{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3551.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3551.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3551.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3551.html"}],"law_id":76670,"edition_id":1,"section_id":76670,"structure_id":16550,"section_number":"38.2-3551","catch_line":"Definitions","history":"2006, c. 427; 2013, c. 751; 2016, c. 1.","full_text":"A\n\nAs used in this article:\n\t\t\t“Eligible dependent” means an individual who may be covered as a dependent under a group health policy or policies and who is eligible, as determined by a small employer health group cooperative, for coverage as a dependent of an eligible employee under a group health policy or policies issued to or through such small employer health group cooperative.\n\t\t\t“Eligible employee” means an employee who works for a small employer on a full-time basis, has a normal work week of 30 or more hours, has satisfied applicable waiting period requirements, and is not a part-time, temporary, or substitute employee.\n\t\t\t“Employer-member” means a small employer participating in a small employer health group cooperative.\n\t\t\t“Group health policy” or “policy” means a group insurance policy providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, a group accident and sickness insurance policy or subscription contract, and a group health care plan for health care services or limited health care services provided by a health maintenance organization. For the purposes of this article, a group health policy or policy shall also mean a policy or plan provided by a dental or optometric services plan, dental plan organization, and a health maintenance organization offering limited health care services as defined in \u00a7 38.2-4300.\n\t\t\t“Health insurance issuer” or “issuer” means a company authorized to issue coverage under Article 3 (\u00a7 38.2-3521.1 et seq.) of Chapter 35, Chapter 42 (\u00a7 38.2-4200 et seq.), Chapter 43 (\u00a7 38.2-4300 et seq.), Chapter 45 (\u00a7 38.2-4500 et seq.), or Chapter 61 (\u00a7 38.2-6100 et seq.) of this title.\n\t\t\t“Health status-related factor” means the following in relation to the individual or a dependent eligible for coverage under a group health plan or health insurance coverage offered by a health insurance issuer:1\n\nHealth status;2\n\nMedical condition, including both physical and mental illnesses;3\n\nClaims experience;4\n\nReceipt of health care;5\n\nMedical history;6\n\nGenetic information;7\n\nEvidence of insurability, including conditions arising out of acts of domestic violence; or8\n\nDisability.\n\t\t\t\t“Service area” means the geographic area within which a health insurance issuer is authorized to sell a group health policy or policies.\n\t\t\t\t“Small employer” means, in connection with a group health policy with respect to a calendar year and a plan year, an employer who employed an average of at least one but not more than 50 employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year.\n\t\t\t\t“Small employer health group cooperative” or “cooperative” means an entity authorized by its employer-members to negotiate with health insurance issuers on their behalf as to the terms, including premium rates, under which a group health policy or policies may be issued, providing coverage for the eligible employees of such employer-members and their eligible dependents.B\n\nThe provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.","order_by":null,"text":{"0":{"id":275229,"text":"As used in this article:\n\t\t\t“Eligible dependent” means an individual who may be covered as a dependent under a group health policy or policies and who is eligible, as determined by a small employer health group cooperative, for coverage as a dependent of an eligible employee under a group health policy or policies issued to or through such small employer health group cooperative.\n\t\t\t“Eligible employee” means an employee who works for a small employer on a full-time basis, has a normal work week of 30 or more hours, has satisfied applicable waiting period requirements, and is not a part-time, temporary, or substitute employee.\n\t\t\t“Employer-member” means a small employer participating in a small employer health group cooperative.\n\t\t\t“Group health policy” or “policy” means a group insurance policy providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, a group accident and sickness insurance policy or subscription contract, and a group health care plan for health care services or limited health care services provided by a health maintenance organization. For the purposes of this article, a group health policy or policy shall also mean a policy or plan provided by a dental or optometric services plan, dental plan organization, and a health maintenance organization offering limited health care services as defined in \u00a7 38.2-4300.\n\t\t\t“Health insurance issuer” or “issuer” means a company authorized to issue coverage under Article 3 (\u00a7 38.2-3521.1 et seq.) of Chapter 35, Chapter 42 (\u00a7 38.2-4200 et seq.), Chapter 43 (\u00a7 38.2-4300 et seq.), Chapter 45 (\u00a7 38.2-4500 et seq.), or Chapter 61 (\u00a7 38.2-6100 et seq.) of this title.\n\t\t\t“Health status-related factor” means the following in relation to the individual or a dependent eligible for coverage under a group health plan or health insurance coverage offered by a health insurance issuer:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":275230,"text":"Health status;","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":275231,"text":"Medical condition, including both physical and mental illnesses;","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":275232,"text":"Claims experience;","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":275233,"text":"Receipt of health care;","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"A5"},"5":{"id":275234,"text":"Medical history;","type":"section","prefixes":["A","5"],"prefix":"5","entire_prefix":"A5","prefix_anchor":"A5","level":2,"prior_prefix":"A4","next_prefix":"A6"},"6":{"id":275235,"text":"Genetic information;","type":"section","prefixes":["A","6"],"prefix":"6","entire_prefix":"A6","prefix_anchor":"A6","level":2,"prior_prefix":"A5","next_prefix":"A7"},"7":{"id":275236,"text":"Evidence of insurability, including conditions arising out of acts of domestic violence; or","type":"section","prefixes":["A","7"],"prefix":"7","entire_prefix":"A7","prefix_anchor":"A7","level":2,"prior_prefix":"A6","next_prefix":"A8"},"8":{"id":275237,"text":"Disability.\n\t\t\t\t“Service area” means the geographic area within which a health insurance issuer is authorized to sell a group health policy or policies.\n\t\t\t\t“Small employer” means, in connection with a group health policy with respect to a calendar year and a plan year, an employer who employed an average of at least one but not more than 50 employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year.\n\t\t\t\t“Small employer health group cooperative” or “cooperative” means an entity authorized by its employer-members to negotiate with health insurance issuers on their behalf as to the terms, including premium rates, under which a group health policy or policies may be issued, providing coverage for the eligible employees of such employer-members and their eligible dependents.","type":"section","prefixes":["A","8"],"prefix":"8","entire_prefix":"A8","prefix_anchor":"A8","level":2,"prior_prefix":"A7","next_prefix":"B"},"9":{"id":275238,"text":"The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A8"}},"ancestry":[{"id":16550,"edition_id":1,"name":"Small Employer Health Insurance Pooling","identifier":"5","label":"article","depth":3,"order_by":1,"parent_id":13348,"metadata":{},"date_created":"2026-06-26 04:23:49","date_modified":"2026-06-26 04:23:49","permalink":{"id":215915,"object_type":"structure","relational_id":16550,"identifier":"5","token":"38.2\/35\/5","url":"\/38.2\/35\/5\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13348,"edition_id":1,"name":"Accident and Sickness Insurance Policies","identifier":"35","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:41","date_modified":"2026-06-26 03:44:41","permalink":{"id":215641,"object_type":"structure","relational_id":13348,"identifier":"35","token":"38.2\/35","url":"\/38.2\/35\/","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":76670,"structure_id":16550,"section_number":"38.2-3551","catch_line":"Definitions","url":"\/38.2-3551\/","token":"38.2\/35\/5\/38.2-3551","metadata":false},{"id":78302,"structure_id":16550,"section_number":"38.2-3552","catch_line":"Small employer health group cooperatives","url":"\/38.2-3552\/","token":"38.2\/35\/5\/38.2-3552","metadata":false},{"id":71043,"structure_id":16550,"section_number":"38.2-3553","catch_line":"Membership in a small employer health group cooperative","url":"\/38.2-3553\/","token":"38.2\/35\/5\/38.2-3553","metadata":false},{"id":83599,"structure_id":16550,"section_number":"38.2-3554","catch_line":"Provisions relating to health insurance issuers","url":"\/38.2-3554\/","token":"38.2\/35\/5\/38.2-3554","metadata":false},{"id":80804,"structure_id":16550,"section_number":"38.2-3555","catch_line":"Authority of the Commission","url":"\/38.2-3555\/","token":"38.2\/35\/5\/38.2-3555","metadata":false}],"next_section":{"id":78302,"structure_id":16550,"section_number":"38.2-3552","catch_line":"Small employer health group cooperatives","url":"\/38.2-3552\/","token":"38.2\/35\/5\/38.2-3552","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3551\/","history_text":"

This law was first created in 2006. The record of its establishment is cataloged in chapter 427<\/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 2 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 2013, chapter 751<\/a>; in 2016, chapter 1<\/a>.<\/p>","references":[{"id":78815,"section_number":"38.2-3449","catch_line":"Prohibiting discrimination based on health status","order_by":null,"url":"\/38.2-3449\/"},{"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":57210,"section_number":"38.2-3438","catch_line":"Definitions","order_by":null,"url":"\/38.2-3438\/"},{"id":83222,"section_number":"38.2-3521.1","catch_line":"Group accident and sickness insurance definitions","order_by":null,"url":"\/38.2-3521.1\/"},{"id":78890,"section_number":"38.2-4200","catch_line":"Applicability of chapter","order_by":null,"url":"\/38.2-4200\/"},{"id":72005,"section_number":"38.2-4300","catch_line":"Definitions","order_by":null,"url":"\/38.2-4300\/"},{"id":59325,"section_number":"38.2-4500","catch_line":"Applicability of chapter","order_by":null,"url":"\/38.2-4500\/"},{"id":64365,"section_number":"38.2-6100","catch_line":"Applicability of chapter","order_by":null,"url":"\/38.2-6100\/"}],"permalink":{"id":215917,"object_type":"law","relational_id":76670,"identifier":"38.2-3551","token":"38.2\/35\/5\/38.2-3551","url":"\/38.2-3551\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3551\/","token":"38.2\/35\/5\/38.2-3551","dublin_core":{"Title":"Definitions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3551","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> As used in this article:\n\t\t\t“Eligible dependent<\/span>” means an individual who may be covered as a dependent under a group health policy<\/span> or policies and who is eligible, as determined by a small employer health group cooperative<\/span>, for coverage as a dependent of an eligible employee<\/span> under a group health policy<\/span> or policies issued to or through such small employer health group cooperative<\/span>.\n\t\t\t“Eligible employee<\/span>” means an employee who works for a small employer on a full-time basis, has a normal work week of 30 or more hours, has satisfied applicable waiting period requirements, and is not a part-time, temporary, or substitute employee.\n\t\t\t“Employer-member<\/span>” means a small employer participating in a small employer health group cooperative<\/span>.\n\t\t\t“Group health policy<\/span>” or “policy” means a group insurance policy providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, a group accident and sickness insurance policy or subscription contract<\/span>, and a group health care plan for health care services or limited health care services provided by a health maintenance organization. For the purposes of this article, a group health policy<\/span> or policy shall also mean a policy or plan provided by a dental or optometric services plan, dental plan organization, and a health maintenance organization offering limited health care services as defined in \u00a7 38.2-4300<\/a>.\n\t\t\t“Health insurance issuer<\/span>” or “issuer” means a company<\/span> authorized to issue<\/span> coverage under Article 3 (\u00a7 38.2-3521.1<\/a> et seq.) of Chapter 35, Chapter 42 (\u00a7 38.2-4200<\/a> et seq.), Chapter 43 (\u00a7 38.2-4300<\/a> et seq.), Chapter 45 (\u00a7 38.2-4500<\/a> et seq.), or Chapter 61 (\u00a7 38.2-6100<\/a> et seq.) of this title.\n\t\t\t“Health status-related factor<\/span>” means the following in relation to the individual or a dependent eligible for coverage under a group health plan or health insurance coverage offered by a health insurance issuer<\/span>: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Health status; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Medical condition, including both physical and mental illnesses; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Claims experience; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Receipt of health care; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Medical history; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Genetic information; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Evidence<\/span> of insurability, including conditions arising out of acts of domestic violence; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> Disability.\n\t\t\t\t“Service area<\/span>” means the geographic area within which a health insurance issuer<\/span> is authorized to sell a group health policy<\/span> or policies.\n\t\t\t\t“Small employer” means, in connection with a group health policy<\/span> with respect to a calendar year and a plan year, an employer who employed an average of at least one but not more than 50 employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year.\n\t\t\t\t“Small employer health group cooperative<\/span>” or “cooperative” means an entity authorized by its employer-members<\/span> to negotiate with health insurance issuers<\/span> on their behalf as to the terms, including premium rates<\/span><\/span>, under which a group health policy<\/span> or policies may be issued, providing coverage for the eligible employees<\/span> of such employer-members<\/span> and their eligible dependents<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438<\/a> et seq.) of Chapter 34. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nDEFINITIONS (\u00a7 38.2-3551)\n\nA. As used in this article:\n\t\t\t“Eligible dependent” means an individual who may be covered as a\ndependent under a group health policy or policies and who is eligible, as\ndetermined by a small employer health group cooperative, for coverage as a\ndependent of an eligible employee under a group health policy or policies issued\nto or through such small employer health group cooperative.\n\t\t\t“Eligible employee” means an employee who works for a small\nemployer on a full-time basis, has a normal work week of 30 or more hours, has\nsatisfied applicable waiting period requirements, and is not a part-time,\ntemporary, or substitute employee.\n\t\t\t“Employer-member” means a small employer participating in a small\nemployer health group cooperative.\n\t\t\t“Group health policy” or “policy” means a group\ninsurance policy providing hospital, medical and surgical or major medical\ncoverage on an expense-incurred basis, a group accident and sickness insurance\npolicy or subscription contract, and a group health care plan for health care\nservices or limited health care services provided by a health maintenance\norganization. For the purposes of this article, a group health policy or policy\nshall also mean a policy or plan provided by a dental or optometric services\nplan, dental plan organization, and a health maintenance organization offering\nlimited health care services as defined in \u00a7 38.2-4300.\n\t\t\t“Health insurance issuer” or “issuer” means a company\nauthorized to issue coverage under Article 3 (\u00a7 38.2-3521.1 et seq.) of Chapter\n35, Chapter 42 (\u00a7 38.2-4200 et seq.), Chapter 43 (\u00a7 38.2-4300 et seq.),\nChapter 45 (\u00a7 38.2-4500 et seq.), or Chapter 61 (\u00a7 38.2-6100 et seq.) of this\ntitle.\n\t\t\t“Health status-related factor” means the following in relation to\nthe individual or a dependent eligible for coverage under a group health plan or\nhealth insurance coverage offered by a health insurance issuer:\n\n 1. Health status;\n\n 2. Medical condition, including both physical and mental illnesses;\n\n 3. Claims experience;\n\n 4. Receipt of health care;\n\n 5. Medical history;\n\n 6. Genetic information;\n\n 7. Evidence of insurability, including conditions arising out of acts of\n domestic violence; or\n\n 8. Disability.\n \t\t\t\t“Service area” means the geographic area within which a health\n insurance issuer is authorized to sell a group health policy or policies.\n \t\t\t\t“Small employer” means, in connection with a group health\n policy with respect to a calendar year and a plan year, an employer who\n employed an average of at least one but not more than 50 employees on business\n days during the preceding calendar year and who employs at least one employee\n on the first day of the plan year.\n \t\t\t\t“Small employer health group cooperative” or\n “cooperative” means an entity authorized by its employer-members\n to negotiate with health insurance issuers on their behalf as to the terms,\n including premium rates, under which a group health policy or policies may be\n issued, providing coverage for the eligible employees of such employer-members\n and their eligible dependents.\n\nB. The provisions of this section shall not apply in any instance in which the\nprovisions of this section are inconsistent or in conflict with a provision of\nArticle 6 (§ 38.2-3438 et seq.) of Chapter 34.\n\nHISTORY: 2006, c. 427; 2013, c. 751; 2016, c. 1.","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}}