{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3430.2.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3430.2.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3430.2.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3430.2.html"}],"law_id":60829,"edition_id":1,"section_id":60829,"structure_id":14047,"section_number":"38.2-3430.2","catch_line":"Definitions","history":"1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.","full_text":"A\n\nThe terms defined in § 38.2-3431 that are used in this article shall have the meanings set forth in that section.B\n\nFor purposes of this article:\n\t\t\t“Eligible individual” means an individual:1\n\n(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\n\nWho 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\n\nWith 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\n\nIf 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\n\nWho, if the individual elected such continuation coverage, has exhausted such continuation coverage under such provision or program; and6\n\nIn 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.\n\t\t\t\tFor 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.","order_by":null,"text":{"0":{"id":222349,"text":"The terms defined in § 38.2-3431 that are used in this article shall have the meanings set forth in that section.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":222350,"text":"For purposes of this article:\n\t\t\t“Eligible individual” means an individual:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":222351,"text":"(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;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":222352,"text":"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;","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"4":{"id":222353,"text":"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;","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"B4"},"5":{"id":222354,"text":"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;","type":"section","prefixes":["B","4"],"prefix":"4","entire_prefix":"B4","prefix_anchor":"B4","level":2,"prior_prefix":"B3","next_prefix":"B5"},"6":{"id":222355,"text":"Who, if the individual elected such continuation coverage, has exhausted such continuation coverage under such provision or program; and","type":"section","prefixes":["B","5"],"prefix":"5","entire_prefix":"B5","prefix_anchor":"B5","level":2,"prior_prefix":"B4","next_prefix":"B6"},"7":{"id":222356,"text":"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.\n\t\t\t\tFor 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.","type":"section","prefixes":["B","6"],"prefix":"6","entire_prefix":"B6","prefix_anchor":"B6","level":2,"prior_prefix":"B5"}},"ancestry":[{"id":14047,"edition_id":1,"name":"Individual Health Insurance Coverage","identifier":"4.1","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:46:41","date_modified":"2026-06-26 03:46:41","permalink":{"id":215365,"object_type":"structure","relational_id":14047,"identifier":"4.1","token":"38.2\/34\/4.1","url":"\/38.2\/34\/4.1\/","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":77688,"structure_id":14047,"section_number":"38.2-3430.1","catch_line":"Application of article","url":"\/38.2-3430.1\/","token":"38.2\/34\/4.1\/38.2-3430.1","metadata":false},{"id":70426,"structure_id":14047,"section_number":"38.2-3430.10","catch_line":"Effective date","url":"\/38.2-3430.10\/","token":"38.2\/34\/4.1\/38.2-3430.10","metadata":false},{"id":55143,"structure_id":14047,"section_number":"38.2-3430.1:1","catch_line":"Health insurance coverage not required","url":"\/38.2-3430.1_1\/","token":"38.2\/34\/4.1\/38.2-3430.1_1","metadata":false},{"id":60829,"structure_id":14047,"section_number":"38.2-3430.2","catch_line":"Definitions","url":"\/38.2-3430.2\/","token":"38.2\/34\/4.1\/38.2-3430.2","metadata":false},{"id":86672,"structure_id":14047,"section_number":"38.2-3430.3","catch_line":"Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage","url":"\/38.2-3430.3\/","token":"38.2\/34\/4.1\/38.2-3430.3","metadata":false},{"id":69767,"structure_id":14047,"section_number":"38.2-3430.3:1","catch_line":"Expired","url":"\/38.2-3430.3_1\/","token":"38.2\/34\/4.1\/38.2-3430.3_1","metadata":false},{"id":85161,"structure_id":14047,"section_number":"38.2-3430.4","catch_line":"Special rules for network plans","url":"\/38.2-3430.4\/","token":"38.2\/34\/4.1\/38.2-3430.4","metadata":false},{"id":83348,"structure_id":14047,"section_number":"38.2-3430.5","catch_line":"Application of financial capacity limits","url":"\/38.2-3430.5\/","token":"38.2\/34\/4.1\/38.2-3430.5","metadata":false},{"id":64965,"structure_id":14047,"section_number":"38.2-3430.6","catch_line":"Market requirements","url":"\/38.2-3430.6\/","token":"38.2\/34\/4.1\/38.2-3430.6","metadata":false},{"id":68860,"structure_id":14047,"section_number":"38.2-3430.7","catch_line":"Renewability of individual health insurance coverage","url":"\/38.2-3430.7\/","token":"38.2\/34\/4.1\/38.2-3430.7","metadata":false},{"id":63144,"structure_id":14047,"section_number":"38.2-3430.8","catch_line":"Certification of coverage","url":"\/38.2-3430.8\/","token":"38.2\/34\/4.1\/38.2-3430.8","metadata":false},{"id":67431,"structure_id":14047,"section_number":"38.2-3430.9","catch_line":"Regulations establishing standards","url":"\/38.2-3430.9\/","token":"38.2\/34\/4.1\/38.2-3430.9","metadata":false}],"previous_section":{"id":55143,"structure_id":14047,"section_number":"38.2-3430.1:1","catch_line":"Health insurance coverage not required","url":"\/38.2-3430.1_1\/","token":"38.2\/34\/4.1\/38.2-3430.1_1","metadata":false},"next_section":{"id":86672,"structure_id":14047,"section_number":"38.2-3430.3","catch_line":"Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage","url":"\/38.2-3430.3\/","token":"38.2\/34\/4.1\/38.2-3430.3","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3430.2\/","history_text":"

This law was first created in 1997. The record of its establishment is cataloged in chapters 807<\/a> and 913<\/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 3 times. 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. Those modifications are as follows: in 1998, chapter 24<\/a>; in 1999, chapter 1004<\/a>; in 2010, chapters 225<\/a> and 642<\/a>.<\/p>","references":[{"id":86672,"section_number":"38.2-3430.3","catch_line":"Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage","order_by":null,"url":"\/38.2-3430.3\/"},{"id":63783,"section_number":"38.2-3432.3","catch_line":"Limitation on preexisting condition exclusion period","order_by":null,"url":"\/38.2-3432.3\/"}],"refers_to":[{"id":68860,"section_number":"38.2-3430.7","catch_line":"Renewability of individual health insurance coverage","order_by":null,"url":"\/38.2-3430.7\/"},{"id":86404,"section_number":"38.2-3431","catch_line":"Application of article; definitions","order_by":null,"url":"\/38.2-3431\/"}],"permalink":{"id":215379,"object_type":"law","relational_id":60829,"identifier":"38.2-3430.2","token":"38.2\/34\/4.1\/38.2-3430.2","url":"\/38.2-3430.2\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3430.2\/","token":"38.2\/34\/4.1\/38.2-3430.2","dublin_core":{"Title":"Definitions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3430.2","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> The terms defined in § 38.2-3431<\/a> that are used in this article shall have the meanings set forth in that section. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> For purposes of this article:\n\t\t\t“Eligible individual<\/span>” means an individual: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> (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<\/span> coverage, a group health plan, governmental plan, church plan, or a state<\/span> plan under Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.), or health insurance<\/span> coverage offered in connection with any such plan; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> 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<\/span> plan under Title XIX of such Act, or any successor program, and does not have other health insurance<\/span> coverage; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> 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<\/a> relating to nonpayment of premiums or fraud<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> If the individual had been offered the option of continuation coverage under a COBRA continuation provision or under a similar state<\/span> program, who elected such coverage; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Who, if the individual elected such continuation coverage, has exhausted such continuation coverage under such provision or program; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> In the case where individual health insurance<\/span> coverage is the most recent creditable coverage, the coverage was nonrenewed by the health insurance<\/span> issuer under the conditions allowed in subdivision C 2 of § 38.2-3430.7<\/a>, in which case the aggregate period of creditable coverage required is reduced to 12 months.\n\t\t\t\tFor 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<\/span> 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. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nDEFINITIONS (\u00a7 38.2-3430.2)\n\nA. The terms defined in § 38.2-3431 that are used in this article shall\nhave the meanings set forth in that section.\n\nB. For purposes of this article:\n\t\t\t“Eligible individual” means an individual:\n\n 1. (i) for whom, as of the date on which the individual seeks coverage under\n this section, the aggregate of the periods of creditable coverage is 18 or\n more months and (ii) whose most recent prior creditable coverage was under\n individual health insurance coverage, a group health plan, governmental plan,\n church plan, or a state plan under Title XIX of the Social Security Act (42\n U.S.C. § 1396 et seq.), or health insurance coverage offered in\n connection with any such plan;\n\n 2. Who is not eligible for coverage under (i) a group health plan, (ii) part A\n or part B of Title XVIII of the Social Security Act, or (iii) a state plan\n under Title XIX of such Act, or any successor program, and does not have other\n health insurance coverage;\n\n 3. With respect to whom the most recent coverage within the coverage period\n described in subdivision 1 was not terminated based on a factor described in\n subdivision B 1 or B 2 of § 38.2-3430.7 relating to nonpayment of\n premiums or fraud;\n\n 4. If the individual had been offered the option of continuation coverage\n under a COBRA continuation provision or under a similar state program, who\n elected such coverage;\n\n 5. Who, if the individual elected such continuation coverage, has exhausted\n such continuation coverage under such provision or program; and\n\n 6. In the case where individual health insurance coverage is the most recent\n creditable coverage, the coverage was nonrenewed by the health insurance\n issuer under the conditions allowed in subdivision C 2 of § 38.2-3430.7,\n in which case the aggregate period of creditable coverage required is reduced\n to 12 months.\n \t\t\t\tFor the purposes of determining the aggregate of the periods of creditable\n coverage under subdivision B 1 (i) of this section, a period of creditable\n coverage shall not be counted with respect to enrollment of an individual\n under a health benefit plan if, after such period, there was a 63-day period\n during all of which the individual was not covered under any creditable\n coverage or was not serving a waiting period for coverage under a group health\n plan, or for group health insurance coverage or was in an affiliation period.\n This period shall begin on the day following an individual’s termination\n of coverage and shall continue until the date an individual submits an\n application for coverage. In those cases where an application is submitted by\n mail, the date of postmark shall be deemed to be the date the application is\n submitted.\n\nHISTORY: 1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.","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}}