                                 CODE OF VIRGINIA

COORDINATION OF BENEFITS; NOTICE OF PRIORITY OF COVERAGE (§ 38.2-3407.13:1)

Each (i) insurer issuing individual or group accident and sickness insurance
policies providing hospital, medical and surgical or major medical coverage on
an expense-incurred basis, (ii) corporation providing individual or group
accident and sickness subscription contracts, and (iii) health maintenance
organization providing a health care plan for health care services, whose
policy, contract or plan, including any certificate or evidence of coverage
issued in connection with any such policy, contract or plan, contains a
coordination of benefits provision shall provide written notification to the
insured, subscriber or member as a prominent part of its enrollment materials
that if such insured, subscriber or member is covered under another group
accident and sickness insurance policy, group accident and sickness subscription
contract, or group health care plan for health care services, that insurance
policy, subscription contract or health care plan may have primary
responsibility for the covered expenses of other family members enrolled with
the insured, subscriber or member. Such written notification shall describe
generally the conditions upon which the other coverage would be primary for
dependent children enrolled under the insured&#8217;s, subscriber&#8217;s, or
member&#8217;s coverage and the method by which the insured, subscriber or
member may verify from the insurer, corporation or health maintenance
organization which coverage would have primary responsibility for the covered
expenses of each family member. The provisions of this section shall not be
construed to abrogate any coordination of benefits provision authorized pursuant
to subsection B of § 38.2-3405.

HISTORY: 2000, c. 149.