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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>65829</law_id><section_number>38.2-4307</section_number><catch_line>Annual statement</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-4302</reference><reference>38.2-4307.1</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="43">Health Maintenance Organizations</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> Each <span class="dictionary">health maintenance organization</span> shall file a statement with the <span class="dictionary">Commission</span> annually by March 1. The statement shall be verified by at least two principal officers and shall cover the preceding calendar year. Each <span class="dictionary">health maintenance organization</span> shall also send a copy of the statement to the <span class="dictionary">State</span> Health <span class="dictionary">Commissioner</span>. <a id="paragraph-239241" class="section-permalink" href="https://vacode.org/38.2-4307/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> The statement shall be on forms prescribed by the <span class="dictionary">Commission</span> and shall include: <a id="paragraph-239242" class="section-permalink" href="https://vacode.org/38.2-4307/#B"><i class="fa fa-link"/></a></p></section>
						<section id="B1" class="indent-1"><p><span class="prefix-number">1.</span> A financial statement of the organization, including its balance sheet and income statement for the preceding year; <a id="paragraph-239243" class="section-permalink" href="https://vacode.org/38.2-4307/#B1"><i class="fa fa-link"/></a></p></section>
						<section id="B2" class="indent-1"><p><span class="prefix-number">2.</span> Any <span class="dictionary">material</span> changes in the information submitted pursuant to subsection B of &#xA7; <a class="law" title="Establishment of health maintenance organizations" href="/38.2-4301/">38.2-4301</a>; <a id="paragraph-239244" class="section-permalink" href="https://vacode.org/38.2-4307/#B2"><i class="fa fa-link"/></a></p></section>
						<section id="B3" class="indent-1"><p><span class="prefix-number">3.</span> The number of <span class="dictionary">persons</span> enrolled during the year, the number of <span class="dictionary">enrollees</span> as of the end of the year and the number of enrollments terminated during the year; and <a id="paragraph-239245" class="section-permalink" href="https://vacode.org/38.2-4307/#B3"><i class="fa fa-link"/></a></p></section>
						<section id="B4" class="indent-1"><p><span class="prefix-number">4.</span> Any other information relating to the operations of the <span class="dictionary">health maintenance organization</span> required by the <span class="dictionary">Commission</span> pursuant to this chapter or Chapter 58 (&#xA7; <a class="law" title="Definitions" href="/38.2-5800/">38.2-5800</a> et seq.) of this title. <a id="paragraph-239246" class="section-permalink" href="https://vacode.org/38.2-4307/#B4"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> If the <span class="dictionary">health maintenance organization</span> is audited annually by an independent certified public accountant, a copy of the certified audit report shall be filed annually with the <span class="dictionary">Commission</span> by June 30. <a id="paragraph-239247" class="section-permalink" href="https://vacode.org/38.2-4307/#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> may extend the time prescribed for filing annual statements or other reports or exhibits of any <span class="dictionary">health maintenance organization</span> for good cause shown. However, the <span class="dictionary">Commission</span> shall not extend the time for filing annual statements beyond sixty days after the time prescribed by subsection A of this section. Any <span class="dictionary">health maintenance organization</span> which fails to file its annual statement within the time prescribed by this section shall be subject to a fine as specified in &#xA7; <a class="law" title="Penalties and restitution payments" href="/38.2-218/">38.2-218</a>. <a id="paragraph-239248" class="section-permalink" href="https://vacode.org/38.2-4307/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> The <span class="dictionary">Commission</span> may prescribe the form of the annual statement and supplemental <span class="dictionary">schedules</span> and exhibits to include additional copies in machine-readable format, and may vary the form requirements for different types of <span class="dictionary">health maintenance organizations</span>. However, as far as practicable, the form for annual statements, supplementary <span class="dictionary">schedules</span>, and exhibits shall be the same as other such forms in general use in the United <span class="dictionary">States</span>. Unless otherwise prescribed by the <span class="dictionary">Commission</span>, such annual statements shall be prepared using an annual statement convention blank developed by the National Association of <span class="dictionary">Insurance</span> <span class="dictionary">Commissioners</span> (NAIC). The annual statement, and supplementary <span class="dictionary">schedules</span> and exhibits required by this section, shall be prepared in accordance with the appropriate annual statement instructions and the accounting practices and procedures manual adopted by the NAIC, or any successor publications. <a id="paragraph-239249" class="section-permalink" href="https://vacode.org/38.2-4307/#E"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> At the request of the <span class="dictionary">Commission</span>, a <span class="dictionary">health maintenance organization</span> that is licensed under this chapter shall annually on or before March 1 of each year, file with the NAIC a copy of its annual statement convention blank, along with such additional filings as prescribed by the <span class="dictionary">Commission</span> for the preceding year. Unless otherwise prescribed by the <span class="dictionary">Commission</span>, the information filed with the NAIC shall be in the same format and scope as that required by the <span class="dictionary">Commission</span> and shall include the signed jurat page and any actuarial certification required by the <span class="dictionary">Commission</span>. Any amendments and addenda to the annual statement filed subsequently with the <span class="dictionary">Commission</span> shall also be filed with the NAIC. <a id="paragraph-239250" class="section-permalink" href="https://vacode.org/38.2-4307/#F"><i class="fa fa-link"/></a></p></section></text><history>1980, c. 720, &#xA7; 38.1-870; 1986, c. 562; 1987, c. 520; 1998, c. 891; 1999, c. 482.</history><metadata></metadata></law>
