{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-4307.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-4307.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-4307.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-4307.html"}],"law_id":65829,"edition_id":1,"section_id":65829,"structure_id":12833,"section_number":"38.2-4307","catch_line":"Annual statement","history":"1980, c. 720, \u00a7 38.1-870; 1986, c. 562; 1987, c. 520; 1998, c. 891; 1999, c. 482.","full_text":"A\n\nEach health maintenance organization shall file a statement with the Commission annually by March 1. The statement shall be verified by at least two principal officers and shall cover the preceding calendar year. Each health maintenance organization shall also send a copy of the statement to the State Health Commissioner.B\n\nThe statement shall be on forms prescribed by the Commission and shall include:1\n\nA financial statement of the organization, including its balance sheet and income statement for the preceding year;2\n\nAny material changes in the information submitted pursuant to subsection B of § 38.2-4301;3\n\nThe number of persons enrolled during the year, the number of enrollees as of the end of the year and the number of enrollments terminated during the year; and4\n\nAny other information relating to the operations of the health maintenance organization required by the Commission pursuant to this chapter or Chapter 58 (§ 38.2-5800 et seq.) of this title.C\n\nIf the health maintenance organization is audited annually by an independent certified public accountant, a copy of the certified audit report shall be filed annually with the Commission by June 30.D\n\nThe Commission may extend the time prescribed for filing annual statements or other reports or exhibits of any health maintenance organization for good cause shown. However, the Commission shall not extend the time for filing annual statements beyond sixty days after the time prescribed by subsection A of this section. Any health maintenance organization which fails to file its annual statement within the time prescribed by this section shall be subject to a fine as specified in § 38.2-218.E\n\nThe Commission may prescribe the form of the annual statement and supplemental schedules and exhibits to include additional copies in machine-readable format, and may vary the form requirements for different types of health maintenance organizations. However, as far as practicable, the form for annual statements, supplementary schedules, and exhibits shall be the same as other such forms in general use in the United States. Unless otherwise prescribed by the Commission, such annual statements shall be prepared using an annual statement convention blank developed by the National Association of Insurance Commissioners (NAIC). The annual statement, and supplementary schedules and exhibits required by this section, shall be prepared in accordance with the appropriate annual statement instructions and the accounting practices and procedures manual adopted by the NAIC, or any successor publications.F\n\nAt the request of the Commission, a health maintenance organization that is licensed under this chapter shall annually on or before March 1 of each year, file with the NAIC a copy of its annual statement convention blank, along with such additional filings as prescribed by the Commission for the preceding year. Unless otherwise prescribed by the Commission, the information filed with the NAIC shall be in the same format and scope as that required by the Commission and shall include the signed jurat page and any actuarial certification required by the Commission. Any amendments and addenda to the annual statement filed subsequently with the Commission shall also be filed with the NAIC.","order_by":null,"text":{"0":{"id":239241,"text":"Each health maintenance organization shall file a statement with the Commission annually by March 1. The statement shall be verified by at least two principal officers and shall cover the preceding calendar year. Each health maintenance organization shall also send a copy of the statement to the State Health Commissioner.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":239242,"text":"The statement shall be on forms prescribed by the Commission and shall include:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":239243,"text":"A financial statement of the organization, including its balance sheet and income statement for the preceding year;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":239244,"text":"Any material changes in the information submitted pursuant to subsection B of § 38.2-4301;","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"4":{"id":239245,"text":"The number of persons enrolled during the year, the number of enrollees as of the end of the year and the number of enrollments terminated during the year; and","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"B4"},"5":{"id":239246,"text":"Any other information relating to the operations of the health maintenance organization required by the Commission pursuant to this chapter or Chapter 58 (§ 38.2-5800 et seq.) of this title.","type":"section","prefixes":["B","4"],"prefix":"4","entire_prefix":"B4","prefix_anchor":"B4","level":2,"prior_prefix":"B3","next_prefix":"C"},"6":{"id":239247,"text":"If the health maintenance organization is audited annually by an independent certified public accountant, a copy of the certified audit report shall be filed annually with the Commission by June 30.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B4","next_prefix":"D"},"7":{"id":239248,"text":"The Commission may extend the time prescribed for filing annual statements or other reports or exhibits of any health maintenance organization for good cause shown. However, the Commission shall not extend the time for filing annual statements beyond sixty days after the time prescribed by subsection A of this section. Any health maintenance organization which fails to file its annual statement within the time prescribed by this section shall be subject to a fine as specified in § 38.2-218.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"8":{"id":239249,"text":"The Commission may prescribe the form of the annual statement and supplemental schedules and exhibits to include additional copies in machine-readable format, and may vary the form requirements for different types of health maintenance organizations. However, as far as practicable, the form for annual statements, supplementary schedules, and exhibits shall be the same as other such forms in general use in the United States. Unless otherwise prescribed by the Commission, such annual statements shall be prepared using an annual statement convention blank developed by the National Association of Insurance Commissioners (NAIC). The annual statement, and supplementary schedules and exhibits required by this section, shall be prepared in accordance with the appropriate annual statement instructions and the accounting practices and procedures manual adopted by the NAIC, or any successor publications.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"9":{"id":239250,"text":"At the request of the Commission, a health maintenance organization that is licensed under this chapter shall annually on or before March 1 of each year, file with the NAIC a copy of its annual statement convention blank, along with such additional filings as prescribed by the Commission for the preceding year. Unless otherwise prescribed by the Commission, the information filed with the NAIC shall be in the same format and scope as that required by the Commission and shall include the signed jurat page and any actuarial certification required by the Commission. Any amendments and addenda to the annual statement filed subsequently with the Commission shall also be filed with the NAIC.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E"}},"ancestry":[{"id":12833,"edition_id":1,"name":"Health Maintenance Organizations","identifier":"43","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:43:55","date_modified":"2026-06-26 03:43:55","permalink":{"id":216835,"object_type":"structure","relational_id":12833,"identifier":"43","token":"38.2\/43","url":"\/38.2\/43\/","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":72005,"structure_id":12833,"section_number":"38.2-4300","catch_line":"Definitions","url":"\/38.2-4300\/","token":"38.2\/43\/38.2-4300","metadata":false},{"id":80882,"structure_id":12833,"section_number":"38.2-4301","catch_line":"Establishment of health maintenance organizations","url":"\/38.2-4301\/","token":"38.2\/43\/38.2-4301","metadata":false},{"id":64417,"structure_id":12833,"section_number":"38.2-4302","catch_line":"Issuance of license; fee; minimum net worth; impairment","url":"\/38.2-4302\/","token":"38.2\/43\/38.2-4302","metadata":false},{"id":73205,"structure_id":12833,"section_number":"38.2-4303","catch_line":"Powers","url":"\/38.2-4303\/","token":"38.2\/43\/38.2-4303","metadata":false},{"id":68216,"structure_id":12833,"section_number":"38.2-4304","catch_line":"Governing body","url":"\/38.2-4304\/","token":"38.2\/43\/38.2-4304","metadata":false},{"id":54130,"structure_id":12833,"section_number":"38.2-4305","catch_line":"Fiduciary responsibilities","url":"\/38.2-4305\/","token":"38.2\/43\/38.2-4305","metadata":false},{"id":81322,"structure_id":12833,"section_number":"38.2-4306","catch_line":"Evidence of coverage and charges for health care services","url":"\/38.2-4306\/","token":"38.2\/43\/38.2-4306","metadata":false},{"id":73640,"structure_id":12833,"section_number":"38.2-4306.1","catch_line":"Interest on claim proceeds","url":"\/38.2-4306.1\/","token":"38.2\/43\/38.2-4306.1","metadata":false},{"id":65829,"structure_id":12833,"section_number":"38.2-4307","catch_line":"Annual statement","url":"\/38.2-4307\/","token":"38.2\/43\/38.2-4307","metadata":false},{"id":85130,"structure_id":12833,"section_number":"38.2-4307.1","catch_line":"Additional reports","url":"\/38.2-4307.1\/","token":"38.2\/43\/38.2-4307.1","metadata":false},{"id":77610,"structure_id":12833,"section_number":"38.2-4308","catch_line":"Repealed","url":"\/38.2-4308\/","token":"38.2\/43\/38.2-4308","metadata":false},{"id":80159,"structure_id":12833,"section_number":"38.2-4309","catch_line":"Investments","url":"\/38.2-4309\/","token":"38.2\/43\/38.2-4309","metadata":false},{"id":84555,"structure_id":12833,"section_number":"38.2-4310","catch_line":"Protection against insolvency","url":"\/38.2-4310\/","token":"38.2\/43\/38.2-4310","metadata":false},{"id":59833,"structure_id":12833,"section_number":"38.2-4310.1","catch_line":"Deposits","url":"\/38.2-4310.1\/","token":"38.2\/43\/38.2-4310.1","metadata":false},{"id":53983,"structure_id":12833,"section_number":"38.2-4311","catch_line":"Repealed","url":"\/38.2-4311\/","token":"38.2\/43\/38.2-4311","metadata":false},{"id":62703,"structure_id":12833,"section_number":"38.2-4312","catch_line":"Prohibited practices","url":"\/38.2-4312\/","token":"38.2\/43\/38.2-4312","metadata":false},{"id":82617,"structure_id":12833,"section_number":"38.2-4312.1","catch_line":"Pharmacies; freedom of choice","url":"\/38.2-4312.1\/","token":"38.2\/43\/38.2-4312.1","metadata":false},{"id":71246,"structure_id":12833,"section_number":"38.2-4312.2","catch_line":"Repealed","url":"\/38.2-4312.2\/","token":"38.2\/43\/38.2-4312.2","metadata":false},{"id":79585,"structure_id":12833,"section_number":"38.2-4312.3","catch_line":"Patient access to emergency services","url":"\/38.2-4312.3\/","token":"38.2\/43\/38.2-4312.3","metadata":false},{"id":70762,"structure_id":12833,"section_number":"38.2-4313","catch_line":"Licensing of agents","url":"\/38.2-4313\/","token":"38.2\/43\/38.2-4313","metadata":false},{"id":73994,"structure_id":12833,"section_number":"38.2-4314","catch_line":"Powers of insurers and health services plans","url":"\/38.2-4314\/","token":"38.2\/43\/38.2-4314","metadata":false},{"id":60856,"structure_id":12833,"section_number":"38.2-4315","catch_line":"Examinations","url":"\/38.2-4315\/","token":"38.2\/43\/38.2-4315","metadata":false},{"id":61029,"structure_id":12833,"section_number":"38.2-4316","catch_line":"Suspension or revocation of license","url":"\/38.2-4316\/","token":"38.2\/43\/38.2-4316","metadata":false},{"id":82370,"structure_id":12833,"section_number":"38.2-4317","catch_line":"Repealed","url":"\/38.2-4317\/","token":"38.2\/43\/38.2-4317","metadata":false},{"id":84618,"structure_id":12833,"section_number":"38.2-4318","catch_line":"License renewals","url":"\/38.2-4318\/","token":"38.2\/43\/38.2-4318","metadata":false},{"id":67952,"structure_id":12833,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","url":"\/38.2-4319\/","token":"38.2\/43\/38.2-4319","metadata":false},{"id":74856,"structure_id":12833,"section_number":"38.2-4320","catch_line":"Authority of Commonwealth to contract with health maintenance organizations","url":"\/38.2-4320\/","token":"38.2\/43\/38.2-4320","metadata":false},{"id":74357,"structure_id":12833,"section_number":"38.2-4320.1","catch_line":"Explanation of benefits for health maintenance organization enrollees who are recipients of medical assistance services or covered by the Family Access to Medical Insurance Security (FAMIS) Plan","url":"\/38.2-4320.1\/","token":"38.2\/43\/38.2-4320.1","metadata":false},{"id":74331,"structure_id":12833,"section_number":"38.2-4321","catch_line":"Health maintenance organization affected by chapter","url":"\/38.2-4321\/","token":"38.2\/43\/38.2-4321","metadata":false},{"id":63129,"structure_id":12833,"section_number":"38.2-4322","catch_line":"Affiliation period","url":"\/38.2-4322\/","token":"38.2\/43\/38.2-4322","metadata":false},{"id":67176,"structure_id":12833,"section_number":"38.2-4323","catch_line":"Alternative methods","url":"\/38.2-4323\/","token":"38.2\/43\/38.2-4323","metadata":false}],"previous_section":{"id":73640,"structure_id":12833,"section_number":"38.2-4306.1","catch_line":"Interest on claim proceeds","url":"\/38.2-4306.1\/","token":"38.2\/43\/38.2-4306.1","metadata":false},"next_section":{"id":85130,"structure_id":12833,"section_number":"38.2-4307.1","catch_line":"Additional reports","url":"\/38.2-4307.1\/","token":"38.2\/43\/38.2-4307.1","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-4307\/","history_text":"

This law was first created in 1980. The record of its establishment is cataloged in chapter 720 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. Unfortunately, the 1980 \u201cActs\u201d aren\u2019t available online. It has been modified 4 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 1986, chapter 562; in 1987, chapter 520; in 1998, chapter 891<\/a>; in 1999, chapter 482<\/a>.<\/p>","references":[{"id":64417,"section_number":"38.2-4302","catch_line":"Issuance of license; fee; minimum net worth; impairment","order_by":null,"url":"\/38.2-4302\/"},{"id":85130,"section_number":"38.2-4307.1","catch_line":"Additional reports","order_by":null,"url":"\/38.2-4307.1\/"}],"refers_to":[{"id":80882,"section_number":"38.2-4301","catch_line":"Establishment of health maintenance organizations","order_by":null,"url":"\/38.2-4301\/"},{"id":77304,"section_number":"38.2-5800","catch_line":"Definitions","order_by":null,"url":"\/38.2-5800\/"}],"permalink":{"id":216869,"object_type":"law","relational_id":65829,"identifier":"38.2-4307","token":"38.2\/43\/38.2-4307","url":"\/38.2-4307\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-4307\/","token":"38.2\/43\/38.2-4307","dublin_core":{"Title":"Annual statement","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-4307","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Each health maintenance organization<\/span> shall file a statement with the Commission<\/span> annually by March 1. The statement shall be verified by at least two principal officers and shall cover the preceding calendar year. Each health maintenance organization<\/span> shall also send a copy of the statement to the State<\/span> Health Commissioner<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The statement shall be on forms prescribed by the Commission<\/span> and shall include: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> A financial statement of the organization, including its balance sheet and income statement for the preceding year; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Any material<\/span> changes in the information submitted pursuant to subsection B of § 38.2-4301<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The number of persons<\/span> enrolled during the year, the number of enrollees<\/span> as of the end of the year and the number of enrollments terminated during the year; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Any other information relating to the operations of the health maintenance organization<\/span> required by the Commission<\/span> pursuant to this chapter or Chapter 58 (§ 38.2-5800<\/a> et seq.) of this title. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> If the health maintenance organization<\/span> is audited annually by an independent certified public accountant, a copy of the certified audit report shall be filed annually with the Commission<\/span> by June 30. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> The Commission<\/span> may extend the time prescribed for filing annual statements or other reports or exhibits of any health maintenance organization<\/span> for good cause shown. However, the Commission<\/span> shall not extend the time for filing annual statements beyond sixty days after the time prescribed by subsection A of this section. Any health maintenance organization<\/span> which fails to file its annual statement within the time prescribed by this section shall be subject to a fine as specified in § 38.2-218<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> The Commission<\/span> may prescribe the form of the annual statement and supplemental schedules<\/span> and exhibits to include additional copies in machine-readable format, and may vary the form requirements for different types of health maintenance organizations<\/span>. However, as far as practicable, the form for annual statements, supplementary schedules<\/span>, and exhibits shall be the same as other such forms in general use in the United States<\/span>. Unless otherwise prescribed by the Commission<\/span>, such annual statements shall be prepared using an annual statement convention blank developed by the National Association of Insurance<\/span> Commissioners<\/span> (NAIC). The annual statement, and supplementary schedules<\/span> and exhibits required by this section, shall be prepared in accordance with the appropriate annual statement instructions and the accounting practices and procedures manual adopted by the NAIC, or any successor publications. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> At the request of the Commission<\/span>, a health maintenance organization<\/span> that is licensed under this chapter shall annually on or before March 1 of each year, file with the NAIC a copy of its annual statement convention blank, along with such additional filings as prescribed by the Commission<\/span> for the preceding year. Unless otherwise prescribed by the Commission<\/span>, the information filed with the NAIC shall be in the same format and scope as that required by the Commission<\/span> and shall include the signed jurat page and any actuarial certification required by the Commission<\/span>. Any amendments and addenda to the annual statement filed subsequently with the Commission<\/span> shall also be filed with the NAIC. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nANNUAL STATEMENT (\u00a7 38.2-4307)\n\nA. Each health maintenance organization shall file a statement with the\nCommission annually by March 1. The statement shall be verified by at least two\nprincipal officers and shall cover the preceding calendar year. Each health\nmaintenance organization shall also send a copy of the statement to the State\nHealth Commissioner.\n\nB. The statement shall be on forms prescribed by the Commission and shall\ninclude:\n\n 1. A financial statement of the organization, including its balance sheet and\n income statement for the preceding year;\n\n 2. Any material changes in the information submitted pursuant to subsection B\n of § 38.2-4301;\n\n 3. The number of persons enrolled during the year, the number of enrollees as\n of the end of the year and the number of enrollments terminated during the\n year; and\n\n 4. Any other information relating to the operations of the health maintenance\n organization required by the Commission pursuant to this chapter or Chapter 58\n (§ 38.2-5800 et seq.) of this title.\n\nC. If the health maintenance organization is audited annually by an independent\ncertified public accountant, a copy of the certified audit report shall be filed\nannually with the Commission by June 30.\n\nD. The Commission may extend the time prescribed for filing annual statements or\nother reports or exhibits of any health maintenance organization for good cause\nshown. However, the Commission shall not extend the time for filing annual\nstatements beyond sixty days after the time prescribed by subsection A of this\nsection. Any health maintenance organization which fails to file its annual\nstatement within the time prescribed by this section shall be subject to a fine\nas specified in § 38.2-218.\n\nE. The Commission may prescribe the form of the annual statement and\nsupplemental schedules and exhibits to include additional copies in\nmachine-readable format, and may vary the form requirements for different types\nof health maintenance organizations. However, as far as practicable, the form\nfor annual statements, supplementary schedules, and exhibits shall be the same\nas other such forms in general use in the United States. Unless otherwise\nprescribed by the Commission, such annual statements shall be prepared using an\nannual statement convention blank developed by the National Association of\nInsurance Commissioners (NAIC). The annual statement, and supplementary\nschedules and exhibits required by this section, shall be prepared in accordance\nwith the appropriate annual statement instructions and the accounting practices\nand procedures manual adopted by the NAIC, or any successor publications.\n\nF. At the request of the Commission, a health maintenance organization that is\nlicensed under this chapter shall annually on or before March 1 of each year,\nfile with the NAIC a copy of its annual statement convention blank, along with\nsuch additional filings as prescribed by the Commission for the preceding year.\nUnless otherwise prescribed by the Commission, the information filed with the\nNAIC shall be in the same format and scope as that required by the Commission\nand shall include the signed jurat page and any actuarial certification required\nby the Commission. Any amendments and addenda to the annual statement filed\nsubsequently with the Commission shall also be filed with the NAIC.\n\nHISTORY: 1980, c. 720, \u00a7 38.1-870; 1986, c. 562; 1987, c. 520; 1998, c. 891;\n1999, c. 482.","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}}