{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-6504.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-6504.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-6504.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-6504.html"}],"law_id":55843,"edition_id":1,"section_id":55843,"structure_id":12800,"section_number":"38.2-6504","catch_line":"Exchange requirements","history":"2020, cc. 916, 917.","full_text":"A\n\nThe Exchange shall make qualified health plans and qualified dental plans available to qualified individuals and qualified employers, beginning on a date set by the Commission, which date shall not be later than January 1, 2023, unless the Commission determines that postponement of such date is necessary to complete the establishment of the Exchange. The Exchange shall not make available any health benefit plan that is not a qualified health plan. The Exchange shall allow a health carrier to offer a qualified dental plan either to supplement a qualified health plan or separately, as practicable.B\n\nThe Exchange shall provide for the establishment of a SHOP exchange that will permit enrollment of eligible employees of qualified small employers in the Commonwealth directly through qualified health plan issuers, qualified dental plan issuers, or licensed agents that meet established Exchange standards.C\n\nThe Exchange shall allow a health carrier to offer a plan that provides limited scope dental benefits meeting the requirements of § 9832(c)(2)(A) of the Internal Revenue Code of 1986 through the Exchange, if the plan provides pediatric dental benefits meeting the requirements of § 1302(b)(1)(J) of the Federal Act.D\n\nNeither the Exchange nor a carrier offering qualified health benefit plans through the Exchange may charge an individual a fee or penalty for termination of coverage if the individual enrolls in another type of minimum essential coverage because the individual has become newly eligible for that coverage or because the individual’s employer-sponsored coverage has become affordable under the standards of § 36B(c)(2)(C) of the Internal Revenue Code of 1986.E\n\nThe Exchange and any associated programs shall be established and operated and offer plans in compliance with § 1321 (b) of the Federal Act.","order_by":null,"text":{"0":{"id":204576,"text":"The Exchange shall make qualified health plans and qualified dental plans available to qualified individuals and qualified employers, beginning on a date set by the Commission, which date shall not be later than January 1, 2023, unless the Commission determines that postponement of such date is necessary to complete the establishment of the Exchange. The Exchange shall not make available any health benefit plan that is not a qualified health plan. The Exchange shall allow a health carrier to offer a qualified dental plan either to supplement a qualified health plan or separately, as practicable.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":204577,"text":"The Exchange shall provide for the establishment of a SHOP exchange that will permit enrollment of eligible employees of qualified small employers in the Commonwealth directly through qualified health plan issuers, qualified dental plan issuers, or licensed agents that meet established Exchange standards.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":204578,"text":"The Exchange shall allow a health carrier to offer a plan that provides limited scope dental benefits meeting the requirements of § 9832(c)(2)(A) of the Internal Revenue Code of 1986 through the Exchange, if the plan provides pediatric dental benefits meeting the requirements of § 1302(b)(1)(J) of the Federal Act.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":204579,"text":"Neither the Exchange nor a carrier offering qualified health benefit plans through the Exchange may charge an individual a fee or penalty for termination of coverage if the individual enrolls in another type of minimum essential coverage because the individual has become newly eligible for that coverage or because the individual’s employer-sponsored coverage has become affordable under the standards of § 36B(c)(2)(C) of the Internal Revenue Code of 1986.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":204580,"text":"The Exchange and any associated programs shall be established and operated and offer plans in compliance with § 1321 (b) of the Federal Act.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D"}},"ancestry":[{"id":12800,"edition_id":1,"name":"Virginia Health Benefit Exchange","identifier":"65","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:43:53","date_modified":"2026-06-26 03:43:53","permalink":{"id":218345,"object_type":"structure","relational_id":12800,"identifier":"65","token":"38.2\/65","url":"\/38.2\/65\/","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":75766,"structure_id":12800,"section_number":"38.2-6500","catch_line":"Definitions","url":"\/38.2-6500\/","token":"38.2\/65\/38.2-6500","metadata":false},{"id":84565,"structure_id":12800,"section_number":"38.2-6501","catch_line":"Exchange objectives","url":"\/38.2-6501\/","token":"38.2\/65\/38.2-6501","metadata":false},{"id":59610,"structure_id":12800,"section_number":"38.2-6502","catch_line":"Division established; Exchange created","url":"\/38.2-6502\/","token":"38.2\/65\/38.2-6502","metadata":false},{"id":74872,"structure_id":12800,"section_number":"38.2-6503","catch_line":"Advisory Committee","url":"\/38.2-6503\/","token":"38.2\/65\/38.2-6503","metadata":false},{"id":55843,"structure_id":12800,"section_number":"38.2-6504","catch_line":"Exchange requirements","url":"\/38.2-6504\/","token":"38.2\/65\/38.2-6504","metadata":false},{"id":76462,"structure_id":12800,"section_number":"38.2-6505","catch_line":"Duties of Exchange","url":"\/38.2-6505\/","token":"38.2\/65\/38.2-6505","metadata":false},{"id":81163,"structure_id":12800,"section_number":"38.2-6506","catch_line":"Certification of health benefit plans as qualified health plans","url":"\/38.2-6506\/","token":"38.2\/65\/38.2-6506","metadata":false},{"id":81440,"structure_id":12800,"section_number":"38.2-6507","catch_line":"Appeal of decertification or denial of certification","url":"\/38.2-6507\/","token":"38.2\/65\/38.2-6507","metadata":false},{"id":67396,"structure_id":12800,"section_number":"38.2-6508","catch_line":"Open enrollment periods","url":"\/38.2-6508\/","token":"38.2\/65\/38.2-6508","metadata":false},{"id":84381,"structure_id":12800,"section_number":"38.2-6509","catch_line":"Choice","url":"\/38.2-6509\/","token":"38.2\/65\/38.2-6509","metadata":false},{"id":67117,"structure_id":12800,"section_number":"38.2-6510","catch_line":"Health Insurance Exchange Fund; assessment","url":"\/38.2-6510\/","token":"38.2\/65\/38.2-6510","metadata":false},{"id":62589,"structure_id":12800,"section_number":"38.2-6511","catch_line":"Procurement, contracting, and personnel","url":"\/38.2-6511\/","token":"38.2\/65\/38.2-6511","metadata":false},{"id":77639,"structure_id":12800,"section_number":"38.2-6512","catch_line":"Confidentiality","url":"\/38.2-6512\/","token":"38.2\/65\/38.2-6512","metadata":false},{"id":80784,"structure_id":12800,"section_number":"38.2-6513","catch_line":"Navigators","url":"\/38.2-6513\/","token":"38.2\/65\/38.2-6513","metadata":false},{"id":85399,"structure_id":12800,"section_number":"38.2-6514","catch_line":"Certified application counselors","url":"\/38.2-6514\/","token":"38.2\/65\/38.2-6514","metadata":false},{"id":82556,"structure_id":12800,"section_number":"38.2-6515","catch_line":"Regulations","url":"\/38.2-6515\/","token":"38.2\/65\/38.2-6515","metadata":false},{"id":53968,"structure_id":12800,"section_number":"38.2-6516","catch_line":"Reports","url":"\/38.2-6516\/","token":"38.2\/65\/38.2-6516","metadata":false},{"id":58428,"structure_id":12800,"section_number":"38.2-6517","catch_line":"Relation to other laws","url":"\/38.2-6517\/","token":"38.2\/65\/38.2-6517","metadata":false}],"previous_section":{"id":74872,"structure_id":12800,"section_number":"38.2-6503","catch_line":"Advisory Committee","url":"\/38.2-6503\/","token":"38.2\/65\/38.2-6503","metadata":false},"next_section":{"id":76462,"structure_id":12800,"section_number":"38.2-6505","catch_line":"Duties of Exchange","url":"\/38.2-6505\/","token":"38.2\/65\/38.2-6505","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-6504\/","history_text":"

This law was first created in 2020. The record of its establishment is cataloged in chapters 916<\/a> and 917<\/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.<\/p>","references":[{"id":81163,"section_number":"38.2-6506","catch_line":"Certification of health benefit plans as qualified health plans","order_by":null,"url":"\/38.2-6506\/"}],"refers_to":false,"permalink":{"id":218363,"object_type":"law","relational_id":55843,"identifier":"38.2-6504","token":"38.2\/65\/38.2-6504","url":"\/38.2-6504\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-6504\/","token":"38.2\/65\/38.2-6504","dublin_core":{"Title":"Exchange requirements","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-6504","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> The Exchange shall make qualified health plans<\/span> and qualified dental plans<\/span> available to qualified individuals<\/span> and qualified employers<\/span>, beginning on a date set by the Commission<\/span>, which date shall not be later than January 1, 2023, unless the Commission<\/span> determines that postponement of such date is necessary to complete the establishment of the Exchange. The Exchange shall not make available any health benefit plan<\/span> that is not a qualified health plan<\/span>. The Exchange shall allow a health carrier<\/span> to offer a qualified dental plan<\/span> either to supplement a qualified health plan<\/span> or separately, as practicable. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The Exchange shall provide for the establishment of a SHOP exchange<\/span> that will permit enrollment of eligible employees<\/span> of qualified small employers<\/span> in the Commonwealth directly through qualified health plan<\/span> issuers, qualified dental plan<\/span> issuers, or licensed agents that meet established Exchange standards. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The Exchange shall allow a health carrier<\/span> to offer a plan that provides limited scope dental benefits meeting the requirements of § 9832(c)(2)(A) of the Internal Revenue Code of 1986 through the Exchange, if the plan provides pediatric dental benefits meeting the requirements of § 1302(b)(1)(J) of the Federal Act<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Neither the Exchange nor a carrier offering qualified health benefit plans<\/span> through the Exchange may charge an individual a fee or penalty<\/span> for termination of coverage if the individual enrolls in another type of minimum essential coverage<\/span> because the individual has become newly eligible for that coverage or because the individual’s employer-sponsored coverage has become affordable under the standards of § 36B(c)(2)(C) of the Internal Revenue Code of 1986. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> The Exchange and any associated programs shall be established and operated and offer plans in compliance with § 1321 (b) of the Federal Act<\/span>. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nEXCHANGE REQUIREMENTS (\u00a7 38.2-6504)\n\nA. The Exchange shall make qualified health plans and qualified dental plans\navailable to qualified individuals and qualified employers, beginning on a date\nset by the Commission, which date shall not be later than January 1, 2023,\nunless the Commission determines that postponement of such date is necessary to\ncomplete the establishment of the Exchange. The Exchange shall not make\navailable any health benefit plan that is not a qualified health plan. The\nExchange shall allow a health carrier to offer a qualified dental plan either to\nsupplement a qualified health plan or separately, as practicable.\n\nB. The Exchange shall provide for the establishment of a SHOP exchange that will\npermit enrollment of eligible employees of qualified small employers in the\nCommonwealth directly through qualified health plan issuers, qualified dental\nplan issuers, or licensed agents that meet established Exchange standards.\n\nC. The Exchange shall allow a health carrier to offer a plan that provides\nlimited scope dental benefits meeting the requirements of § 9832(c)(2)(A)\nof the Internal Revenue Code of 1986 through the Exchange, if the plan provides\npediatric dental benefits meeting the requirements of § 1302(b)(1)(J) of\nthe Federal Act.\n\nD. Neither the Exchange nor a carrier offering qualified health benefit plans\nthrough the Exchange may charge an individual a fee or penalty for termination\nof coverage if the individual enrolls in another type of minimum essential\ncoverage because the individual has become newly eligible for that coverage or\nbecause the individual’s employer-sponsored coverage has become affordable\nunder the standards of § 36B(c)(2)(C) of the Internal Revenue Code of 1986.\n\nE. The Exchange and any associated programs shall be established and operated\nand offer plans in compliance with § 1321 (b) of the Federal Act.\n\nHISTORY: 2020, cc. 916, 917.","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}}