{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-508.5.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-508.5.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-508.5.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-508.5.html"}],"law_id":77794,"edition_id":1,"section_id":77794,"structure_id":13684,"section_number":"38.2-508.5","catch_line":"Re-underwriting individual under existing group or individual accident and sickness insurance policy prohibited; exceptions","history":"2003, c. 699; 2011, c. 882.","full_text":"A\n\nNo premium increase, including a reduced premium increase in the form of a discount, may be implemented for an insured individual under existing individual health insurance coverage as defined in subsection B of § 38.2-3431 subsequent to the initial effective date of coverage under such policy or certificate to the extent that such premium increase is determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431 or (ii) the past or prospective claim experience of the individual insured.B\n\nNo reduction in benefits may be implemented for an insured individual under existing individual health insurance coverage as defined in subsection B of § 38.2-3431 subsequent to the initial effective date of coverage under such policy or certificate to the extent that such reduction in benefits is determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431 or (ii) the past or prospective claim experience of the individual insured.C\n\nNo modifications to contractual terms and conditions may be implemented for an insured individual under existing individual health insurance coverage as defined in subsection B of § 38.2-3431 subsequent to the initial effective date of coverage under such policy or certificate to the extent that such modifications to contractual terms and conditions are determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431 or (ii) the past or prospective claim experience of the individual insured.D\n\nThis section shall not prohibit adjustments to premium, rescission of, or amendments to the insurance contract in the following circumstances:1\n\nWhen an insurer learns of information subsequent to issuing the policy or certificate that was not disclosed in the underwriting process and that, had it been known, would have resulted in a higher premium level or denial of coverage. Any adjustment to premium or rescission of coverage made for this reason may be made only to extent that it would have been made had the information been disclosed in the application process, and shall not be imposed beyond any period of incontestability, or beyond any time period proscribing an insurer from asserting defenses based upon misstatements in applications, as otherwise may be provided by applicable law. Any such rescission shall be consistent with § 38.2-3430.3 regarding guaranteed availability.2\n\nWhen an insurer provides a lifestyle-based good health discount based upon an individual’s adherence to a healthy lifestyle and this discount is not based upon a specific health condition or diagnosis.3\n\nWhen an insurer removes waivers or riders attached to the policy at issue that limit coverage for specific named pre-existing medical conditions.E\n\nFor purposes of this section, re-underwriting means the reevaluation of any health-status-related factor of an individual for purposes of adjusting premiums, benefits or contractual terms as provided in subsections A, B, and C.F\n\nThe provisions of this section shall not apply to individual health insurance coverage issued to members of a bona fide association, as defined in subsection B of § 38.2-3431, where coverage is available to all members of the association and eligible dependents of such members without regard to any health-status-related factor.G\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":278990,"text":"No premium increase, including a reduced premium increase in the form of a discount, may be implemented for an insured individual under existing individual health insurance coverage as defined in subsection B of § 38.2-3431 subsequent to the initial effective date of coverage under such policy or certificate to the extent that such premium increase is determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431 or (ii) the past or prospective claim experience of the individual insured.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":278991,"text":"No reduction in benefits may be implemented for an insured individual under existing individual health insurance coverage as defined in subsection B of § 38.2-3431 subsequent to the initial effective date of coverage under such policy or certificate to the extent that such reduction in benefits is determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431 or (ii) the past or prospective claim experience of the individual insured.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":278992,"text":"No modifications to contractual terms and conditions may be implemented for an insured individual under existing individual health insurance coverage as defined in subsection B of § 38.2-3431 subsequent to the initial effective date of coverage under such policy or certificate to the extent that such modifications to contractual terms and conditions are determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431 or (ii) the past or prospective claim experience of the individual insured.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":278993,"text":"This section shall not prohibit adjustments to premium, rescission of, or amendments to the insurance contract in the following circumstances:","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"D1"},"4":{"id":278994,"text":"When an insurer learns of information subsequent to issuing the policy or certificate that was not disclosed in the underwriting process and that, had it been known, would have resulted in a higher premium level or denial of coverage. Any adjustment to premium or rescission of coverage made for this reason may be made only to extent that it would have been made had the information been disclosed in the application process, and shall not be imposed beyond any period of incontestability, or beyond any time period proscribing an insurer from asserting defenses based upon misstatements in applications, as otherwise may be provided by applicable law. Any such rescission shall be consistent with § 38.2-3430.3 regarding guaranteed availability.","type":"section","prefixes":["D","1"],"prefix":"1","entire_prefix":"D1","prefix_anchor":"D1","level":2,"prior_prefix":"D","next_prefix":"D2"},"5":{"id":278995,"text":"When an insurer provides a lifestyle-based good health discount based upon an individual’s adherence to a healthy lifestyle and this discount is not based upon a specific health condition or diagnosis.","type":"section","prefixes":["D","2"],"prefix":"2","entire_prefix":"D2","prefix_anchor":"D2","level":2,"prior_prefix":"D1","next_prefix":"D3"},"6":{"id":278996,"text":"When an insurer removes waivers or riders attached to the policy at issue that limit coverage for specific named pre-existing medical conditions.","type":"section","prefixes":["D","3"],"prefix":"3","entire_prefix":"D3","prefix_anchor":"D3","level":2,"prior_prefix":"D2","next_prefix":"E"},"7":{"id":278997,"text":"For purposes of this section, re-underwriting means the reevaluation of any health-status-related factor of an individual for purposes of adjusting premiums, benefits or contractual terms as provided in subsections A, B, and C.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D3","next_prefix":"F"},"8":{"id":278998,"text":"The provisions of this section shall not apply to individual health insurance coverage issued to members of a bona fide association, as defined in subsection B of § 38.2-3431, where coverage is available to all members of the association and eligible dependents of such members without regard to any health-status-related factor.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"9":{"id":278999,"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":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F"}},"ancestry":[{"id":13684,"edition_id":1,"name":"Unfair Trade Practices","identifier":"5","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:45:33","date_modified":"2026-06-26 03:45:33","permalink":{"id":217475,"object_type":"structure","relational_id":13684,"identifier":"5","token":"38.2\/5","url":"\/38.2\/5\/","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":66905,"structure_id":13684,"section_number":"38.2-500","catch_line":"Declaration of purpose","url":"\/38.2-500\/","token":"38.2\/5\/38.2-500","metadata":false},{"id":79956,"structure_id":13684,"section_number":"38.2-501","catch_line":"Definitions","url":"\/38.2-501\/","token":"38.2\/5\/38.2-501","metadata":false},{"id":79437,"structure_id":13684,"section_number":"38.2-502","catch_line":"Misrepresentations and false advertising of insurance policies","url":"\/38.2-502\/","token":"38.2\/5\/38.2-502","metadata":false},{"id":54663,"structure_id":13684,"section_number":"38.2-503","catch_line":"False information and advertising generally","url":"\/38.2-503\/","token":"38.2\/5\/38.2-503","metadata":false},{"id":82451,"structure_id":13684,"section_number":"38.2-504","catch_line":"Defamation","url":"\/38.2-504\/","token":"38.2\/5\/38.2-504","metadata":false},{"id":84128,"structure_id":13684,"section_number":"38.2-505","catch_line":"Boycott, coercion and intimidation","url":"\/38.2-505\/","token":"38.2\/5\/38.2-505","metadata":false},{"id":78214,"structure_id":13684,"section_number":"38.2-506","catch_line":"False statements and entries","url":"\/38.2-506\/","token":"38.2\/5\/38.2-506","metadata":false},{"id":56726,"structure_id":13684,"section_number":"38.2-507","catch_line":"Stock operations and advisory board contracts","url":"\/38.2-507\/","token":"38.2\/5\/38.2-507","metadata":false},{"id":67626,"structure_id":13684,"section_number":"38.2-508","catch_line":"Unfair discrimination","url":"\/38.2-508\/","token":"38.2\/5\/38.2-508","metadata":false},{"id":80488,"structure_id":13684,"section_number":"38.2-508.1","catch_line":"Unfair discrimination; members of the armed forces","url":"\/38.2-508.1\/","token":"38.2\/5\/38.2-508.1","metadata":false},{"id":63719,"structure_id":13684,"section_number":"38.2-508.2","catch_line":"Discrimination prohibited","url":"\/38.2-508.2\/","token":"38.2\/5\/38.2-508.2","metadata":false},{"id":79096,"structure_id":13684,"section_number":"38.2-508.3","catch_line":"Consideration of Medicaid eligibility prohibited","url":"\/38.2-508.3\/","token":"38.2\/5\/38.2-508.3","metadata":false},{"id":61622,"structure_id":13684,"section_number":"38.2-508.4","catch_line":"Genetic information privacy","url":"\/38.2-508.4\/","token":"38.2\/5\/38.2-508.4","metadata":false},{"id":77794,"structure_id":13684,"section_number":"38.2-508.5","catch_line":"Re-underwriting individual under existing group or individual accident and sickness insurance policy prohibited; exceptions","url":"\/38.2-508.5\/","token":"38.2\/5\/38.2-508.5","metadata":false},{"id":66721,"structure_id":13684,"section_number":"38.2-509","catch_line":"Rebates","url":"\/38.2-509\/","token":"38.2\/5\/38.2-509","metadata":false},{"id":56597,"structure_id":13684,"section_number":"38.2-510","catch_line":"Unfair claim settlement practices","url":"\/38.2-510\/","token":"38.2\/5\/38.2-510","metadata":false},{"id":80252,"structure_id":13684,"section_number":"38.2-511","catch_line":"Failure to maintain record of complaints","url":"\/38.2-511\/","token":"38.2\/5\/38.2-511","metadata":false},{"id":77547,"structure_id":13684,"section_number":"38.2-512","catch_line":"Misrepresentation in insurance documents or communications","url":"\/38.2-512\/","token":"38.2\/5\/38.2-512","metadata":false},{"id":64491,"structure_id":13684,"section_number":"38.2-513","catch_line":"Repealed","url":"\/38.2-513\/","token":"38.2\/5\/38.2-513","metadata":false},{"id":68759,"structure_id":13684,"section_number":"38.2-513.1","catch_line":"Insurance sales by depository institutions and other lending institutions","url":"\/38.2-513.1\/","token":"38.2\/5\/38.2-513.1","metadata":false},{"id":84848,"structure_id":13684,"section_number":"38.2-514","catch_line":"Failure to make disclosure","url":"\/38.2-514\/","token":"38.2\/5\/38.2-514","metadata":false},{"id":75763,"structure_id":13684,"section_number":"38.2-514.1","catch_line":"Disclosure required","url":"\/38.2-514.1\/","token":"38.2\/5\/38.2-514.1","metadata":false},{"id":72002,"structure_id":13684,"section_number":"38.2-514.2","catch_line":"Disclosures required of motor vehicle rental contract insurance agents and enrollers","url":"\/38.2-514.2\/","token":"38.2\/5\/38.2-514.2","metadata":false},{"id":77046,"structure_id":13684,"section_number":"38.2-515","catch_line":"Power of Commission","url":"\/38.2-515\/","token":"38.2\/5\/38.2-515","metadata":false},{"id":62747,"structure_id":13684,"section_number":"38.2-515.1","catch_line":"Power of Commission; policies issued outside of the Commonwealth","url":"\/38.2-515.1\/","token":"38.2\/5\/38.2-515.1","metadata":false},{"id":67332,"structure_id":13684,"section_number":"38.2-516","catch_line":"Prohibited compensation for intra-company replacement","url":"\/38.2-516\/","token":"38.2\/5\/38.2-516","metadata":false},{"id":76418,"structure_id":13684,"section_number":"38.2-517","catch_line":"Unfair settlement practices; replacement and repair; penalty","url":"\/38.2-517\/","token":"38.2\/5\/38.2-517","metadata":false},{"id":74674,"structure_id":13684,"section_number":"38.2-518","catch_line":"Certificates of insurance","url":"\/38.2-518\/","token":"38.2\/5\/38.2-518","metadata":false}],"previous_section":{"id":61622,"structure_id":13684,"section_number":"38.2-508.4","catch_line":"Genetic information privacy","url":"\/38.2-508.4\/","token":"38.2\/5\/38.2-508.4","metadata":false},"next_section":{"id":66721,"structure_id":13684,"section_number":"38.2-509","catch_line":"Rebates","url":"\/38.2-509\/","token":"38.2\/5\/38.2-509","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-508.5\/","history_text":"

This law was first created in 2003. The record of its establishment is cataloged in chapter 699<\/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 2011, chapter 882<\/a>.<\/p>","references":[{"id":74720,"section_number":"38.2-3441","catch_line":"Rescissions","order_by":null,"url":"\/38.2-3441\/"},{"id":78815,"section_number":"38.2-3449","catch_line":"Prohibiting discrimination based on health status","order_by":null,"url":"\/38.2-3449\/"}],"refers_to":[{"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":86404,"section_number":"38.2-3431","catch_line":"Application of article; definitions","order_by":null,"url":"\/38.2-3431\/"},{"id":57210,"section_number":"38.2-3438","catch_line":"Definitions","order_by":null,"url":"\/38.2-3438\/"}],"permalink":{"id":217529,"object_type":"law","relational_id":77794,"identifier":"38.2-508.5","token":"38.2\/5\/38.2-508.5","url":"\/38.2-508.5\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-508.5\/","token":"38.2\/5\/38.2-508.5","dublin_core":{"Title":"Re-underwriting individual under existing group or individual accident and sickness insurance policy prohibited; exceptions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-508.5","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> No premium increase, including a reduced premium increase in the form of a discount, may be implemented for an insured individual under existing individual health insurance<\/span> coverage as defined in subsection B of § 38.2-3431<\/a> subsequent to the initial effective date of coverage under such policy or certificate to the extent that such premium increase is determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431<\/a> or (ii) the past or prospective claim experience of the individual insured. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> No reduction in benefits may be implemented for an insured individual under existing individual health insurance<\/span> coverage as defined in subsection B of § 38.2-3431<\/a> subsequent to the initial effective date of coverage under such policy or certificate to the extent that such reduction in benefits is determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431<\/a> or (ii) the past or prospective claim experience of the individual insured. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> No modifications to contractual terms and conditions may be implemented for an insured individual under existing individual health insurance<\/span> coverage as defined in subsection B of § 38.2-3431<\/a> subsequent to the initial effective date of coverage under such policy or certificate to the extent that such modifications to contractual terms and conditions are determined based upon: (i) a change in a health-status-related factor of the individual insured as defined in subsection B of § 38.2-3431<\/a> or (ii) the past or prospective claim experience of the individual insured. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> This section shall not prohibit adjustments to premium, rescission of, or amendments to the insurance contract<\/span> in the following circumstances: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> When an insurer<\/span> learns of information subsequent to issuing the policy or certificate that was not disclosed in the underwriting process and that, had it been known, would have resulted in a higher premium level or denial of coverage. Any adjustment to premium or rescission of coverage made for this reason may be made only to extent that it would have been made had the information been disclosed in the application process, and shall not be imposed beyond any period of incontestability, or beyond any time period proscribing an insurer<\/span> from asserting defenses based upon misstatements in applications, as otherwise may be provided by applicable law<\/span>. Any such rescission shall be consistent with § 38.2-3430.3<\/a> regarding guaranteed availability. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> When an insurer<\/span> provides a lifestyle-based good health discount based upon an individual’s adherence to a healthy lifestyle and this discount is not based upon a specific health condition or diagnosis. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> When an insurer<\/span> removes waivers<\/span> or riders attached to the policy at issue<\/span> that limit coverage for specific named pre-existing medical conditions. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> For purposes of this section, re-underwriting means the reevaluation of any health-status-related factor of an individual for purposes of adjusting premiums, benefits or contractual terms as provided in subsections A, B, and C. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> The provisions of this section shall not apply to individual health insurance coverage issued to members of a bona fide association, as defined in subsection B of § 38.2-3431<\/a>, where coverage is available to all members of the association and eligible dependents of such members without regard to any health-status-related factor. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/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\nRE-UNDERWRITING INDIVIDUAL UNDER EXISTING GROUP OR INDIVIDUAL ACCIDENT AND\nSICKNESS INSURANCE POLICY PROHIBITED; EXCEPTIONS (\u00a7 38.2-508.5)\n\nA. No premium increase, including a reduced premium increase in the form of a\ndiscount, may be implemented for an insured individual under existing individual\nhealth insurance coverage as defined in subsection B of § 38.2-3431\nsubsequent to the initial effective date of coverage under such policy or\ncertificate to the extent that such premium increase is determined based upon:\n(i) a change in a health-status-related factor of the individual insured as\ndefined in subsection B of § 38.2-3431 or (ii) the past or prospective\nclaim experience of the individual insured.\n\nB. No reduction in benefits may be implemented for an insured individual under\nexisting individual health insurance coverage as defined in subsection B of\n§ 38.2-3431 subsequent to the initial effective date of coverage under such\npolicy or certificate to the extent that such reduction in benefits is\ndetermined based upon: (i) a change in a health-status-related factor of the\nindividual insured as defined in subsection B of § 38.2-3431 or (ii) the\npast or prospective claim experience of the individual insured.\n\nC. No modifications to contractual terms and conditions may be implemented for\nan insured individual under existing individual health insurance coverage as\ndefined in subsection B of § 38.2-3431 subsequent to the initial effective\ndate of coverage under such policy or certificate to the extent that such\nmodifications to contractual terms and conditions are determined based upon: (i)\na change in a health-status-related factor of the individual insured as defined\nin subsection B of § 38.2-3431 or (ii) the past or prospective claim\nexperience of the individual insured.\n\nD. This section shall not prohibit adjustments to premium, rescission of, or\namendments to the insurance contract in the following circumstances:\n\n 1. When an insurer learns of information subsequent to issuing the policy or\n certificate that was not disclosed in the underwriting process and that, had\n it been known, would have resulted in a higher premium level or denial of\n coverage. Any adjustment to premium or rescission of coverage made for this\n reason may be made only to extent that it would have been made had the\n information been disclosed in the application process, and shall not be\n imposed beyond any period of incontestability, or beyond any time period\n proscribing an insurer from asserting defenses based upon misstatements in\n applications, as otherwise may be provided by applicable law. Any such\n rescission shall be consistent with § 38.2-3430.3 regarding guaranteed\n availability.\n\n 2. When an insurer provides a lifestyle-based good health discount based upon\n an individual’s adherence to a healthy lifestyle and this discount is\n not based upon a specific health condition or diagnosis.\n\n 3. When an insurer removes waivers or riders attached to the policy at issue\n that limit coverage for specific named pre-existing medical conditions.\n\nE. For purposes of this section, re-underwriting means the reevaluation of any\nhealth-status-related factor of an individual for purposes of adjusting\npremiums, benefits or contractual terms as provided in subsections A, B, and C.\n\nF. The provisions of this section shall not apply to individual health insurance\ncoverage issued to members of a bona fide association, as defined in subsection\nB of § 38.2-3431, where coverage is available to all members of the\nassociation and eligible dependents of such members without regard to any\nhealth-status-related factor.\n\nG. 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: 2003, c. 699; 2011, c. 882.","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}}