                                 CODE OF VIRGINIA

DEDUCTIBLES AND COINSURANCE OPTIONS REQUIRED (§ 38.2-3417)

A. An insurer issuing accident and sickness insurance or a corporation issuing
subscription contracts on an expense incurred basis shall make available in
offering such coverage or contract to the potential insured or contract holder
one or more of the following options under which the individual insured or group
certificate holder pays for:

   1. The first $100 of the cost of the services covered or benefits payable by
   the policy or contract during a 12-month period;

   2. Twenty percent of the first $1,000 of the cost of the services covered or
   benefits payable by the policy or contract during a 12-month period;

   3. The first $100 and 20 percent of the next $1,000 of the cost of the
   services covered or benefits payable by the policy or contract during a
   12-month period; or

   4. Any other option containing a greater deductible, coinsurance, or
   cost-sharing provision. However, the option shall not be inconsistent with
   standards established with respect to deductibles, coinsurance, or
   cost-sharing pursuant to &#xA7; 38.2-3519.

B. As used in this section, &#8220;make available&#8221; means that the insurer
or corporation shall disseminate information concerning the option or options
and make a policy or contract containing the option or options available to
potential insureds or contract holders at the same time and in the same manner
as the insurer or corporation disseminates information concerning other policies
or contracts and coverage options and makes other policies or contracts and
coverage options available.

C. This section shall not apply to short-term travel, accident only, or limited
or specified disease policies or contracts, nor to policies or contracts
designed for issuance to persons eligible for coverage under Title XVIII of the
Social Security Act, known as Medicare, or any other similar coverage under
state or federal governmental plans.

D. 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; 38.2-3438 et seq.) of Chapter 34.

HISTORY: 1981, c. 322, § 38.1-348.12:1; 1986, c. 562; 2013, c. 751; 2014, c.
814.