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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>67462</law_id><section_number>38.2-3522.1</section_number><catch_line>Limits of group accident and sickness insurance</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-3449</reference><reference>38.2-3521.1</reference><reference>38.2-3523.1</reference><reference>38.2-3523.2</reference><reference>38.2-3523.3</reference><reference>38.2-3526</reference><reference>38.2-3533</reference><reference>38.2-4214</reference><reference>38.2-4319</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="35">Accident and Sickness Insurance Policies</unit><unit label="article" level="3" order_by="1" identifier="3">Group Accident and Sickness Insurance Policies</unit></structure><text>
						<section><p>Group accident and sickness <span class="dictionary">insurance</span> offered to a resident of this Commonwealth under a group accident and sickness <span class="dictionary">insurance</span> policy issued to a group other than one described in &#xA7;&#xA0;<a class="law" title="Group accident and sickness insurance definitions" href="/38.2-3521.1/">38.2-3521.1</a> shall be subject to the following requirements:</p></section>
						<section id="A"><p><span class="prefix-number">A.</span> No such group accident and sickness <span class="dictionary">insurance</span> policy shall be delivered in this Commonwealth unless the <span class="dictionary">Commission</span> finds that: <a id="paragraph-244443" class="section-permalink" href="https://vacode.org/38.2-3522.1/#A"><i class="fa fa-link"/></a></p></section>
						<section id="A1" class="indent-1"><p><span class="prefix-number">1.</span> The issuance of such group policy is not contrary to Virginia&#x2019;s public policy and is in the best interest of the citizens of this Commonwealth; <a id="paragraph-244444" class="section-permalink" href="https://vacode.org/38.2-3522.1/#A1"><i class="fa fa-link"/></a></p></section>
						<section id="A2" class="indent-1"><p><span class="prefix-number">2.</span> The issuance of the group policy would result in economies of acquisition or administration; and <a id="paragraph-244445" class="section-permalink" href="https://vacode.org/38.2-3522.1/#A2"><i class="fa fa-link"/></a></p></section>
						<section id="A3" class="indent-1"><p><span class="prefix-number">3.</span> The benefits are reasonable in relation to the premiums charged.
				<span class="dictionary">Insurers</span> filing policy forms seeking approval under the provisions of this subsection shall accompany the forms with a certification, signed by the officer of the <span class="dictionary">company</span> with the responsibility for forms compliance, in which the <span class="dictionary">company</span> certifies that each such policy form will be issued only where the requirements set forth in subdivisions 1 through 3 of this subsection have been met. <a id="paragraph-244446" class="section-permalink" href="https://vacode.org/38.2-3522.1/#A3"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> No such group accident and sickness <span class="dictionary">insurance</span> coverage may be offered in this Commonwealth by an <span class="dictionary">insurer</span> under a policy issued in another <span class="dictionary">state</span> unless this Commonwealth or another <span class="dictionary">state</span> having requirements substantially similar to those contained in subdivisions 1, 2, and 3 of subsection A has made a determination that such requirements have been met. <a id="paragraph-244447" class="section-permalink" href="https://vacode.org/38.2-3522.1/#B"><i class="fa fa-link"/></a></p></section>
						<section id="B1" class="indent-1"><p><span class="prefix-number">1.</span> An <span class="dictionary">insurer</span> offering group accident and sickness <span class="dictionary">insurance</span> coverage in this Commonwealth under this subsection shall file a certification, signed by the officer of the <span class="dictionary">company</span> having responsibility for forms compliance, in which the <span class="dictionary">company</span> certifies that all group <span class="dictionary">insurance</span> coverage marketed to residents of this Commonwealth under policies which have not been approved by this Commonwealth will comply with the provisions of &#xA7; <a class="law" title="Group accident and sickness insurance definitions" href="/38.2-3521.1/">38.2-3521.1</a> or have met the requirements set forth in subdivisions A 1 through A 3 of this section, and which clearly demonstrates that the substantially similar requirements of the <span class="dictionary">state</span> in which the <span class="dictionary">contract</span> will be issued have been met. The certification shall be accompanied by documentation from such <span class="dictionary">state</span>, evidencing the determination that such requirements have been met. <a id="paragraph-244448" class="section-permalink" href="https://vacode.org/38.2-3522.1/#B1"><i class="fa fa-link"/></a></p></section>
						<section id="B2" class="indent-1"><p><span class="prefix-number">2.</span> An <span class="dictionary">insurer</span> offering group accident and sickness <span class="dictionary">insurance</span> in this Commonwealth under this subsection that is unable to provide the documentation required in subdivision 1 of this subsection shall be required to file policy forms consistent with requirements in &#xA7; <a class="law" title="Policy forms to be filed with Commission; notice of approval or disapproval; exceptions" href="/38.2-316/">38.2-316</a> which are imposed on policies issued in Virginia. The policy shall be required to be approved as meeting all requirements of this title prior to its being offered to residents of this Commonwealth. <a id="paragraph-244449" class="section-permalink" href="https://vacode.org/38.2-3522.1/#B2"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The premium for the policy shall be paid either from the policyholder&#x2019;s funds or from funds contributed by the covered <span class="dictionary">persons</span>, or from both. <a id="paragraph-244450" class="section-permalink" href="https://vacode.org/38.2-3522.1/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> An <span class="dictionary">insurer</span> may exclude or limit the coverage on any <span class="dictionary">person</span> as to whom <span class="dictionary">evidence</span> of individual insurability is not satisfactory to the <span class="dictionary">insurer</span>, except as otherwise prohibited in this title. <a id="paragraph-244451" class="section-permalink" href="https://vacode.org/38.2-3522.1/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</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 (&#xA7; <a class="law" title="Definitions" href="/38.2-3438/">38.2-3438</a> et seq.) of Chapter 34. <a id="paragraph-244452" class="section-permalink" href="https://vacode.org/38.2-3522.1/#E"><i class="fa fa-link"/></a></p></section></text><history>1998, c. 154; 2013, c. 751.</history><metadata></metadata></law>
