{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-6510.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-6510.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-6510.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-6510.html"}],"law_id":67117,"edition_id":1,"section_id":67117,"structure_id":12800,"section_number":"38.2-6510","catch_line":"Health Insurance Exchange Fund; assessment","history":"2020, cc. 916, 917.","full_text":"A\n\nThe Exchange shall be authorized to fund its operations through (i) special fund revenues generated by assessment fees on health carriers offering plans through the Exchange, (ii) funds described in subsection H, or (iii) such funds as the General Assembly may from time to time appropriate. All such funds received under this section and paid into the state treasury shall be deposited to a special fund designated “Health Insurance Exchange Special Fund State Corporation Commission.” Interest earned on moneys in the Fund shall remain in the Fund and be credited to it. Any moneys remaining in the Fund, including interest thereon, at the end of each fiscal year shall not revert to the general fund but shall remain in the Fund. Moneys in the Fund shall be used solely for the purposes of supporting the Exchange through initial start-up costs associated with establishment of the Exchange, Exchange operations, outreach, and enrollment, a Navigator program, and other means of supporting the Exchange.B\n\nThe Exchange shall have funding from the sources described in subsection A in an amount sufficient to support its ongoing operations.C\n\nAssessments on health carriers shall be reasonable and necessary to support the development, operations, and prudent cash management of the Exchange. Assessments shall be approved by the Commission prior to implementation and shall not exceed three percent of the carrier’s total monthly premium as described in this subsection, except that the Commission may, after notice and opportunity to be heard, adjust the assessment rate if necessary to ensure that the Exchange is fully funded. The assessment shall be based on the premium charged by a carrier for health benefits plans issued on the American Health Benefits Exchange and each qualified dental plan offered on the American Health Benefits Exchange during any period in which qualified health plans and qualified dental plans are effective on the American Health Benefits Exchange.D\n\nTaxes, fees, or assessments used to finance the Exchange shall be clearly disclosed by the Exchange as such.E\n\nTaxes, fees, or assessments used to finance the Exchange shall be considered a state tax or assessment, as defined in § 2718(a) of the PHSA and its implementing regulations, and shall be excluded from health carrier administrative costs for the purpose of calculating medical loss ratios or rebates.F\n\nAssessments and fees shall not affect the requirement under § 1301 of the Federal Act that carriers charge the same premium rate for each qualified health plan whether offered inside or outside the Exchange.G\n\nA written report on the implementation and performance of the Exchange functions during the preceding fiscal year, including, at a minimum, the manner in which funds were expended, shall be made available to the public on the website of the Exchange.H\n\nThe Exchange is authorized to apply for and accept federal grants, other federal funds, and grants from nongovernmental organizations for the purposes of developing, implementing, and administering the Exchange.I\n\nThe Commission shall not use any special fund revenues dedicated to its other functions and duties, including revenues from utility consumer taxes or fees from licensees regulated by the Commission, or fees paid to the office of the clerk of the Commission, to fund any of the activities or operating expenses of the Exchange.","order_by":null,"text":{"0":{"id":243238,"text":"The Exchange shall be authorized to fund its operations through (i) special fund revenues generated by assessment fees on health carriers offering plans through the Exchange, (ii) funds described in subsection H, or (iii) such funds as the General Assembly may from time to time appropriate. All such funds received under this section and paid into the state treasury shall be deposited to a special fund designated “Health Insurance Exchange Special Fund State Corporation Commission.” Interest earned on moneys in the Fund shall remain in the Fund and be credited to it. Any moneys remaining in the Fund, including interest thereon, at the end of each fiscal year shall not revert to the general fund but shall remain in the Fund. Moneys in the Fund shall be used solely for the purposes of supporting the Exchange through initial start-up costs associated with establishment of the Exchange, Exchange operations, outreach, and enrollment, a Navigator program, and other means of supporting the Exchange.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":243239,"text":"The Exchange shall have funding from the sources described in subsection A in an amount sufficient to support its ongoing operations.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":243240,"text":"Assessments on health carriers shall be reasonable and necessary to support the development, operations, and prudent cash management of the Exchange. Assessments shall be approved by the Commission prior to implementation and shall not exceed three percent of the carrier’s total monthly premium as described in this subsection, except that the Commission may, after notice and opportunity to be heard, adjust the assessment rate if necessary to ensure that the Exchange is fully funded. The assessment shall be based on the premium charged by a carrier for health benefits plans issued on the American Health Benefits Exchange and each qualified dental plan offered on the American Health Benefits Exchange during any period in which qualified health plans and qualified dental plans are effective on the American Health Benefits Exchange.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":243241,"text":"Taxes, fees, or assessments used to finance the Exchange shall be clearly disclosed by the Exchange as such.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":243242,"text":"Taxes, fees, or assessments used to finance the Exchange shall be considered a state tax or assessment, as defined in § 2718(a) of the PHSA and its implementing regulations, and shall be excluded from health carrier administrative costs for the purpose of calculating medical loss ratios or rebates.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"5":{"id":243243,"text":"Assessments and fees shall not affect the requirement under § 1301 of the Federal Act that carriers charge the same premium rate for each qualified health plan whether offered inside or outside the Exchange.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"6":{"id":243244,"text":"A written report on the implementation and performance of the Exchange functions during the preceding fiscal year, including, at a minimum, the manner in which funds were expended, shall be made available to the public on the website of the Exchange.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"7":{"id":243245,"text":"The Exchange is authorized to apply for and accept federal grants, other federal funds, and grants from nongovernmental organizations for the purposes of developing, implementing, and administering the Exchange.","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"I"},"8":{"id":243246,"text":"The Commission shall not use any special fund revenues dedicated to its other functions and duties, including revenues from utility consumer taxes or fees from licensees regulated by the Commission, or fees paid to the office of the clerk of the Commission, to fund any of the activities or operating expenses of the Exchange.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H"}},"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":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},"next_section":{"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},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-6510\/","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":false,"refers_to":false,"permalink":{"id":218387,"object_type":"law","relational_id":67117,"identifier":"38.2-6510","token":"38.2\/65\/38.2-6510","url":"\/38.2-6510\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-6510\/","token":"38.2\/65\/38.2-6510","dublin_core":{"Title":"Health Insurance Exchange Fund; assessment","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-6510","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> The Exchange shall be authorized to fund its operations through (i) special fund revenues generated by assessment fees on health carriers<\/span> offering plans<\/span> through the Exchange, (ii) funds described in subsection H, or (iii) such funds as the General Assembly may from time to time appropriate. All such funds received under this section and paid into the state<\/span> treasury shall be deposited to a special fund designated “Health Insurance<\/span> Exchange Special Fund State<\/span> Corporation Commission<\/span>.” Interest earned on moneys in the Fund shall remain in the Fund and be credited to it. Any moneys remaining in the Fund, including interest thereon, at the end of each fiscal year shall not revert to the general fund but shall remain in the Fund. Moneys in the Fund shall be used solely for the purposes of supporting the Exchange through initial start-up costs associated with establishment of the Exchange, Exchange operations, outreach, and enrollment, a Navigator<\/span> program, and other means of supporting the Exchange. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The Exchange shall have funding from the sources described in subsection A in an amount sufficient to support its ongoing operations. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> Assessments on health carriers<\/span> shall be reasonable and necessary to support the development, operations, and prudent cash management of the Exchange. Assessments shall be approved by the Commission<\/span> prior to implementation and shall not exceed three percent of the carrier<\/span>’s total monthly premium as described in this subsection, except that the Commission<\/span> may, after notice and opportunity to be heard, adjust the assessment rate<\/span> if necessary to ensure that the Exchange is fully funded. The assessment shall be based on the premium charged by a carrier<\/span> for health benefits plans issued on the American Health Benefits Exchange and each qualified dental plan<\/span> offered on the American Health Benefits Exchange during any period in which qualified health plans<\/span> and qualified dental plans<\/span> are effective on the American Health Benefits Exchange. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Taxes, fees, or assessments used to finance the Exchange shall be clearly disclosed by the Exchange as such. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Taxes, fees, or assessments used to finance the Exchange shall be considered a state<\/span> tax or assessment, as defined in § 2718(a) of the PHSA<\/span> and its implementing regulations, and shall be excluded from health carrier<\/span> administrative costs for the purpose of calculating medical loss ratios or rebates. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> Assessments and fees shall not affect the requirement under § 1301 of the Federal Act<\/span> that carriers charge the same premium rate<\/span> for each qualified health plan<\/span> whether offered inside or outside the Exchange. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> A written report on the implementation and performance of the Exchange functions during the preceding fiscal year, including, at a minimum, the manner in which funds were expended, shall be made available to the public on the website of the Exchange. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> The Exchange is authorized to apply for and accept federal grants, other federal funds, and grants from nongovernmental organizations for the purposes of developing, implementing, and administering the Exchange. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> The Commission<\/span> shall not use any special fund revenues dedicated to its other functions and duties, including revenues from utility consumer taxes or fees from licensees regulated by the Commission<\/span>, or fees paid to the office of the clerk of the Commission<\/span>, to fund any of the activities or operating expenses of the Exchange. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nHEALTH INSURANCE EXCHANGE FUND; ASSESSMENT (\u00a7 38.2-6510)\n\nA. The Exchange shall be authorized to fund its operations through (i) special\nfund revenues generated by assessment fees on health carriers offering plans\nthrough the Exchange, (ii) funds described in subsection H, or (iii) such funds\nas the General Assembly may from time to time appropriate. All such funds\nreceived under this section and paid into the state treasury shall be deposited\nto a special fund designated “Health Insurance Exchange Special Fund State\nCorporation Commission.” Interest earned on moneys in the Fund shall\nremain in the Fund and be credited to it. Any moneys remaining in the Fund,\nincluding interest thereon, at the end of each fiscal year shall not revert to\nthe general fund but shall remain in the Fund. Moneys in the Fund shall be used\nsolely for the purposes of supporting the Exchange through initial start-up\ncosts associated with establishment of the Exchange, Exchange operations,\noutreach, and enrollment, a Navigator program, and other means of supporting the\nExchange.\n\nB. The Exchange shall have funding from the sources described in subsection A in\nan amount sufficient to support its ongoing operations.\n\nC. Assessments on health carriers shall be reasonable and necessary to support\nthe development, operations, and prudent cash management of the Exchange.\nAssessments shall be approved by the Commission prior to implementation and\nshall not exceed three percent of the carrier’s total monthly premium as\ndescribed in this subsection, except that the Commission may, after notice and\nopportunity to be heard, adjust the assessment rate if necessary to ensure that\nthe Exchange is fully funded. The assessment shall be based on the premium\ncharged by a carrier for health benefits plans issued on the American Health\nBenefits Exchange and each qualified dental plan offered on the American Health\nBenefits Exchange during any period in which qualified health plans and\nqualified dental plans are effective on the American Health Benefits Exchange.\n\nD. Taxes, fees, or assessments used to finance the Exchange shall be clearly\ndisclosed by the Exchange as such.\n\nE. Taxes, fees, or assessments used to finance the Exchange shall be considered\na state tax or assessment, as defined in § 2718(a) of the PHSA and its\nimplementing regulations, and shall be excluded from health carrier\nadministrative costs for the purpose of calculating medical loss ratios or\nrebates.\n\nF. Assessments and fees shall not affect the requirement under § 1301 of\nthe Federal Act that carriers charge the same premium rate for each qualified\nhealth plan whether offered inside or outside the Exchange.\n\nG. A written report on the implementation and performance of the Exchange\nfunctions during the preceding fiscal year, including, at a minimum, the manner\nin which funds were expended, shall be made available to the public on the\nwebsite of the Exchange.\n\nH. The Exchange is authorized to apply for and accept federal grants, other\nfederal funds, and grants from nongovernmental organizations for the purposes of\ndeveloping, implementing, and administering the Exchange.\n\nI. The Commission shall not use any special fund revenues dedicated to its other\nfunctions and duties, including revenues from utility consumer taxes or fees\nfrom licensees regulated by the Commission, or fees paid to the office of the\nclerk of the Commission, to fund any of the activities or operating expenses of\nthe Exchange.\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}}