span>, or health maintenance organization providing coverage to the child of a noncustodial parent shall (i) provide to the custodial parent, upon request, any information that is necessary to obtain benefits for such child under such coverage; (ii) permit the custodial parent, or the provider of health services if approved by the custodial parent, to submit claims for services without the approval of the noncustodial parent; and (iii) make payment on claims submitted pursuant to clause (ii) directly to such custodial parent, provider, or the Department of Medical Assistance Services. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nCOVERAGE FOR MEDICAL CHILD SUPPORT (\u00a7 38.2-3407.2)\n\nA. No insurer, health services plan, or health maintenance organization shall\nrefuse to enroll a child under a parent’s coverage because (i) the child\nwas born out of wedlock; (ii) the child is not claimed as a dependent on the\nparent’s federal income tax return; or (iii) the child does not reside\nwith the parent or in the insurer’s, health services plan’s, or\nhealth maintenance organization’s service area.\n\nB. Upon receipt of proof that a parent eligible for family coverage under an\naccident and sickness policy, health services plan, or health maintenance\norganization contract has been required by a court or administrative order to\nprovide health coverage for a child, the insurer, health services plan, or\nhealth maintenance organization shall:\n\n 1. Permit such parent to enroll under such family coverage any such child who\n is otherwise eligible for such coverage, without regard to any enrollment\n season restrictions;\n\n 2. If such parent is enrolled but fails to make application to obtain coverage\n for such child, enroll such child upon application by the child’s other\n parent or by the Department of Social Services; and\n\n 3. Not disenroll or otherwise eliminate coverage of such child unless the\n insurer, health services plan, or health maintenance organization is provided\n satisfactory written evidence that:\n \t\t\t\ta. Such court or administrative order is no longer in effect;\n \t\t\t\tb. Such child is or will be enrolled in comparable health coverage through\n another insurer, health services plan, or health maintenance organization\n which will take effect not later than the effective date of termination of the\n child’s coverage under the policy or contract issued by the insurer,\n health services plan, or health maintenance organization; or\n \t\t\t\tc. Family health coverage has been eliminated under the insurance policy,\n health services plan, or health maintenance organization contract.\n\nC. Any insurer, health services plan, or health maintenance organization\nproviding coverage to the child of a noncustodial parent shall (i) provide to\nthe custodial parent, upon request, any information that is necessary to obtain\nbenefits for such child under such coverage; (ii) permit the custodial parent,\nor the provider of health services if approved by the custodial parent, to\nsubmit claims for services without the approval of the noncustodial parent; and\n(iii) make payment on claims submitted pursuant to clause (ii) directly to such\ncustodial parent, provider, or the Department of Medical Assistance Services.\n\nHISTORY: 1994, c. 213.","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}}