A. Every individual policy, subscription contract or plan delivered, issued for delivery or renewal in this Commonwealth providing benefits to or on behalf of an individual shall provide for the renewability of such coverage at the sole option of the insured, policyholder, subscriber, or enrollee. The insurer, health services plan or health maintenance organization issuing such policy, subscription contract or plan shall be permitted to refuse to renew the policy, subscription contract or plan only for one or more of the following reasons:
1. Nonpayment of the required premiums by the insured, policyholder, subscriber, or enrollee, or such individual's representative;
2. In the event that the policy, subscription contract or plan contains a provision requiring the use of network providers, a documented pattern of abuse or misuse of such provision by the insured, policyholder, subscriber, or enrollee, continuing for a period of no less than two years;
3. Subject to the time limits contained in subdivision 2 of § 38.2-3503 or in regulations adopted by the Commission governing the practices of health maintenance organizations, for fraud or material misrepresentation by the individual, with respect to his application for coverage;
4. Eligibility of an individual insured for Medicare, provided that such coverage may not terminate with respect to other individuals insured under the same policy, subscription contract or plan and who are not eligible for Medicare; and
5. The insured, subscriber, or enrollee has not maintained a legal residence in the service area of the insurer, health services plan or health maintenance organization for a period of at least six months.
B. This section shall not apply to the following insurance policies, subscription contracts or plans:
1. Short-term travel;
2. Accident-only;
3. Disability income;
4. Limited or specified disease contracts;
5. Long-term care insurance;
6. Short-term nonrenewable policies or contracts of not more than six months' duration which are subject to no medical underwriting or minimal underwriting; and
7. Individual health insurance coverage as defined in subsection B of § 38.2-3431.
1996, c. 550; 1998, c. 24.
Structure Code of Virginia
Chapter 35 - Accident and Sickness Insurance Policies
§ 38.2-3501. Policy forms; powers of Commission
§ 38.2-3502. Notice to be printed on policy; return of policy to insurer
§ 38.2-3503. Required accident and sickness policy provisions
§ 38.2-3505. Inapplicable or inconsistent provisions
§ 38.2-3506. Order of certain policy provisions
§ 38.2-3507. Third-party ownership
§ 38.2-3508. Requirements of other jurisdictions
§ 38.2-3509. Denial or reduction of benefits because of existence of other like insurance
§ 38.2-3510. Conforming to statute
§ 38.2-3514.1. Preexisting conditions provisions
§ 38.2-3514.2. Renewability of coverage
§ 38.2-3518. Standards for policy provisions
§ 38.2-3519. Minimum standards for excepted benefits
§ 38.2-3520. Coverage of preexisting conditions
§ 38.2-3521.1. Group accident and sickness insurance definitions
§ 38.2-3521.2. Blanket accident and sickness insurance
§ 38.2-3522.1. Limits of group accident and sickness insurance
§ 38.2-3523.1. Review of records
§ 38.2-3523.2. Policies issued outside of the Commonwealth of Virginia
§ 38.2-3523.3. Requirements for those marketing group accident and sickness insurance
§ 38.2-3523.4. Minimum number of persons covered
§ 38.2-3526. Standard provisions required; exceptions
§ 38.2-3529. Entire contract; statements deemed representations
§ 38.2-3530. Evidence of individual insurability
§ 38.2-3531. Additional exclusions and limitations
§ 38.2-3532. Misstatement of age
§ 38.2-3533. Individual certificates
§ 38.2-3537. Time of payment of claims
§ 38.2-3538. Payment of benefits
§ 38.2-3539. Physical examinations and autopsy
§ 38.2-3540.1. Claims experience
§ 38.2-3540.2. Employee wellness program
§ 38.2-3541. Continuation on termination of eligibility
§ 38.2-3541.2. Enrollment following change in eligibility status under assistance programs
§ 38.2-3542. Notice to employees upon termination of coverage; penalty for failure to remit funds
§ 38.2-3543. Provisions required by other jurisdictions
§ 38.2-3543.2. Applicability of laws
§ 38.2-3544. Definition of industrial sick benefit insurance
§ 38.2-3545. Further restrictions as to beneficiaries
§ 38.2-3546. Cancellation of sick benefit portion of policy
§ 38.2-3547. Excessive insurance; remedy
§ 38.2-3548. Agents subject to other insurance laws
§ 38.2-3549. Benefits not subject to legal process
§ 38.2-3552. Small employer health group cooperatives
§ 38.2-3553. Membership in a small employer health group cooperative
§ 38.2-3554. Provisions relating to health insurance issuers