{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3430.5.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3430.5.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3430.5.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3430.5.html"}],"law_id":83348,"edition_id":1,"section_id":83348,"structure_id":14047,"section_number":"38.2-3430.5","catch_line":"Application of financial capacity limits","history":"1997, cc. 807, 913.","full_text":"A\n\nA health insurance issuer may deny health insurance coverage in the individual market to an eligible individual if the health insurance issuer has demonstrated to the satisfaction of the Commission that:1\n\nIt does not have the financial reserves necessary to underwrite additional coverage; and2\n\nIt is applying this section uniformly to all individuals in the individual market in the Commonwealth consistent with the laws of this Commonwealth and without regard to any health status-related factor of such individuals and without regard to whether the individuals are eligible individuals.B\n\nA health insurance issuer, upon denying individual health insurance coverage in any service area in accordance with subsection A, may not offer such coverage in the individual market within such service area for a period of 180 days after the date such coverage is denied or until the health insurance issuer has demonstrated to the satisfaction of the Commission that the health insurance issuer has sufficient financial reserves to underwrite additional coverage, whichever is later.","order_by":null,"text":{"0":{"id":298613,"text":"A health insurance issuer may deny health insurance coverage in the individual market to an eligible individual if the health insurance issuer has demonstrated to the satisfaction of the Commission that:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":298614,"text":"It does not have the financial reserves necessary to underwrite additional coverage; and","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":298615,"text":"It is applying this section uniformly to all individuals in the individual market in the Commonwealth consistent with the laws of this Commonwealth and without regard to any health status-related factor of such individuals and without regard to whether the individuals are eligible individuals.","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"B"},"3":{"id":298616,"text":"A health insurance issuer, upon denying individual health insurance coverage in any service area in accordance with subsection A, may not offer such coverage in the individual market within such service area for a period of 180 days after the date such coverage is denied or until the health insurance issuer has demonstrated to the satisfaction of the Commission that the health insurance issuer has sufficient financial reserves to underwrite additional coverage, whichever is later.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A2"}},"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 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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":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},"next_section":{"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},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3430.5\/","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.<\/p>","references":false,"refers_to":false,"permalink":{"id":215395,"object_type":"law","relational_id":83348,"identifier":"38.2-3430.5","token":"38.2\/34\/4.1\/38.2-3430.5","url":"\/38.2-3430.5\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3430.5\/","token":"38.2\/34\/4.1\/38.2-3430.5","dublin_core":{"Title":"Application of financial capacity limits","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3430.5","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> A health insurance<\/span> issuer may deny health insurance<\/span> coverage in the individual market to an eligible individual if the health insurance<\/span> issuer has demonstrated to the satisfaction of the Commission<\/span> that: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> It does not have the financial reserves necessary to underwrite additional coverage; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> It is applying this section uniformly to all individuals in the individual market in the Commonwealth consistent with the laws<\/span> of this Commonwealth and without regard to any health status-related factor of such individuals and without regard to whether the individuals are eligible individuals. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> A health insurance<\/span> issuer, upon denying individual health insurance<\/span> coverage in any service area in accordance with subsection A, may not offer such coverage in the individual market within such service area for a period of 180 days after the date such coverage is denied or until the health insurance<\/span> issuer has demonstrated to the satisfaction of the Commission<\/span> that the health insurance<\/span> issuer has sufficient financial reserves to underwrite additional coverage, whichever is later. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nAPPLICATION OF FINANCIAL CAPACITY LIMITS (\u00a7 38.2-3430.5)\n\nA. A health insurance issuer may deny health insurance coverage in the\nindividual market to an eligible individual if the health insurance issuer has\ndemonstrated to the satisfaction of the Commission that:\n\n 1. It does not have the financial reserves necessary to underwrite additional\n coverage; and\n\n 2. It is applying this section uniformly to all individuals in the individual\n market in the Commonwealth consistent with the laws of this Commonwealth and\n without regard to any health status-related factor of such individuals and\n without regard to whether the individuals are eligible individuals.\n\nB. A health insurance issuer, upon denying individual health insurance coverage\nin any service area in accordance with subsection A, may not offer such coverage\nin the individual market within such service area for a period of 180 days after\nthe date such coverage is denied or until the health insurance issuer has\ndemonstrated to the satisfaction of the Commission that the health insurance\nissuer has sufficient financial reserves to underwrite additional coverage,\nwhichever is later.\n\nHISTORY: 1997, cc. 807, 913.","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}}