General Assembly>Division of Legislative Services>Publications>Session Summaries>2007>Insurance


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Insurance

Passed

P HB 1622

Group accident and sickness insurance; student medical leaves of absence. Requires that coverage under a health insurance policy for a dependent child who is enrolled as a full-time student shall continue in force for up to 12 months from the date the child ceases to be a full-time student if the child is unable to continue as a full-time student due to a medical condition. The child's treating physician must certify when the child withdraws from school that the absence is medically necessary. The measure applies only to covered children under age 25.
Patron - Alexander

P HB 1957

Insurance consultants; contracts. Requires those consultants that do not sell, solicit or negotiate insurance to enter into a written contract with clients prior to acting as a consultant. Consultants that sell, solicit or negotiate insurance will be required to enter into a written contract with clients before they purchase insurance. Currently, all consultants are required to enter into a written contract with clients prior to taking any action as a consultant.
Patron - Hargrove

P HB 2001

Life insurance; insurable interest requirement. Clarifies that the provisions addressing when a trustee has an insurable interest in a life insurance policy are to be applied whether the policy was owned by a trustee before, on, or after July 1, 2005, which is the effective date of the legislation that enacted such provisions. The measure also provides that the 2005 legislation was intended to permit charitable organizations that satisfied the criteria set out in the criteria of that law to continue to acquire charitable certificates after July 1, 2005.
Patron - Kilgore

P HB 2351

Virginia Life, Accident and Sickness Insurance Guaranty Association. Provides that a maximum of $250,000 in the present value of annuity benefits is to be considered in calculating the maximum amount of the contractual obligations for which the Virginia Life, Accident and Sickness Insurance Guaranty Association may become liable with respect to any one life. To qualify, an annuity shall be established and maintained as an individual retirement account, Section 457 Plan account, defined contribution plan account, or Keogh Plan account. The measure responds to recent FDIC rules that provide up to $250,000 of protection for bank deposits and accounts utilized for certain self-directed individual retirement accounts. The measure also increases the maximum amount that the Association may be liable to expend in the aggregate with respect to any one individual from $300,000 to $350,000.
Patron - Tata

P HB 2394

Insurance companies; confidentiality of analyses. Provides that regulatory analyses, financial analyses, and examination synopses, including working papers, concerning insurance companies or insurance transactions that are submitted to the Commission by the National Association of Insurance Commissioners shall be kept confidential. These confidentiality requirements are made applicable to health maintenance organizations.
Patron - Nixon

P HB 3016

Insurance agents; license termination. Repeals a provision that directs the automatic termination of an insurance agent's license for failure to hold at least one active appointment within 183 calendar days from the date of issuance of the insurance license or the cancellation by an insurer of an agent's only appointment.
Patron - Hargrove

P HB 3055

Miscellaneous casualty insurance; burglary and theft insurance. Authorizes miscellaneous casualty insurance and burglary and theft insurance policies to include appropriate provisions obligating the insurer to pay medical, hospital, surgical, and funeral expenses arising out of the death, dismemberment, sickness, or injury of any person, and death and dismemberment benefits in the event of death or dismemberment, if the death, dismemberment, sickness, or injury is caused by or is incidental to a cause of loss insured under the policy.
Patron - Purkey

P HB 3137

Expedited review of final adverse health coverage decisions. Requires the Commissioner of Insurance or his designee to issue a final ruling no later than one business day following the receipt of the impartial health entity's recommendation if the regular process for the issuance of a ruling will delay the rendering of treatment for a patient whose condition would be terminal without the treatment. Currently, the commissioner has 10 working days to issue his final ruling. The utilization review entity is required to comply with the Commissioner's ruling within three business days of receipt of an expedited ruling. The State Corporation Commission is required to promulgate regulations regarding expedited consideration of appeals in cases involving a terminal condition.
Patron - Fralin

P SB 1084

Pharmacy benefits management. Requires every contract for pharmacy benefits management to provide that payment for clean claims submitted electronically by participating pharmacies be paid electronically if the claim is required to be submitted electronically, the claim is in the form required by the payor, the pharmacy agrees to accept payments electronically, and the pharmacy provides accurate electronic funds transfer information. The measure will become effective if reenacted by the 2008 Session of the General Assembly.
Patron - Puckett

P SB 1113

Surplus lines insurance. Clarifies that an alien insurer cannot be approved as a surplus lines carrier unless it maintains at least $2.5 million in an irrevocable trust fund, in addition to capital and surplus requirements. Other provisions address the authority of the Commission to deem the capital and surplus requirements to be satisfied by an unlicensed insurer possessing less than that amount. The measure clarifies that the reporting date is March 1 unless the insurer's home state establishes a later date and makes several technical changes.
Patron - Miller

P SB 1303

Health maintenance organizations; conversions. Establishes a procedure by which a health maintenance organization may convert, without reincorporating, to an accident and sickness insurer.
Patron - Newman

P SB 1317

Insurance; risk-based capital. Corrects an erroneous cross-reference regarding the definition of adjusted risk-based capital reports. The measure also clarifies that negative trend, in the context of a life and health insurer, is determined in accordance with the trend test calculation included in the life insurance risk-based capital instructions. Finally, provisions regarding the trend test for property and casualty insurers are added.
Patron - Colgan

Failed

F HB 1954

Pharmacy benefits managers. Establishes requirements for the regulation of pharmacy benefits managers within the Commonwealth. The measure provides that a pharmacy benefits manager owes a fiduciary duty to an entity providing health coverage, and requires a pharmacy benefits manager to perform its duties with care, skill, prudence, and diligence and in accordance with the standards of conduct applicable to a fiduciary in an enterprise of a like character and with like aims. In addition, it establishes requirements for prompt payment of claims and disclosures and other contractual provisions in agreements between pharmacy benefits managers and pharmacy providers.
Patron - Morgan

F HB 1958

Insurance continuing education board; membership. Increases the size of the insurance continuing education board from 12 to 14 persons. The two new members may be appointed without regard to their affiliation with any insurance entity.
Patron - Hargrove

F HB 1975

Health insurance; mandated coverage for CyberKnife procedures. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the cost of procedures utilizing CyberKnife or a like noninvasive radiosurgery technology that uses an image guided localization system to locate the position of a tumor and deliver concentrated and accurate beams of radiation to targets for the treatment of cancerous tumors.
Patron - Fralin

F HB 1994

Title insurance; settlement subsidies. Authorizes a title insurance company, title insurance agency, or agent to pay to a settlement agent a portion of the premium that is payable on a title insurance policy purchased by the purchaser or borrower in the real estate transaction, where the payment is used to subsidize the costs of the escrow, closing or settlement services.
Patron - Suit

F HB 2120

Small Employer Health Insurance Exchange. Creates the Small Employer Health Insurance Exchange as a nonprofit legal entity and charges it with providing a single, centralized market, analogous to a stock exchange, to facilitate the buying and selling of health insurance for employers with 100 or fewer employees. Employers may designate the exchange as their group health insurance plan for purposes of federal law and may allow employees to purchase health insurance coverage through the Exchange. The Exchange will offer an annual open season during which participants could select or switch coverage. After the first day of the plan year following the first regular open season conducted by the Exchange, no carrier may issue or renew a group health benefit plan for employers with 100 or fewer employees, other than through the Exchange.
Patron - Marshall, R.G.

F HB 2121

Virginia Health Insurance Exchange. Creates the Virginia Health Insurance Exchange as a nonprofit legal entity and charges it with providing a single, centralized system to facilitate the buying and selling of health insurance. Employers may designate the exchange as their group health insurance plan for purposes of federal regulation and tax law and allow employees to purchase health insurance coverage through the Exchange. The Exchange would offer an annual open season during which participants could select or switch coverage. The Commonwealth is directed to enter into an agreement with the Exchange to be the sponsor of a participating employer plan on behalf of current and retired state employees. After the first day of the plan year following the first regular open season conducted by the Exchange, no carrier may issue or renew an individual or small employer group health benefit plan, other than through the Exchange. Effective January 1, 2009, individuals are required to shall offer proof of their ability to pay for medical care for themselves and their dependents by either having insurance overage or posting a $10,000 bond or letter of credit.
Patron - Marshall, R.G.

F HB 2122

Virginia Health Reinsurance Pool Act. Establishes the Virginia Health Insurance Risk Transfer Plan as a nonstock corporation, and every health insurance carrier writing health insurance in the Commonwealth, except Medicaid-only health maintenance organizations and certain other carriers, shall be a member. Self-funded health insurance plans may also become members, provided that, if they join the pool, they are required to remain liable for Pool assessments for three years after withdrawing from the Plan. Voting power is allocated based on the number of covered individuals, provided members will have no more than 49% of the voting power. The Plan is directed to submit to the Commissioner of Insurance a proposed plan of operation that provides for the creation of a reinsurance pool. Members may cede risk to the reinsurance pool. Plan members ceding a risk to the Pool shall pay the Pool a premium determined by the rules governing the Pool.
Patron - Marshall, R.G.

F HB 2149

Individual health insurance policies; Medicare coverage. Requires any individual health insurance policy that is issued for delivery, or renewed on or after July 1, 2007, to include a notice stating whether the policy provides coverage for all medical treatments that are covered under Medicare Parts A and B.
Patron - Fralin

F HB 2156

Health insurance; mandated coverage for evaluations of brain tumors. Requires health insurers, health maintenance organizations, and corporations providing healthcare coverage subscription contracts to provide coverage for a second opinion evaluation, at a medical center designated by the National Cancer Institute as a comprehensive cancer center, of a brain tumor that has been diagnosed as a primary malignant brain tumor.
Patron - O'Bannon

F HB 2426

Health insurance; coverage for bone marrow transplants. Repeals the provision that has required health insurers, health care subscription plans, and health maintenance organizations to offer and make available coverage for the treatment of breast cancer by dose-intensive chemotherapy/autologous bone marrow transplants or stem cell transplants.
Patron - Byron

F HB 2447

Health insurance; mandated coverage for enteral formulas necessitated by inborn metabolic disorders. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage, under a policy, contract, or plan that provides prescription drug coverage, for enteral formulas, including modified solid food products, necessitated by inborn metabolic disorders. The coverage for modified solid food products is limited to $5,000 in any year.
Patron - Frederick

F HB 2492

Licensing of insurance agents. Requires that applicants for insurance licensure submit fingerprints for a criminal history records check. The bill also allows any current or former law-enforcement officer applying for a license to provide an alternative address for purposes of service of process.
Patron - Albo

F HB 2543

Motor vehicle repair labor rates; survey; report. Requires the State Corporation Commission to conduct quarterly surveys of a sample of motor vehicle repair facilities in the Commonwealth to collect information regarding their hourly labor rates for body repair work. The results, including information for each Department of Transportation Regional Districts, shall be available to the public and posted to the Bureau of Insurance website. No person shall be required to pay rates for body repair work based on the results of the surveys.
Patron - Lingamfelter

F HB 2562

Joint payment of health insurance claims. Requires every health insurer, health services plan, or health maintenance organization, when paying a claim for services rendered by a health care provider that does not participate in the provider panel, to pay the claim by sending a check made payable to both the insured, subscriber, or member and to the nonparticipating health services provider.
Patron - Ware, R.L.

F HB 2635

Special Advisory Commission on Mandated Health Insurance Benefits. Abolishes the Special Advisory Commission on Mandated Health Insurance Benefits.
Patron - Reid

F HB 2683

Motor vehicle insurance; premiums based on credit. Prohibits insurers from setting rates for motor vehicle insurance on the basis of a person's credit history or credit score.
Patron - Frederick

F HB 2792

Insurable interest in life insurance polices; void. Clarifies that a trustee has an insurable interest in a life insurance policy and makes the same retroactive.
Patron - Lohr

F HB 2877

Health insurance; mandated coverage for human papillomavirus vaccinations. Requires health insurers, healthcare subscription plans, and health maintenance organizations to provide coverage for the cost of human papillomavirus vaccinations for women in accordance with recommendations of the Center for Disease Control's Advisory Committee on Immunization Practices.
Patron - McEachin

F HB 2887

Insurance; use of credit history. Prohibits insurers and agents from setting rates or making policy issuance and renewal decisions for motor vehicle insurance, homeowners insurance, and renters insurance on the basis of a person's credit history, lack of credit history, or credit score.
Patron - Phillips

F HB 2908

Motor vehicle insurance; rate increases. Prohibits a motor vehicle insurer from increasing the premium for renewal of a policy of motor vehicle insurance as a result of any claim made under the policy due to an accident for which the insured was neither wholly nor partially at fault.
Patron - Spruill

F HB 2949

Health insurance; mandated coverage for treatment by intensity modulated radiation therapy. Requires health insurers, health maintenance organizations, and corporations providing health care coverage subscription contracts to provide coverage for the treatment by intensity modulated radiation therapy of tumors when such treatment is performed pursuant to protocol dose volume constraints approved by the institutional review board of any United States medical teaching college or the National Cancer Institute. The requirement for coverage applies only if the patient resides within a medically underserved area of the Commonwealth.
Patron - Wittman

F HB 3035

Insurance; unfair claims settlement practices. Provides that the unfair insurance claim settlement practices identified in current law apply to uninsured and underinsured motorist claims presented to the insurer whether such claims are presented before or after judgment against the uninsured or underinsured tortfeasor.
Patron - Nixon

F HB 3042

Fire Programs Fund. Increases the assessment on certain property and casualty insurers for the Fire Programs Fund from one percent to two percent of their total direct gross premium income.
Patron - BaCote

F HB 3160

Health insurance; policies to protect the uninsured. Authorizes health insurers, health plans, and health maintenance organizations to offer "Protect the Uninsured" (PTU) policies. PTU polices may be sold to small employers with no more than 50 employees, to provide coverage for their employees who have been uninsured for the preceding six months. The coverage provided under a PTU policy will be determined at the discretion of the health insurer issuing the policy, and specifically is not required to include state-mandated health benefits.
Patron - Marshall, D.W.

F SB 774

Birth-Related Neurological Injury Compensation Program; board of directors. Increases the number of members of the board of directors of the Birth-Related Neurological Injury Compensation Program from seven to eight and directs that one member shall be the parent of an infant who is a claimant and has been awarded benefits under the Act.
Patron - Cuccinelli

F SB 931

Health insurance; mandated coverage for prosthetic devices and components. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the cost of prosthetic devices and components, if the treating physician certifies the medical necessity of the prosthetic device and component as a proposed course of treatment. The coverage shall, at a minimum, equal the coverage provided under provisions of the federal Medicare program.
Patron - Ticer

F SB 991

Health insurance; coverage for bone marrow transplants. Repeals the provision that requires health insurers, health care subscription plans, and health maintenance organizations to offer and make available coverage for the treatment of breast cancer by dose-intensive chemotherapy/autologous bone marrow transplants. The existing requirement that health insurers, health care subscription plans, and health maintenance organizations offer and make available coverage for the treatment of breast cancer by stem cell transplants is unchanged.
Patron - Blevins

F SB 1336

Health insurance; accurate utilization data. Requires a health insurance issuer offering group health insurance coverage to provide an employer with correct data regarding the utilization of benefits and services by covered individuals. A health insurance issuer that fails to provide correct data to an employer is liable to the employer for an amount equal to 25% of the annual premium for a first violation and 50% for a second or subsequent violation.
Patron - Ruff

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