                                 CODE OF VIRGINIA

ELIGIBILITY TO ENROLL (§ 38.2-3436)

A. A health insurance issuer offering group health insurance coverage, may not
establish rules for eligibility (including continued eligibility) of any
individual to enroll under the terms of the plan based on any of the health
status-related factors.

B. The provisions of this section shall not be construed:

   1. To require a group health insurance coverage to provide particular benefits
   other than those provided under the terms of such plan or coverage; or

   2. To prevent a health insurance issuer offering group health insurance
   coverage from establishing limitations or restrictions on the amount, level,
   extent or nature of the benefits or coverage for similarly situated
   individuals enrolled in the plan or coverage rules for eligibility to enroll
   under a plan which includes rules defining any applicable waiting periods for
   such enrollment.

C. A health insurance issuer offering group health insurance coverage, may not
require an individual (as a condition of enrollment or continued enrollment
under the plan) to pay a premium or contribution which is greater than such
premium or contribution for a similarly situated individual enrolled in the plan
on the basis of any health status related factor in relation to the individual
or to an individual enrolled under the plan as a dependent of the individual.

D. Nothing in subsection C shall be construed:

   1. To restrict the amount that an employee may be charged for coverage under a
   group health plan or group health insurance coverage; or

   2. To prevent a health insurance issuer offering group health insurance
   coverage, from establishing premium discounts or rebates or modifying
   otherwise applicable copayments or deductibles in return for adherence to
   programs of health promotion and disease prevention.

E. 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: 1997, cc. 807, 913; 2013, c. 751.