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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>67117</law_id><section_number>38.2-6510</section_number><catch_line>Health Insurance Exchange Fund; assessment</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><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 be authorized to fund its operations through (i) special fund revenues generated by assessment fees on <span class="dictionary">health carriers</span> offering <span class="dictionary">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 <span class="dictionary">state</span> treasury shall be deposited to a special fund designated &#x201C;Health <span class="dictionary">Insurance</span> Exchange Special Fund <span class="dictionary">State</span> Corporation <span class="dictionary">Commission</span>.&#x201D; 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 <span class="dictionary">Navigator</span> program, and other means of supporting the Exchange. <a id="paragraph-243238" class="section-permalink" href="https://vacode.org/38.2-6510/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> The Exchange shall have funding from the sources described in subsection A in an amount sufficient to support its ongoing operations. <a id="paragraph-243239" class="section-permalink" href="https://vacode.org/38.2-6510/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> Assessments on <span class="dictionary">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 <span class="dictionary">Commission</span> prior to implementation and shall not exceed three percent of the <span class="dictionary">carrier</span>&#x2019;s total monthly premium as described in this subsection, except that the <span class="dictionary">Commission</span> may, after notice and opportunity to be heard, adjust the assessment <span class="dictionary">rate</span> if necessary to ensure that the Exchange is fully funded. The assessment shall be based on the premium charged by a <span class="dictionary">carrier</span> for health benefits plans issued on the American Health Benefits Exchange and each <span class="dictionary">qualified dental plan</span> offered on the American Health Benefits Exchange during any period in which <span class="dictionary">qualified health plans</span> and <span class="dictionary">qualified dental plans</span> are effective on the American Health Benefits Exchange. <a id="paragraph-243240" class="section-permalink" href="https://vacode.org/38.2-6510/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> Taxes, fees, or assessments used to finance the Exchange shall be clearly disclosed by the Exchange as such. <a id="paragraph-243241" class="section-permalink" href="https://vacode.org/38.2-6510/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> Taxes, fees, or assessments used to finance the Exchange shall be considered a <span class="dictionary">state</span> tax or assessment, as defined in &#xA7; 2718(a) of the <span class="dictionary">PHSA</span> and its implementing regulations, and shall be excluded from <span class="dictionary">health carrier</span> administrative costs for the purpose of calculating medical loss ratios or rebates. <a id="paragraph-243242" class="section-permalink" href="https://vacode.org/38.2-6510/#E"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> Assessments and fees shall not affect the requirement under &#xA7; 1301 of the <span class="dictionary">Federal Act</span> that carriers charge the same premium <span class="dictionary">rate</span> for each <span class="dictionary">qualified health plan</span> whether offered inside or outside the Exchange. <a id="paragraph-243243" class="section-permalink" href="https://vacode.org/38.2-6510/#F"><i class="fa fa-link"/></a></p></section>
						<section id="G"><p><span class="prefix-number">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. <a id="paragraph-243244" class="section-permalink" href="https://vacode.org/38.2-6510/#G"><i class="fa fa-link"/></a></p></section>
						<section id="H"><p><span class="prefix-number">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. <a id="paragraph-243245" class="section-permalink" href="https://vacode.org/38.2-6510/#H"><i class="fa fa-link"/></a></p></section>
						<section id="I"><p><span class="prefix-number">I.</span> The <span class="dictionary">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 <span class="dictionary">Commission</span>, or fees paid to the office of the clerk of the <span class="dictionary">Commission</span>, to fund any of the activities or operating expenses of the Exchange. <a id="paragraph-243246" class="section-permalink" href="https://vacode.org/38.2-6510/#I"><i class="fa fa-link"/></a></p></section></text><history>2020, cc. 916, 917.</history><metadata></metadata></law>
