                                 CODE OF VIRGINIA

APPLICABILITY OF CERTAIN SECTIONS (§ 38.2-3445.06)

A. Except as provided in this section, the provisions of &#xA7;&#xA7; 38.2-3445
through 38.2-3445.05 shall not apply to an entity providing or administering an
employee welfare benefit plan, as defined in &#xA7; 3(1) of the Employee
Retirement Income Security Act of 1974, 29 U.S.C. &#xA7; 1002(1), that is
self-insured or self-funded with respect to such plan. Such an entity may elect
to be subject to the provisions of &#xA7;&#xA7; 38.2-3445 through 38.2-3445.06
in the same manner as applied to a health carrier by providing notice to the
Commission annually, in a form and manner prescribed by the Commission,
attesting to the plan&#8217;s participation and agreeing to be bound by the
provisions of &#xA7;&#xA7; 38.2-3445 through 38.2-3445.06. Such entity shall
amend the plan, policies, contracts, and other documents to reflect such
election. In addition, the entity that elects to opt in pursuant to this section
shall file current plan documentation confirming that the plan accepts the
obligations of &#xA7;&#xA7; 38.2-3445 through 38.2-3445.06 and attests that any
amended plan documents will be filed with the Commission before the effective
date of such amendments. The Commission shall post on its website a list of
entities, including relevant plan information, that have elected to be subject
to the provisions of &#xA7;&#xA7; 38.2-3445 through 38.2-3445.06. The Commission
shall update such list at least once per quarter.

B. The provisions of &#xA7;&#xA7; 38.2-3445.01 and 38.2-3445.02 shall not apply
to services when the provider&#8217;s fees are subject to schedules or other
monetary limitations under any other law, including the Virginia Workers&#8217;
Compensation Act, and such sections shall not preempt any such law.

C. The provisions of &#xA7;&#xA7; 38.2-3445 through 38.2-3445.05 shall apply to
health coverage insurance offered to state employees pursuant to &#xA7; 2.2-2818
and may apply to health insurance coverage offered to employees of local
governments, local officers, teachers, and retirees, and the dependents of such
employees, officers, teachers, and retirees pursuant to &#xA7; 2.2-1204.

D. Except for its facilitation of arbitration pursuant to &#xA7; 38.2-3445.02
and its role in any appeals process established pursuant to subsection J of
&#xA7; 38.2-3445.02, the Commission shall have no jurisdiction to resolve
disputes arising out of &#xA7; 38.2-3445.01.

E. Except for in a provider contract between a carrier and an in-network
provider, no person shall waive, be required to waive, or require another person
to waive the provisions of &#xA7;&#xA7; 38.2-3445 through 38.2-3445.05.

HISTORY: 2020, cc. 1080, 1081.