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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>55944</law_id><section_number>38.2-326</section_number><catch_line>Plan management functions</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-16</reference><reference>38.2-4214</reference><reference>38.2-4319</reference><reference>38.2-4509</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="3">Provisions Relating to Insurance Policies and Contracts</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> As used in this section:
			&#x201C;<span class="dictionary">Exchange</span>&#x201D; means either the (i) federal health benefit <span class="dictionary">exchange</span> established by the Secretary of the U.S. Department of Health and Human Services pursuant to &#xA7; 1321 of the Patient Protection and Affordable Care Act codified as 42 U.S.C. &#xA7; 18041(c) in the Commonwealth or (ii) <span class="dictionary">state</span>-based <span class="dictionary">exchange</span> established pursuant to Chapter 65 (&#xA7; <a class="law" title="Definitions" href="/38.2-6500/">38.2-6500</a> et seq.) and &#xA7; 1311(b) of the Patient Protection and Affordable Care Act codified as 42 U.S.C. &#xA7; 18031.
			&#x201C;<span class="dictionary">Plan management functions</span>&#x201D; means analyses and reviews necessary to support the certification, decertification, and recertification of qualified health plans and stand-alone dental plans for the participation in an <span class="dictionary">exchange</span> and the collection of data necessary to perform the above functions. <a id="paragraph-204926" class="section-permalink" href="https://vacode.org/38.2-326/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> The <span class="dictionary">Commission</span>&#x2019;s <span class="dictionary">Bureau of Insurance</span>, with the assistance of the Virginia Department of Health, shall perform <span class="dictionary">plan management functions</span> required to certify health benefit plans and stand-alone dental plans for participation in the <span class="dictionary">exchange</span>, provided that: (i) full funding is available; (ii) the technology infrastructure, including integration with federal, <span class="dictionary">state</span>, and other necessary entities, is made available to the <span class="dictionary">Commission</span> in <span class="dictionary">order</span> for it to carry out the <span class="dictionary">plan management functions</span> authorized in this section; and (iii) there are no other impediments that effectively prevent the <span class="dictionary">Commission</span> from performing any required <span class="dictionary">plan management functions</span>. <a id="paragraph-204927" class="section-permalink" href="https://vacode.org/38.2-326/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The <span class="dictionary">Commission</span>&#x2019;s <span class="dictionary">Bureau of Insurance</span> may <span class="dictionary">contract</span> and enter into memoranda of understanding to carry out its <span class="dictionary">plan management functions</span>. <a id="paragraph-204928" class="section-permalink" href="https://vacode.org/38.2-326/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> The <span class="dictionary">Commission</span> shall not use any special fund revenues dedicated to its other functions and duties unrelated to <span class="dictionary">exchange</span> operations, including revenues from utility consumer taxes or fees from licensees or registrants regulated by the <span class="dictionary">Commission</span> or fees paid to the Clerk&#x2019;s Office, to fund the <span class="dictionary">plan management functions</span>. <a id="paragraph-204929" class="section-permalink" href="https://vacode.org/38.2-326/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> Technology resources provided by the <span class="dictionary">Commission</span> in carrying out the <span class="dictionary">plan management functions</span> shall be limited to existing <span class="dictionary">Commission</span> technology support functions such as desktop support, network administration support, web services support, or other similar support functions. <a id="paragraph-204930" class="section-permalink" href="https://vacode.org/38.2-326/#E"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> The <span class="dictionary">Commission</span> shall make available to the public on its website a written report on the implementation and performance of its <span class="dictionary">plan management functions</span> during the preceding fiscal year, including, at a minimum, the manner in which all funds utilized for its <span class="dictionary">plan management functions</span> were expended. <a id="paragraph-204931" class="section-permalink" href="https://vacode.org/38.2-326/#F"><i class="fa fa-link"/></a></p></section></text><history>2013, cc. 670, 679; 2020, cc. 916, 917.</history><metadata></metadata></law>
