Article 1 Individual Accident and Sickness Insurance Policies 38.2-3500 – 38.2-3515
Article 2 Individual Accident and Sickness Insurance Minimum Standards 38.2-3516 – 38.2-3520
Article 3 Group Accident and Sickness Insurance Policies 38.2-3521.1 – 38.2-3543.2
Article 4 Industrial Sick Benefit Insurance 38.2-3544 – 38.2-3550
Article 5 Small Employer Health Insurance Pooling 38.2-3551 – 38.2-3555

Terms Used In Virginia Code > Title 38.2 > Chapter 35

  • Accident and sickness insurance: means insurance against loss resulting from sickness, or from bodily injury or death by accident or accidental means, or from a combination of any or all of these perils. See Virginia Code 38.2-109
  • Adult: means a person 18 years of age or more. See Virginia Code 1-203
  • Commission: means the State Corporation Commission. See Virginia Code 38.2-100
  • Company: means any association, aggregate of individuals, business, corporation, individual, joint-stock company, Lloyds type of organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Virginia Code 38.2-100
  • cooperative: 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. See Virginia Code 38.2-3551
  • Eligible employee: 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. See Virginia Code 38.2-3551
  • Employer-member: means a small employer participating in a small employer health group cooperative. See Virginia Code 38.2-3551
  • Form: means policies, contracts, riders, endorsements, and applications. See Virginia Code 38.2-3517
  • Health services plan: means any arrangement for offering or administering health services or similar or related services by a corporation licensed under Chapter 42 (§ 38. See Virginia Code 38.2-100
  • Health status-related factor: 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. See Virginia Code 38.2-3551

  • in writing: include any representation of words, letters, symbols, numbers, or figures, whether (i) printed or inscribed on a tangible medium or (ii) stored in an electronic or other medium and retrievable in a perceivable form and whether an electronic signature authorized by Chapter 42. See Virginia Code 1-257
  • Insurance: means the business of transferring risk by contract wherein a person, for a consideration, undertakes (i) to indemnify another person, (ii) to pay or provide a specified or ascertainable amount of money, or (iii) to provide a benefit or service upon the occurrence of a determinable risk contingency. See Virginia Code 38.2-100
  • insurance policies: shall include contracts of fidelity, indemnity, guaranty and suretyship. See Virginia Code 38.2-100
  • insured: as used in this article , shall not be construed to prevent a person with a proper insurable interest from applying for and owning a policy covering another person or from being entitled to any indemnities, benefits and rights provided under the policy. See Virginia Code 38.2-3507
  • Insurer: means an insurance company. See Virginia Code 38.2-100
  • issuer: means a company authorized to issue coverage under Article 3 (§ 38. See Virginia Code 38.2-3551
  • Life insurance: includes policies that also provide (i) endowment benefits; (ii) additional benefits incidental to a loss in the event of death, dismemberment, or loss by accident or accidental means; (iii) additional benefits to safeguard the contract from lapse or to provide a special surrender value, a special benefit or an annuity, in the event of total and permanent disability of the insured; and (iv) optional modes of settlement of proceeds. See Virginia Code 38.2-102
  • Medicare: means the "Health Insurance for the Aged Act" Title XVIII of the Social Security Amendment of 1965, as amended. See Virginia Code 38.2-100
  • Month: means a calendar month and "year" means a calendar year. See Virginia Code 1-223
  • Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds type of organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Virginia Code 38.2-100
  • Personal representative: includes the executor of a will or the assets of the estate, pay debts, and distribute residue to those entitled to it. See Virginia Code 1-234
  • Policy: means the entire contract between the insurer and the insured, including the policy riders, endorsements, and the application, if attached. See Virginia Code 38.2-3517
  • policy: 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. See Virginia Code 38.2-3551
  • Process: includes subpoenas, the summons and complaint in a civil action, and process in statutory actions. See Virginia Code 1-237
  • rates: means any rate of premium, policy fee, membership fee or any other charge made by an insurer for or in connection with a contract or policy of insurance. See Virginia Code 38.2-100
  • Service area: means the geographic area within which a health insurance issuer is authorized to sell a group health policy or policies. See Virginia Code 38.2-3551
  • Small employer: 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. See Virginia Code 38.2-3551
  • State: means any commonwealth, state, territory, district or insular possession of the United States. See Virginia Code 38.2-100
  • Subscriber: means a person obligated under a reciprocal insurance agreement. See Virginia Code 38.2-1201
  • United States: includes the 50 states, the District of Columbia the Commonwealth of Puerto Rico, Guam, the Northern Mariana Islands and the United States Virgin Islands. See Virginia Code 1-255