{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-5200.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-5200.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-5200.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-5200.html"}],"law_id":81666,"edition_id":1,"section_id":81666,"structure_id":15692,"section_number":"38.2-5200","catch_line":"Definitions","history":"1987, c. 586; 1990, c. 285; 2000, c. 559.","full_text":"As used in this chapter:\n\t\t“Applicant” means in the case of an individual long-term care insurance policy, the person who seeks to contract for such benefits, or in the case of a group long-term care insurance policy, the proposed certificateholder.\n\t\t“Certificate” means any certificate or evidence of coverage issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this Commonwealth.\n\t\t“Group long-term care insurance” means a long-term care insurance policy delivered or issued for delivery in this Commonwealth to any group which complies with \u00a7 38.2-3521.1.\n\t\t“Long-term care insurance” means any insurance policy or rider advertised, marketed, offered or designed to provide coverage for not less than twelve consecutive months for each covered person on an expense incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal care, mental health or substance abuse services, provided in a setting other than an acute care unit of a hospital. Such term includes group and individual annuities and life insurance policies or riders that provide directly or that supplement long-term care insurance. Such term shall also include qualified long-term insurance contracts. Long-term care insurance may be issued by insurers, fraternal benefit societies, health services plans, health maintenance organizations, cooperative nonprofit life benefit companies or mutual assessment life, accident and sickness insurers to the extent they are otherwise authorized to issue life or accident and sickness insurance. Health maintenance organizations, cooperative nonprofit life benefit companies and mutual assessment life, accident and sickness insurers may apply to the Commission for approval to provide long-term care insurance.\n\t\t“Policy” means any individual or group policy of insurance, contract, subscriber agreement, certificate, rider or endorsement delivered or issued for delivery in this Commonwealth by an insurer, fraternal benefit society, health services plan, health maintenance organization or any similar organization.\n\t\t“Qualified long-term care insurance policy” or “federally tax-qualified long-term care insurance contract” means an individual or group insurance policy or contract that meets the requirements of \u00a7 7702B (b) of the Internal Revenue Code of 1986, as amended. Such term shall also include the portion of a life insurance policy or contract that provides long-term care insurance coverage by rider or as part of the contract and that satisfies the requirements of \u00a7\u00a7 7702B (b) and 7702B (e) of the Internal Revenue Code of 1986, as amended.","order_by":null,"text":{"0":{"id":292533,"text":"As used in this chapter:\n\t\t“Applicant” means in the case of an individual long-term care insurance policy, the person who seeks to contract for such benefits, or in the case of a group long-term care insurance policy, the proposed certificateholder.\n\t\t“Certificate” means any certificate or evidence of coverage issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this Commonwealth.\n\t\t“Group long-term care insurance” means a long-term care insurance policy delivered or issued for delivery in this Commonwealth to any group which complies with \u00a7 38.2-3521.1.\n\t\t“Long-term care insurance” means any insurance policy or rider advertised, marketed, offered or designed to provide coverage for not less than twelve consecutive months for each covered person on an expense incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal care, mental health or substance abuse services, provided in a setting other than an acute care unit of a hospital. Such term includes group and individual annuities and life insurance policies or riders that provide directly or that supplement long-term care insurance. Such term shall also include qualified long-term insurance contracts. Long-term care insurance may be issued by insurers, fraternal benefit societies, health services plans, health maintenance organizations, cooperative nonprofit life benefit companies or mutual assessment life, accident and sickness insurers to the extent they are otherwise authorized to issue life or accident and sickness insurance. Health maintenance organizations, cooperative nonprofit life benefit companies and mutual assessment life, accident and sickness insurers may apply to the Commission for approval to provide long-term care insurance.\n\t\t“Policy” means any individual or group policy of insurance, contract, subscriber agreement, certificate, rider or endorsement delivered or issued for delivery in this Commonwealth by an insurer, fraternal benefit society, health services plan, health maintenance organization or any similar organization.\n\t\t“Qualified long-term care insurance policy” or “federally tax-qualified long-term care insurance contract” means an individual or group insurance policy or contract that meets the requirements of \u00a7 7702B (b) of the Internal Revenue Code of 1986, as amended. Such term shall also include the portion of a life insurance policy or contract that provides long-term care insurance coverage by rider or as part of the contract and that satisfies the requirements of \u00a7\u00a7 7702B (b) and 7702B (e) of the Internal Revenue Code of 1986, as amended.","type":"section","prefixes":[""],"prefix":"","entire_prefix":"","prefix_anchor":"","level":1}},"ancestry":[{"id":15692,"edition_id":1,"name":"Long-Term Care Insurance","identifier":"52","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:57:59","date_modified":"2026-06-26 03:57:59","permalink":{"id":217773,"object_type":"structure","relational_id":15692,"identifier":"52","token":"38.2\/52","url":"\/38.2\/52\/","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":81666,"structure_id":15692,"section_number":"38.2-5200","catch_line":"Definitions","url":"\/38.2-5200\/","token":"38.2\/52\/38.2-5200","metadata":false},{"id":69288,"structure_id":15692,"section_number":"38.2-5201","catch_line":"What laws applicable","url":"\/38.2-5201\/","token":"38.2\/52\/38.2-5201","metadata":false},{"id":60910,"structure_id":15692,"section_number":"38.2-5202","catch_line":"Promulgation of regulations; standards for policy provisions","url":"\/38.2-5202\/","token":"38.2\/52\/38.2-5202","metadata":false},{"id":81626,"structure_id":15692,"section_number":"38.2-5202.1","catch_line":"Refund of premium for cancellation or termination of policy","url":"\/38.2-5202.1\/","token":"38.2\/52\/38.2-5202.1","metadata":false},{"id":63690,"structure_id":15692,"section_number":"38.2-5203","catch_line":"Prohibited provisions","url":"\/38.2-5203\/","token":"38.2\/52\/38.2-5203","metadata":false},{"id":78536,"structure_id":15692,"section_number":"38.2-5204","catch_line":"Preexisting conditions","url":"\/38.2-5204\/","token":"38.2\/52\/38.2-5204","metadata":false},{"id":72116,"structure_id":15692,"section_number":"38.2-5205","catch_line":"Prior institutionalization","url":"\/38.2-5205\/","token":"38.2\/52\/38.2-5205","metadata":false},{"id":60114,"structure_id":15692,"section_number":"38.2-5206","catch_line":"Rates","url":"\/38.2-5206\/","token":"38.2\/52\/38.2-5206","metadata":false},{"id":61118,"structure_id":15692,"section_number":"38.2-5206.1","catch_line":"Rate increases; notice requirements","url":"\/38.2-5206.1\/","token":"38.2\/52\/38.2-5206.1","metadata":false},{"id":78975,"structure_id":15692,"section_number":"38.2-5207","catch_line":"Disclosure","url":"\/38.2-5207\/","token":"38.2\/52\/38.2-5207","metadata":false},{"id":86980,"structure_id":15692,"section_number":"38.2-5207.1","catch_line":"Disclosure; life insurance policies","url":"\/38.2-5207.1\/","token":"38.2\/52\/38.2-5207.1","metadata":false},{"id":66370,"structure_id":15692,"section_number":"38.2-5207.2","catch_line":"Long-term care benefits; monthly report","url":"\/38.2-5207.2\/","token":"38.2\/52\/38.2-5207.2","metadata":false},{"id":61536,"structure_id":15692,"section_number":"38.2-5208","catch_line":"Right to return; free look provision","url":"\/38.2-5208\/","token":"38.2\/52\/38.2-5208","metadata":false},{"id":65391,"structure_id":15692,"section_number":"38.2-5209","catch_line":"Incontestability","url":"\/38.2-5209\/","token":"38.2\/52\/38.2-5209","metadata":false},{"id":74733,"structure_id":15692,"section_number":"38.2-5210","catch_line":"Nonforfeiture benefit","url":"\/38.2-5210\/","token":"38.2\/52\/38.2-5210","metadata":false}],"next_section":{"id":69288,"structure_id":15692,"section_number":"38.2-5201","catch_line":"What laws applicable","url":"\/38.2-5201\/","token":"38.2\/52\/38.2-5201","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-5200\/","history_text":"

This law was first created in 1987. The record of its establishment is cataloged in chapter 586 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 1987 \u201cActs\u201d aren\u2019t available online. 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 1990, chapter 285; in 2000, chapter 559<\/a>.<\/p>","references":[{"id":82480,"section_number":"38.2-2201","catch_line":"Provisions for payment of medical expense and loss of income benefits; assignment of certain benefits","order_by":null,"url":"\/38.2-2201\/"},{"id":65309,"section_number":"38.2-4123","catch_line":"Exemptions","order_by":null,"url":"\/38.2-4123\/"},{"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":71560,"section_number":"8.01-27.5","catch_line":"Duty of in-network providers to submit claims to health insurers; liability of covered patients for unbilled health care services","order_by":null,"url":"\/8.01-27.5\/"}],"refers_to":[{"id":83222,"section_number":"38.2-3521.1","catch_line":"Group accident and sickness insurance definitions","order_by":null,"url":"\/38.2-3521.1\/"}],"permalink":{"id":217775,"object_type":"law","relational_id":81666,"identifier":"38.2-5200","token":"38.2\/52\/38.2-5200","url":"\/38.2-5200\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-5200\/","token":"38.2\/52\/38.2-5200","dublin_core":{"Title":"Definitions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-5200","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

As used in this chapter:\n\t\t“Applicant<\/span>” means in the case of an individual long-term care insurance<\/span> policy, the person<\/span> who seeks to contract for such benefits, or in the case of a group long-term care insurance<\/span><\/span> policy, the proposed certificateholder.\n\t\t“Certificate<\/span>” means any certificate<\/span> or evidence<\/span> of coverage issued under a group long-term care insurance<\/span><\/span> policy, which policy has been delivered or issued for delivery in this Commonwealth.\n\t\t“Group long-term care insurance<\/span><\/span>” means a long-term care insurance<\/span> policy delivered or issued for delivery in this Commonwealth to any group which complies with \u00a7 38.2-3521.1<\/a>.\n\t\t“Long-term care insurance<\/span>” means any insurance policy or rider advertised, marketed, offered or designed to provide coverage for not less than twelve consecutive months for each covered person<\/span> on an expense incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal care, mental health or substance abuse services, provided in a setting other than an acute care unit of a hospital. Such term includes group and individual annuities and life insurance policies<\/span> or riders that provide directly or that supplement long-term care insurance<\/span>. Such term shall also include qualified long-term insurance contracts<\/span>. Long-term care insurance<\/span> may be issued by insurers<\/span>, fraternal benefit societies, health services plans<\/span>, health maintenance organizations, cooperative nonprofit life benefit companies or mutual assessment life, accident and sickness insurers<\/span> to the extent they are otherwise authorized to issue<\/span> life or accident and sickness insurance. Health maintenance organizations, cooperative nonprofit life benefit companies and mutual assessment life, accident and sickness insurers<\/span> may apply to the Commission<\/span> for approval to provide long-term care insurance<\/span>.\n\t\t“Policy” means any individual or group policy of insurance, contract, subscriber agreement, certificate<\/span>, rider or endorsement delivered or issued for delivery in this Commonwealth by an insurer<\/span>, fraternal benefit society, health services plan<\/span>, health maintenance organization or any similar organization.\n\t\t“Qualified long-term care insurance<\/span> policy<\/span>” or “federally tax-qualified long-term care insurance<\/span> contract<\/span>” means an individual or group insurance policy or contract that meets the requirements of \u00a7 7702B (b) of the Internal Revenue Code of 1986, as amended. Such term shall also include the portion of a life insurance policy or contract that provides long-term care insurance<\/span> coverage by rider or as part of the contract and that satisfies the requirements of \u00a7\u00a7 7702B (b) and 7702B (e) of the Internal Revenue Code of 1986, as amended.<\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nDEFINITIONS (\u00a7 38.2-5200)\n\nAs used in this chapter:\n\t\t“Applicant” means in the case of an individual long-term care\ninsurance policy, the person who seeks to contract for such benefits, or in the\ncase of a group long-term care insurance policy, the proposed certificateholder.\n\t\t“Certificate” means any certificate or evidence of coverage issued\nunder a group long-term care insurance policy, which policy has been delivered\nor issued for delivery in this Commonwealth.\n\t\t“Group long-term care insurance” means a long-term care insurance\npolicy delivered or issued for delivery in this Commonwealth to any group which\ncomplies with \u00a7 38.2-3521.1.\n\t\t“Long-term care insurance” means any insurance policy or rider\nadvertised, marketed, offered or designed to provide coverage for not less than\ntwelve consecutive months for each covered person on an expense incurred,\nindemnity, prepaid, or other basis, for one or more necessary or medically\nnecessary diagnostic, preventive, therapeutic, rehabilitative, maintenance,\npersonal care, mental health or substance abuse services, provided in a setting\nother than an acute care unit of a hospital. Such term includes group and\nindividual annuities and life insurance policies or riders that provide directly\nor that supplement long-term care insurance. Such term shall also include\nqualified long-term insurance contracts. Long-term care insurance may be issued\nby insurers, fraternal benefit societies, health services plans, health\nmaintenance organizations, cooperative nonprofit life benefit companies or\nmutual assessment life, accident and sickness insurers to the extent they are\notherwise authorized to issue life or accident and sickness insurance. Health\nmaintenance organizations, cooperative nonprofit life benefit companies and\nmutual assessment life, accident and sickness insurers may apply to the\nCommission for approval to provide long-term care insurance.\n\t\t“Policy” means any individual or group policy of insurance,\ncontract, subscriber agreement, certificate, rider or endorsement delivered or\nissued for delivery in this Commonwealth by an insurer, fraternal benefit\nsociety, health services plan, health maintenance organization or any similar\norganization.\n\t\t“Qualified long-term care insurance policy” or “federally\ntax-qualified long-term care insurance contract” means an individual or\ngroup insurance policy or contract that meets the requirements of \u00a7 7702B (b)\nof the Internal Revenue Code of 1986, as amended. Such term shall also include\nthe portion of a life insurance policy or contract that provides long-term care\ninsurance coverage by rider or as part of the contract and that satisfies the\nrequirements of \u00a7\u00a7 7702B (b) and 7702B (e) of the Internal Revenue Code of\n1986, as amended.\n\nHISTORY: 1987, c. 586; 1990, c. 285; 2000, c. 559.","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}}