{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3439.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3439.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3439.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3439.html"}],"law_id":55902,"edition_id":1,"section_id":55902,"structure_id":13819,"section_number":"38.2-3439","catch_line":"Dependent coverage for individuals to age 26","history":"2011, c. 882; 2013, c. 751.","full_text":"A\n\nNotwithstanding any provision of \u00a7 38.2-3500 or 38.2-3525, or any other section of this title to the contrary, a health carrier that makes available dependent coverage for a child shall make that coverage available for a child until such child attains the age of 26.1\n\nA health carrier shall not define “dependent” for purposes of eligibility for dependent coverage for a child other than in terms of a relationship between a child and the covered person.2\n\nA health carrier shall not deny or restrict coverage for a child who has not attained the age of 26 based on the presence or absence of the child’s financial dependency on the covered person, residency with the covered person, marital status, student status, employment, or any combination of those factors.3\n\nNothing in this section shall be construed to require a health carrier to make coverage available for the child of a child receiving dependent coverage, unless the grandparent becomes the legal guardian or adoptive parent of that grandchild.4\n\nThe terms of coverage in a health benefit plan offered by a health carrier providing dependent coverage may not vary based on age except for children who are 26 years of age or older.5\n\nA health carrier shall not deny or restrict coverage of a child based on eligibility for other coverage.B\n\nAny child whose coverage ended, who was denied coverage, or who was not eligible for group or individual health insurance coverage under a health benefit plan because, under the terms of such plan, the availability of dependent coverage of a child ended before the attainment of the age of 26, shall be given written notice of the opportunity to enroll. The child shall be offered all the benefit packages available to, and shall not be required to pay more for coverage than, similarly situated individuals who did not lose coverage by reason of cessation of dependent status.1\n\nThe health carrier shall give such child written notice of the opportunity to enroll not later than the first day of the next plan year or policy year, and shall provide for an enrollment period that continues for at least 30 days.2\n\nThe written notice of opportunity to enroll shall include a statement that a child is eligible to enroll in dependent coverage if coverage ended, coverage was denied, or the child was ineligible for coverage because the availability of dependent coverage for a child ended before the attainment of the age of 26.\n\t\t\t\ta. The notice may be provided to the covered person on behalf of the covered person’s child.\n\t\t\t\tb. For group health insurance coverage, the notice may be included with other enrollment materials that the health carrier distributes to employees, provided the statement is prominent.3\n\nFor any child of a covered person who enrolls, the coverage shall take effect not later than the first day of such plan year or policy year.C\n\nThis section shall apply to any health carrier providing individual or group health insurance coverage, except that for plan years beginning before January 1, 2014, a grandfathered group health plan that makes available dependent coverage for a child may exclude a child who has not attained the age of 26 from coverage only if the child is eligible to enroll in an eligible employer-sponsored health benefit plan, as defined in § 5000A(f)(2) of the Internal Revenue Code, other than the group health plan of a parent.\n\t\t\tFor plan years beginning on or after January 1, 2014, any grandfathered plan shall comply with the requirements of subsections A and B.","order_by":null,"text":{"0":{"id":204797,"text":"Notwithstanding any provision of \u00a7 38.2-3500 or 38.2-3525, or any other section of this title to the contrary, a health carrier that makes available dependent coverage for a child shall make that coverage available for a child until such child attains the age of 26.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":204798,"text":"A health carrier shall not define “dependent” for purposes of eligibility for dependent coverage for a child other than in terms of a relationship between a child and the covered person.","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":204799,"text":"A health carrier shall not deny or restrict coverage for a child who has not attained the age of 26 based on the presence or absence of the child’s financial dependency on the covered person, residency with the covered person, marital status, student status, employment, or any combination of those factors.","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":204800,"text":"Nothing in this section shall be construed to require a health carrier to make coverage available for the child of a child receiving dependent coverage, unless the grandparent becomes the legal guardian or adoptive parent of that grandchild.","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":204801,"text":"The terms of coverage in a health benefit plan offered by a health carrier providing dependent coverage may not vary based on age except for children who are 26 years of age or older.","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"A5"},"5":{"id":204802,"text":"A health carrier shall not deny or restrict coverage of a child based on eligibility for other coverage.","type":"section","prefixes":["A","5"],"prefix":"5","entire_prefix":"A5","prefix_anchor":"A5","level":2,"prior_prefix":"A4","next_prefix":"B"},"6":{"id":204803,"text":"Any child whose coverage ended, who was denied coverage, or who was not eligible for group or individual health insurance coverage under a health benefit plan because, under the terms of such plan, the availability of dependent coverage of a child ended before the attainment of the age of 26, shall be given written notice of the opportunity to enroll. The child shall be offered all the benefit packages available to, and shall not be required to pay more for coverage than, similarly situated individuals who did not lose coverage by reason of cessation of dependent status.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A5","next_prefix":"B1"},"7":{"id":204804,"text":"The health carrier shall give such child written notice of the opportunity to enroll not later than the first day of the next plan year or policy year, and shall provide for an enrollment period that continues for at least 30 days.","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"8":{"id":204805,"text":"The written notice of opportunity to enroll shall include a statement that a child is eligible to enroll in dependent coverage if coverage ended, coverage was denied, or the child was ineligible for coverage because the availability of dependent coverage for a child ended before the attainment of the age of 26.\n\t\t\t\ta. The notice may be provided to the covered person on behalf of the covered person’s child.\n\t\t\t\tb. For group health insurance coverage, the notice may be included with other enrollment materials that the health carrier distributes to employees, provided the statement is prominent.","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"9":{"id":204806,"text":"For any child of a covered person who enrolls, the coverage shall take effect not later than the first day of such plan year or policy year.","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"C"},"10":{"id":204807,"text":"This section shall apply to any health carrier providing individual or group health insurance coverage, except that for plan years beginning before January 1, 2014, a grandfathered group health plan that makes available dependent coverage for a child may exclude a child who has not attained the age of 26 from coverage only if the child is eligible to enroll in an eligible employer-sponsored health benefit plan, as defined in § 5000A(f)(2) of the Internal Revenue Code, other than the group health plan of a parent.\n\t\t\tFor plan years beginning on or after January 1, 2014, any grandfathered plan shall comply with the requirements of subsections A and B.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B3"}},"ancestry":[{"id":13819,"edition_id":1,"name":"Federal Market Reforms","identifier":"6","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:45:59","date_modified":"2026-06-26 03:45:59","permalink":{"id":215457,"object_type":"structure","relational_id":13819,"identifier":"6","token":"38.2\/34\/6","url":"\/38.2\/34\/6\/","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":57210,"structure_id":13819,"section_number":"38.2-3438","catch_line":"Definitions","url":"\/38.2-3438\/","token":"38.2\/34\/6\/38.2-3438","metadata":false},{"id":55902,"structure_id":13819,"section_number":"38.2-3439","catch_line":"Dependent coverage for individuals to age 26","url":"\/38.2-3439\/","token":"38.2\/34\/6\/38.2-3439","metadata":false},{"id":59514,"structure_id":13819,"section_number":"38.2-3440","catch_line":"Lifetime and annual limits","url":"\/38.2-3440\/","token":"38.2\/34\/6\/38.2-3440","metadata":false},{"id":74720,"structure_id":13819,"section_number":"38.2-3441","catch_line":"Rescissions","url":"\/38.2-3441\/","token":"38.2\/34\/6\/38.2-3441","metadata":false},{"id":81548,"structure_id":13819,"section_number":"38.2-3442","catch_line":"Preventive services","url":"\/38.2-3442\/","token":"38.2\/34\/6\/38.2-3442","metadata":false},{"id":54833,"structure_id":13819,"section_number":"38.2-3443","catch_line":"Choice of a health care professional","url":"\/38.2-3443\/","token":"38.2\/34\/6\/38.2-3443","metadata":false},{"id":68187,"structure_id":13819,"section_number":"38.2-3444","catch_line":"Preexisting condition exclusions","url":"\/38.2-3444\/","token":"38.2\/34\/6\/38.2-3444","metadata":false},{"id":60836,"structure_id":13819,"section_number":"38.2-3445","catch_line":"Patient access to emergency services","url":"\/38.2-3445\/","token":"38.2\/34\/6\/38.2-3445","metadata":false},{"id":57195,"structure_id":13819,"section_number":"38.2-3445.01","catch_line":"Balance billing for certain services; prohibited","url":"\/38.2-3445.01\/","token":"38.2\/34\/6\/38.2-3445.01","metadata":false},{"id":74656,"structure_id":13819,"section_number":"38.2-3445.02","catch_line":"Arbitration","url":"\/38.2-3445.02\/","token":"38.2\/34\/6\/38.2-3445.02","metadata":false},{"id":57491,"structure_id":13819,"section_number":"38.2-3445.03","catch_line":"Data sets for determining commercially reasonable payments","url":"\/38.2-3445.03\/","token":"38.2\/34\/6\/38.2-3445.03","metadata":false},{"id":55717,"structure_id":13819,"section_number":"38.2-3445.04","catch_line":"Transparency","url":"\/38.2-3445.04\/","token":"38.2\/34\/6\/38.2-3445.04","metadata":false},{"id":67926,"structure_id":13819,"section_number":"38.2-3445.05","catch_line":"Enforcement","url":"\/38.2-3445.05\/","token":"38.2\/34\/6\/38.2-3445.05","metadata":false},{"id":66467,"structure_id":13819,"section_number":"38.2-3445.06","catch_line":"Applicability of certain sections","url":"\/38.2-3445.06\/","token":"38.2\/34\/6\/38.2-3445.06","metadata":false},{"id":72898,"structure_id":13819,"section_number":"38.2-3445.07","catch_line":"Rules and regulations","url":"\/38.2-3445.07\/","token":"38.2\/34\/6\/38.2-3445.07","metadata":false},{"id":68114,"structure_id":13819,"section_number":"38.2-3445.1","catch_line":"Repealed","url":"\/38.2-3445.1\/","token":"38.2\/34\/6\/38.2-3445.1","metadata":false},{"id":63588,"structure_id":13819,"section_number":"38.2-3445.2","catch_line":"Out-of-network claims; reporting requirements","url":"\/38.2-3445.2\/","token":"38.2\/34\/6\/38.2-3445.2","metadata":false},{"id":86937,"structure_id":13819,"section_number":"38.2-3446","catch_line":"Applicability of federal law","url":"\/38.2-3446\/","token":"38.2\/34\/6\/38.2-3446","metadata":false},{"id":66501,"structure_id":13819,"section_number":"38.2-3447","catch_line":"(Effective January 1, 2026) Restrictions relating to premium rates","url":"\/38.2-3447\/","token":"38.2\/34\/6\/38.2-3447","metadata":false},{"id":79799,"structure_id":13819,"section_number":"38.2-3448","catch_line":"Guaranteed availability","url":"\/38.2-3448\/","token":"38.2\/34\/6\/38.2-3448","metadata":false},{"id":78815,"structure_id":13819,"section_number":"38.2-3449","catch_line":"Prohibiting discrimination based on health status","url":"\/38.2-3449\/","token":"38.2\/34\/6\/38.2-3449","metadata":false},{"id":67706,"structure_id":13819,"section_number":"38.2-3449.1","catch_line":"Prohibited discrimination based on gender identity or status as a transgender individual","url":"\/38.2-3449.1\/","token":"38.2\/34\/6\/38.2-3449.1","metadata":false},{"id":64622,"structure_id":13819,"section_number":"38.2-3450","catch_line":"Genetic information and testing","url":"\/38.2-3450\/","token":"38.2\/34\/6\/38.2-3450","metadata":false},{"id":83154,"structure_id":13819,"section_number":"38.2-3451","catch_line":"Essential health benefits","url":"\/38.2-3451\/","token":"38.2\/34\/6\/38.2-3451","metadata":false},{"id":76537,"structure_id":13819,"section_number":"38.2-3452","catch_line":"Waiting periods","url":"\/38.2-3452\/","token":"38.2\/34\/6\/38.2-3452","metadata":false},{"id":86395,"structure_id":13819,"section_number":"38.2-3453","catch_line":"Clinical trials","url":"\/38.2-3453\/","token":"38.2\/34\/6\/38.2-3453","metadata":false},{"id":81951,"structure_id":13819,"section_number":"38.2-3454","catch_line":"Wellness programs","url":"\/38.2-3454\/","token":"38.2\/34\/6\/38.2-3454","metadata":false},{"id":84250,"structure_id":13819,"section_number":"38.2-3454.1","catch_line":"Renewal of health benefit plans; special exception","url":"\/38.2-3454.1\/","token":"38.2\/34\/6\/38.2-3454.1","metadata":false}],"previous_section":{"id":57210,"structure_id":13819,"section_number":"38.2-3438","catch_line":"Definitions","url":"\/38.2-3438\/","token":"38.2\/34\/6\/38.2-3438","metadata":false},"next_section":{"id":59514,"structure_id":13819,"section_number":"38.2-3440","catch_line":"Lifetime and annual limits","url":"\/38.2-3440\/","token":"38.2\/34\/6\/38.2-3440","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3439\/","history_text":"

This law was first created in 2011. The record of its establishment is cataloged in chapter 882<\/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 2013, chapter 751<\/a>.<\/p>","references":false,"refers_to":[{"id":81706,"section_number":"38.2-3500","catch_line":"Form of policy","order_by":null,"url":"\/38.2-3500\/"},{"id":78059,"section_number":"38.2-3525","catch_line":"Group accident and sickness insurance coverages of spouses, dependent children or other persons","order_by":null,"url":"\/38.2-3525\/"}],"permalink":{"id":215463,"object_type":"law","relational_id":55902,"identifier":"38.2-3439","token":"38.2\/34\/6\/38.2-3439","url":"\/38.2-3439\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3439\/","token":"38.2\/34\/6\/38.2-3439","dublin_core":{"Title":"Dependent coverage for individuals to age 26","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3439","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Notwithstanding any provision of \u00a7 38.2-3500<\/a> or 38.2-3525<\/a>, or any other section of this title to the contrary, a health carrier that makes available dependent coverage for a child shall make that coverage available for a child until such child attains the age of 26. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> A health carrier shall not define “dependent” for purposes of eligibility for dependent coverage for a child other than in terms of a relationship between a child and the covered person<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> A health carrier shall not deny or restrict coverage for a child who has not attained the age of 26 based on the presence or absence of the child’s financial dependency on the covered person<\/span>, residency with the covered person<\/span>, marital status, student status, employment, or any combination of those factors. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Nothing in this section shall be construed to require a health carrier to make coverage available for the child of a child receiving dependent coverage, unless the grandparent becomes the legal guardian or adoptive parent of that grandchild. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> The terms of coverage in a health benefit plan offered by a health carrier providing dependent coverage may not vary based on age except for children who are 26 years of age or older. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> A health carrier shall not deny or restrict coverage of a child based on eligibility for other coverage. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Any child whose coverage ended, who was denied coverage, or who was not eligible for group or individual health insurance<\/span> coverage under a health benefit plan because, under the terms of such plan, the availability of dependent coverage of a child ended before the attainment of the age of 26, shall be given written notice of the opportunity to enroll. The child shall be offered all the benefit packages available to, and shall not be required to pay more for coverage than, similarly situated individuals who did not lose coverage by reason of cessation of dependent status. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> The health carrier shall give such child written notice of the opportunity to enroll not later than the first day of the next plan year or policy year, and shall provide for an enrollment period that continues for at least 30 days. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The written notice of opportunity to enroll shall include a statement that a child is eligible to enroll in dependent coverage if coverage ended, coverage was denied, or the child was ineligible for coverage because the availability of dependent coverage for a child ended before the attainment of the age of 26.\n\t\t\t\ta. The notice may be provided to the covered person<\/span> on behalf of the covered person<\/span>’s child.\n\t\t\t\tb. For group health insurance<\/span> coverage, the notice may be included with other enrollment materials<\/span> that the health carrier distributes to employees, provided the statement is prominent. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> For any child of a covered person<\/span> who enrolls, the coverage shall take effect not later than the first day of such plan year or policy year. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> This section shall apply to any health carrier providing individual or group health insurance<\/span> coverage, except that for plan years beginning before January 1, 2014, a grandfathered group health plan that makes available dependent coverage for a child may exclude a child who has not attained the age of 26 from coverage only if the child is eligible to enroll in an eligible employer-sponsored health benefit plan, as defined in § 5000A(f)(2) of the Internal Revenue Code, other than the group health plan of a parent.\n\t\t\tFor plan years beginning on or after January 1, 2014, any grandfathered plan shall comply with the requirements of subsections A and B. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nDEPENDENT COVERAGE FOR INDIVIDUALS TO AGE 26 (\u00a7 38.2-3439)\n\nA. Notwithstanding any provision of \u00a7 38.2-3500 or 38.2-3525, or any other\nsection of this title to the contrary, a health carrier that makes available\ndependent coverage for a child shall make that coverage available for a child\nuntil such child attains the age of 26.\n\n 1. A health carrier shall not define “dependent” for purposes of\n eligibility for dependent coverage for a child other than in terms of a\n relationship between a child and the covered person.\n\n 2. A health carrier shall not deny or restrict coverage for a child who has\n not attained the age of 26 based on the presence or absence of the\n child’s financial dependency on the covered person, residency with the\n covered person, marital status, student status, employment, or any combination\n of those factors.\n\n 3. Nothing in this section shall be construed to require a health carrier to\n make coverage available for the child of a child receiving dependent coverage,\n unless the grandparent becomes the legal guardian or adoptive parent of that\n grandchild.\n\n 4. The terms of coverage in a health benefit plan offered by a health carrier\n providing dependent coverage may not vary based on age except for children who\n are 26 years of age or older.\n\n 5. A health carrier shall not deny or restrict coverage of a child based on\n eligibility for other coverage.\n\nB. Any child whose coverage ended, who was denied coverage, or who was not\neligible for group or individual health insurance coverage under a health\nbenefit plan because, under the terms of such plan, the availability of\ndependent coverage of a child ended before the attainment of the age of 26,\nshall be given written notice of the opportunity to enroll. The child shall be\noffered all the benefit packages available to, and shall not be required to pay\nmore for coverage than, similarly situated individuals who did not lose coverage\nby reason of cessation of dependent status.\n\n 1. The health carrier shall give such child written notice of the opportunity\n to enroll not later than the first day of the next plan year or policy year,\n and shall provide for an enrollment period that continues for at least 30\n days.\n\n 2. The written notice of opportunity to enroll shall include a statement that\n a child is eligible to enroll in dependent coverage if coverage ended,\n coverage was denied, or the child was ineligible for coverage because the\n availability of dependent coverage for a child ended before the attainment of\n the age of 26.\n \t\t\t\ta. The notice may be provided to the covered person on behalf of the\n covered person’s child.\n \t\t\t\tb. For group health insurance coverage, the notice may be included with\n other enrollment materials that the health carrier distributes to employees,\n provided the statement is prominent.\n\n 3. For any child of a covered person who enrolls, the coverage shall take\n effect not later than the first day of such plan year or policy year.\n\nC. This section shall apply to any health carrier providing individual or group\nhealth insurance coverage, except that for plan years beginning before January\n1, 2014, a grandfathered group health plan that makes available dependent\ncoverage for a child may exclude a child who has not attained the age of 26 from\ncoverage only if the child is eligible to enroll in an eligible\nemployer-sponsored health benefit plan, as defined in § 5000A(f)(2) of the\nInternal Revenue Code, other than the group health plan of a parent.\n\t\t\tFor plan years beginning on or after January 1, 2014, any grandfathered plan\nshall comply with the requirements of subsections A and B.\n\nHISTORY: 2011, c. 882; 2013, c. 751.","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}}