A. Coverage under a group accident and sickness insurance policy, except a policy issued pursuant to subsection B of § 38.2-3521.1, may be extended to insure:
1. The spouse and any child who is (i) under the age of 19 years, (ii) who is a dependent and under the age of 25 years, or (iii) who is a dependent and a full-time student under 25 years of age, without regard to whether such child resides in the same household as the insured group member, or any class of spouse and dependent children, of each insured group member who so elects; and
2. Any other class of persons as may mutually be agreed upon by the insurer and the group policyholder.
B. The amount of accident and sickness insurance for the spouse, dependent child or other person shall not exceed the amount of accident and sickness insurance for the insured group member.
C. At the insurer's option and subject to the policyholder's election, the coverage for children of the insured group member may be extended beyond the ages established in subsection A. Any such extension of coverage shall be as mutually agreed upon by the insurer and the group policyholder.
D. Notwithstanding the provisions of § 38.2-3538, one certificate may be issued for each insured group member if a statement concerning any spouse's, dependent child's, or other person's coverage is included in the certificate.
E. When a policy provides coverage for a dependent child who is enrolled based upon the child's status as a full-time student and such child is unable due to a medical condition to continue as a full-time student, coverage under the policy for such child nevertheless shall continue in force provided the child's treating physician certifies to the insurer at the time the child withdraws as a full-time student that the child's absence is medically necessary. Coverage for such child shall continue in force until the earlier of (i) the date that is 12 months from the date the child ceases to be a full-time student or (ii) the date the child no longer qualifies as a dependent child under the terms of the group policy. A child's status as a full-time student shall be determined in accordance with the criteria specified by the institution in which the child is enrolled.
F. 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 (§ 38.2-3438 et seq.) of Chapter 34.
1986, c. 562; 1993, c. 306; 1998, c. 154; 2004, c. 771; 2005, c. 871; 2007, c. 428; 2008, c. 209; 2011, c. 882.
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