                                 CODE OF VIRGINIA

DEFINITIONS (§ 38.2-3430.2)

A. The terms defined in &#xA7; 38.2-3431 that are used in this article shall
have the meanings set forth in that section.

B. For purposes of this article:
			&#8220;Eligible individual&#8221; means an individual:

   1. (i) for whom, as of the date on which the individual seeks coverage under
   this section, the aggregate of the periods of creditable coverage is 18 or
   more months and (ii) whose most recent prior creditable coverage was under
   individual health insurance coverage, a group health plan, governmental plan,
   church plan, or a state plan under Title XIX of the Social Security Act (42
   U.S.C. &#xA7; 1396 et seq.), or health insurance coverage offered in
   connection with any such plan;

   2. Who is not eligible for coverage under (i) a group health plan, (ii) part A
   or part B of Title XVIII of the Social Security Act, or (iii) a state plan
   under Title XIX of such Act, or any successor program, and does not have other
   health insurance coverage;

   3. With respect to whom the most recent coverage within the coverage period
   described in subdivision 1 was not terminated based on a factor described in
   subdivision B 1 or B 2 of &#xA7; 38.2-3430.7 relating to nonpayment of
   premiums or fraud;

   4. If the individual had been offered the option of continuation coverage
   under a COBRA continuation provision or under a similar state program, who
   elected such coverage;

   5. Who, if the individual elected such continuation coverage, has exhausted
   such continuation coverage under such provision or program; and

   6. In the case where individual health insurance coverage is the most recent
   creditable coverage, the coverage was nonrenewed by the health insurance
   issuer under the conditions allowed in subdivision C 2 of &#xA7; 38.2-3430.7,
   in which case the aggregate period of creditable coverage required is reduced
   to 12 months.
   				For the purposes of determining the aggregate of the periods of creditable
   coverage under subdivision B 1 (i) of this section, a period of creditable
   coverage shall not be counted with respect to enrollment of an individual
   under a health benefit plan if, after such period, there was a 63-day period
   during all of which the individual was not covered under any creditable
   coverage or was not serving a waiting period for coverage under a group health
   plan, or for group health insurance coverage or was in an affiliation period.
   This period shall begin on the day following an individual&#8217;s termination
   of coverage and shall continue until the date an individual submits an
   application for coverage. In those cases where an application is submitted by
   mail, the date of postmark shall be deemed to be the date the application is
   submitted.

HISTORY: 1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.