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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>55843</law_id><section_number>38.2-6504</section_number><catch_line>Exchange requirements</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-6506</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="65">Virginia Health Benefit Exchange</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> The Exchange shall make <span class="dictionary">qualified health plans</span> and <span class="dictionary">qualified dental plans</span> available to <span class="dictionary">qualified individuals</span> and <span class="dictionary">qualified employers</span>, beginning on a date set by the <span class="dictionary">Commission</span>, which date shall not be later than January 1, 2023, unless the <span class="dictionary">Commission</span> determines that postponement of such date is necessary to complete the establishment of the Exchange. The Exchange shall not make available any <span class="dictionary">health benefit plan</span> that is not a <span class="dictionary">qualified health plan</span>. The Exchange shall allow a <span class="dictionary">health carrier</span> to offer a <span class="dictionary">qualified dental plan</span> either to supplement a <span class="dictionary">qualified health plan</span> or separately, as practicable. <a id="paragraph-204576" class="section-permalink" href="https://vacode.org/38.2-6504/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> The Exchange shall provide for the establishment of a <span class="dictionary">SHOP exchange</span> that will permit enrollment of <span class="dictionary">eligible employees</span> of qualified <span class="dictionary">small employers</span> in the Commonwealth directly through <span class="dictionary">qualified health plan</span> issuers, <span class="dictionary">qualified dental plan</span> issuers, or licensed agents that meet established Exchange standards. <a id="paragraph-204577" class="section-permalink" href="https://vacode.org/38.2-6504/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The Exchange shall allow a <span class="dictionary">health carrier</span> to offer a plan that provides limited scope dental benefits meeting the requirements of &#xA7; 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 &#xA7; 1302(b)(1)(J) of the <span class="dictionary">Federal Act</span>. <a id="paragraph-204578" class="section-permalink" href="https://vacode.org/38.2-6504/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> Neither the Exchange nor a carrier offering qualified <span class="dictionary">health benefit plans</span> through the Exchange may charge an individual a fee or <span class="dictionary">penalty</span> for termination of coverage if the individual enrolls in another type of <span class="dictionary">minimum essential coverage</span> because the individual has become newly eligible for that coverage or because the individual&#x2019;s employer-sponsored coverage has become affordable under the standards of &#xA7; 36B(c)(2)(C) of the Internal Revenue Code of 1986. <a id="paragraph-204579" class="section-permalink" href="https://vacode.org/38.2-6504/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> The Exchange and any associated programs shall be established and operated and offer plans in compliance with &#xA7; 1321 (b) of the <span class="dictionary">Federal Act</span>. <a id="paragraph-204580" class="section-permalink" href="https://vacode.org/38.2-6504/#E"><i class="fa fa-link"/></a></p></section></text><history>2020, cc. 916, 917.</history><metadata></metadata></law>
