                                 CODE OF VIRGINIA

LIMITS OF GROUP ACCIDENT AND SICKNESS INSURANCE (§ 38.2-3522.1)

Group accident and sickness insurance offered to a resident of this Commonwealth
under a group accident and sickness insurance policy issued to a group other
than one described in § 38.2-3521.1 shall be subject to the following
requirements:

A. No such group accident and sickness insurance policy shall be delivered in
this Commonwealth unless the Commission finds that:

   1. The issuance of such group policy is not contrary to Virginia&#8217;s
   public policy and is in the best interest of the citizens of this
   Commonwealth;

   2. The issuance of the group policy would result in economies of acquisition
   or administration; and

   3. The benefits are reasonable in relation to the premiums charged.
   				Insurers filing policy forms seeking approval under the provisions of this
   subsection shall accompany the forms with a certification, signed by the
   officer of the company with the responsibility for forms compliance, in which
   the company certifies that each such policy form will be issued only where the
   requirements set forth in subdivisions 1 through 3 of this subsection have
   been met.

B. No such group accident and sickness insurance coverage may be offered in this
Commonwealth by an insurer under a policy issued in another state unless this
Commonwealth or another state having requirements substantially similar to those
contained in subdivisions 1, 2, and 3 of subsection A has made a determination
that such requirements have been met.

   1. An insurer offering group accident and sickness insurance coverage in this
   Commonwealth under this subsection shall file a certification, signed by the
   officer of the company having responsibility for forms compliance, in which
   the company certifies that all group insurance coverage marketed to residents
   of this Commonwealth under policies which have not been approved by this
   Commonwealth will comply with the provisions of &#xA7; 38.2-3521.1 or have met
   the requirements set forth in subdivisions A 1 through A 3 of this section,
   and which clearly demonstrates that the substantially similar requirements of
   the state in which the contract will be issued have been met. The
   certification shall be accompanied by documentation from such state,
   evidencing the determination that such requirements have been met.

   2. An insurer offering group accident and sickness insurance in this
   Commonwealth under this subsection that is unable to provide the documentation
   required in subdivision 1 of this subsection shall be required to file policy
   forms consistent with requirements in &#xA7; 38.2-316 which are imposed on
   policies issued in Virginia. The policy shall be required to be approved as
   meeting all requirements of this title prior to its being offered to residents
   of this Commonwealth.

C. The premium for the policy shall be paid either from the policyholder&#8217;s
funds or from funds contributed by the covered persons, or from both.

D. An insurer may exclude or limit the coverage on any person as to whom
evidence of individual insurability is not satisfactory to the insurer, except
as otherwise prohibited in this title.

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: 1998, c. 154; 2013, c. 751.