                                 CODE OF VIRGINIA

SPECIAL RULES FOR NETWORK PLANS (§ 38.2-3430.4)

A health insurance issuer that offers health insurance coverage in the
individual market may:

1. Limit the eligible individuals who may be enrolled under such coverage to
those who live, reside, or work within the service area for such network plan;

2. Within the service area of such plan, deny such coverage to such individuals
if the health insurance issuer has demonstrated to the Commission that: (i) it
will not have the capacity to deliver services adequately to additional
individual enrollees because of its obligations to existing group contract
holders, enrollees and enrollees covered under individual contracts; and (ii) it
is applying this section uniformly to individuals without regard to any health
status-related factor of such individuals and without regard to whether the
individuals are eligible individuals;

3. A health insurance issuer, upon denying health insurance coverage in any
service area in accordance with subdivision 2, may not offer coverage in the
individual market within such service area for a period of 180 days after such
coverage is denied.

HISTORY: 1997, cc. 807, 913; 1998, c. 24.