                                 CODE OF VIRGINIA

DEFINITIONS (§ 38.2-3551)

A. As used in this article:
			&#8220;Eligible dependent&#8221; means an individual who may be covered as a
dependent under a group health policy or policies and who is eligible, as
determined by a small employer health group cooperative, for coverage as a
dependent of an eligible employee under a group health policy or policies issued
to or through such small employer health group cooperative.
			&#8220;Eligible employee&#8221; means an employee who works for a small
employer on a full-time basis, has a normal work week of 30 or more hours, has
satisfied applicable waiting period requirements, and is not a part-time,
temporary, or substitute employee.
			&#8220;Employer-member&#8221; means a small employer participating in a small
employer health group cooperative.
			&#8220;Group health policy&#8221; or &#8220;policy&#8221; means a group
insurance policy providing hospital, medical and surgical or major medical
coverage on an expense-incurred basis, a group accident and sickness insurance
policy or subscription contract, and a group health care plan for health care
services or limited health care services provided by a health maintenance
organization. For the purposes of this article, a group health policy or policy
shall also mean a policy or plan provided by a dental or optometric services
plan, dental plan organization, and a health maintenance organization offering
limited health care services as defined in § 38.2-4300.
			&#8220;Health insurance issuer&#8221; or &#8220;issuer&#8221; means a company
authorized to issue coverage under Article 3 (§ 38.2-3521.1 et seq.) of Chapter
35, Chapter 42 (§ 38.2-4200 et seq.), Chapter 43 (§ 38.2-4300 et seq.),
Chapter 45 (§ 38.2-4500 et seq.), or Chapter 61 (§ 38.2-6100 et seq.) of this
title.
			&#8220;Health status-related factor&#8221; means the following in relation to
the individual or a dependent eligible for coverage under a group health plan or
health insurance coverage offered by a health insurance issuer:

   1. Health status;

   2. Medical condition, including both physical and mental illnesses;

   3. Claims experience;

   4. Receipt of health care;

   5. Medical history;

   6. Genetic information;

   7. Evidence of insurability, including conditions arising out of acts of
   domestic violence; or

   8. Disability.
   				&#8220;Service area&#8221; means the geographic area within which a health
   insurance issuer is authorized to sell a group health policy or policies.
   				&#8220;Small employer&#8221; means, in connection with a group health
   policy with respect to a calendar year and a plan year, an employer who
   employed an average of at least one but not more than 50 employees on business
   days during the preceding calendar year and who employs at least one employee
   on the first day of the plan year.
   				&#8220;Small employer health group cooperative&#8221; or
   &#8220;cooperative&#8221; means an entity authorized by its employer-members
   to negotiate with health insurance issuers on their behalf as to the terms,
   including premium rates, under which a group health policy or policies may be
   issued, providing coverage for the eligible employees of such employer-members
   and their eligible dependents.

B. 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: 2006, c. 427; 2013, c. 751; 2016, c. 1.