General Assembly>Division of Legislative Services>Publications>Session Summaries>2008>Insurance

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Insurance

Passed

P HB116

Foreign title insurance companies; unearned premium reserves. Authorizes foreign title insurance companies to establish and maintain unearned premium reserves on title insurance policies issued on Virginia properties pursuant to the reserving laws of the companies' domiciliary regulator, if the domiciliary regulator is accredited under the National Association of Insurance Commissioner's Financial Regulation Standards and Accreditation Program. Currently, foreign title insurance companies are required to maintain unearned premium reserves at the higher of the amount required of domestic title insurance companies or the amount required in the jurisdiction of domicile.
Patron - Ware, R.L.

P HB196

Group health insurance; coverage for students. Clarifies that when a group health insurance policy provides coverage for a dependent child who is enrolled based upon his status as a full-time student and who becomes unable to continue as a full-time student due to a medical condition, coverage under the policy will continue if the child's treating physician certifies that the child's absence is medically necessary. Coverage for the child shall continue until (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 under the group policy, whichever first occurs.
Patron - Alexander

P HB298

Surplus lines insurance; "diligent effort" requirement. Eliminates the requirement that surplus lines brokers make a diligent effort to procure insurance, in a form and at a premium acceptable to the insured, from an insurer licensed in Virginia before he provides a surplus lines policy.
Patron - Hargrove

P HB336

Insurance market analyses; confidentiality. Establishes that (i) market analyses concerning insurance companies and obtained from the National Association of Insurance Commissioners, (ii) all market analyses generated by the State Corporation Commission, (iii) working papers, recorded information, and documents generated in the course of a market analysis or market conduct action, and (iv) documents or information received in the course of a market analysis or market conduct action from the NAIC, a law-enforcement official of any state or country, or regulatory officials of any state or country that are confidential in those jurisdictions shall receive confidential treatment by the Commission, shall not be subject to subpoena, and are not public records. The measure also requires the Commission to consider the results of market analyses in determining the nature, scope, and frequency of insurance company examinations. Finally, the measure provides that procedures for market conduct examinations shall be subject to provisions regarding confidentiality of ancillary information and immunity from liability.
Patron - McClellan

P HB349

Insurance licensing; certificates of authority. Eliminates the requirement that a foreign or domestic business entity first obtain a certificate of authority, including a certificate of registration, certificate of organization, certificate of limited partnership, or charter, from the State Corporation Commission prior to being eligible to obtain a license as an insurance agent, consultant, surplus lines broker, or viatical settlement broker.
Patron - Plum

P HB397

Health maintenance organizations; deductibles. Removes limitations on the deductibles or co-payments, or both, that a health maintenance organization may require enrollees to pay.
Patron - Hamilton

P HB431

Title insurance agents; pre-licensing education course. Requires applicants for a resident title insurance agent license to have completed, within the year preceding application and examination, at least 16 hours of instruction through a classroom or distance education.
Patron - Frederick

P HB504

Health insurance; exclusive provider policies or contracts. Authorizes insurers to offer individual or group exclusive provider policies or contracts, which are insurance policies or contracts that condition the payment of benefits on the use of preferred providers. The insurer is required to provide an option in group contracts whereby each enrollee may, at no additional cost to the group contract holder, select a benefit for preferred and nonpreferred providers. Exclusive provider policies or contracts shall provide out-of-network emergency services at the minimum level required by the preferred provider policy or contract.
Patron - Hamilton

P HB542

Insurance agents; notice of appointment. Requires the insurer, rather than the State Corporation Commission, to notify an appointed agent of the status of his appointment. The notice shall be given within five business days of the insurer's receipt of notice from the Commission that the appointment of the agent is valid or invalid. An agent is prohibited from selling or soliciting insurance after receiving notice of an invalid appointment.
Patron - Nixon

P HB549

Insurance; funding agreements. Provides that the assets of a separate account to which an insurer has allocated assets under a funding agreement shall not be chargeable with liabilities arising out of any other business that the insurer conducts. If a separate account is not chargeable with liabilities arising out of such other business, a risk charge will be payable from the separate account to the insurer's general account. The measure also provides that funding agreement assets held in the insurer's general account, and other obligations due under the funding agreement from the general account, will be treated as an insurance contract. In addition, a domestic insurer that has established separate accounts for funding agreements and has allocated funds to such separate accounts shall file with the State Corporation Commission any prescribed periodic or special reports. An insurer shall not make an agreement providing for the allocation of funding agreement amounts to a separate account until a statement as to its methods of operation has been approved by the Commission.
Patron - Nixon

P HB728

Uniform group health insurance application form. Directs the State Corporation Commission's Bureau of Insurance, with the assistance of a work group comprised of representatives of health insurers, insurance agent organizations, employer organizations, and the Virginia Association of Health Plans, to develop a uniform group health insurance application form. The development of the uniform form is to be completed by July 1, 2009. Upon completion of the form, the Bureau shall provide copies to insurers, along with instructions for its use.
Patron - Scott, E.T.

P HB831

State Corporation Commission; confidentiality. Authorizes the State Corporation Commission to share information with local law-enforcement authorities, provided the recipient agrees to maintain its confidential and privileged status.
Patron - Hargrove

P HB914

Nonrenewal of liability, fire, and motor vehicle insurance policies. Establishes exceptions to prohibitions on the refusal to renew certain liability, fire, and motor vehicle insurance policies. Such renewal provisions will not apply to an insurer if an affiliated insurer has manifested its willingness to provide coverage at a lower premium than would have been charged for the same exposures on the expiring policy. SB 612 is identical.
Patron - Purkey

P HB1176

Motor vehicle insurance; payments for paint and materials. Provides that setting arbitrary and unreasonable limits on what an insurer will allow as reimbursement for paint and materials is an unfair settlement practice. Identical to SB 697.
Patron - Lingamfelter

P HB1305

Virginia Birth-Related Neurological Injury Compensation Program. Increases the annual assessment for physicians who participate in the Virginia Birth-Related Neurological Injury Compensation Program from its current level of $5,300 to $5,600, which amount will increase thereafter to a maximum of $6,200. The annual participating hospital assessment will increase from $50 per live birth to $52.50 per live birth in 2008, which amount will increase each year thereafter by $2.50 per live birth to a maximum of $55 per live birth. The size of the board of directors of the Program is increased from seven to nine. Provision is made for covered expenses to cover therapeutic, nursing and attendant care, medications and supplies, and for attendant nursing care that is provided by the claimant's relatives when beyond what is normally provided family members of uninjured children. The measure also (i) requires that only one member of the panel of physicians be from the field of obstetrics; and (ii) requires the Program to pay $3,000 per claim reviewed to the medical school that performs an assessment; and (iii) clarifies the method for calculating payments for loss of earnings. SB 211 is identical.
Patron - Morgan

P HB1512

Health care sharing ministries. Declares that insurance laws do not apply to a health care sharing ministry. A health care sharing ministry that, through its publication to members, solicits funds for the payment of medical expenses of other members, will not be considered to be engaging in the business of insurance and will not be subject to the jurisdiction of the State Corporation Commission. A health care sharing ministry is a health care cost sharing arrangement among individuals of the same religion, administered by a non-profit, tax-exempt organization that, among other things, acts as an organizational clearinghouse for information about members who have financial or medical needs and matches them with members with the ability to assist those with such needs, and provides for the financial or medical needs of members through payments directly from one member to another.
Patron - Byron

P SB182

Insurance company investments; preferred stocks. Revises the rating criteria stated for preferred stock in which a domestic insurer may invest. References to specific rating categories of the National Association of Insurance Commissioners' Securities Valuation Office are deleted, and in their place are added the categories of "highest quality," "high quality," and "medium quality."
Patron - Miller, Y.B.

P SB207

Foreign and alien insurers; exemption for insuring industrial insureds. Revises the criteria for qualifying as an industrial insured. Certain acts involving insurance contracts issued to an industrial insured are excluded from the acts that constitute transacting the business of insurance in the Commonwealth. The revisions to the criteria (i) allow the insured to procure insurance by using a licensed insurance consultant, (ii) increase the required amount of annual insurance premiums from $25,000 to $100,000, and (iii) require the insured to have either gross assets in excess of $3 million or annual gross revenues in excess of $5 million. Other revisions specify that the insured risks do not include life or annuity contracts and that the aggregate annual premiums do not include premiums from life, annuity, and accident and sickness insurance.
Patron - Stosch

P SB211

Virginia Birth-Related Neurological Injury Compensation Program. Increases the annual assessment for physicians who participate in the Virginia Birth-Related Neurological Injury Compensation Program from its current level of $5,300 to $5,600, which amount will increase thereafter to a maximum of $6,200. The annual participating hospital assessment will increase from $50 per live birth to $52.50 per live birth in 2008, which amount will increase each year thereafter by $2.50 per live birth to a maximum of $55 per live birth. The size of the board of directors of the Program is increased from seven to nine. Provision is made for covered expenses to cover therapeutic, nursing and attendant care, medications and supplies, and for attendant nursing care that is provided by the claimant's relatives when beyond what is normally provided family members of uninjured children. The measure also (i) requires that only one member of the panel of physicians be from the field of obstetrics; (ii) requires the Program to pay $3,000 per claim reviewed to the medical school that performs an assessment; and (iii) clarifies the method for calculating payments for loss of earnings. HB 1305 is identical. SB 568 is incorporated into this bill.
Patron - Edwards

P SB212

Virginia Birth-Related Neurological Injury Compensation Act; evidence. Allows all parties to a claim under the Virginia Birth-Related Neurological Injury Compensation Act to confront and cross-examine witnesses, and provides that a party shall not be precluded from conducting depositions of any witness from whom evidence is elicited. The measure also creates a mechanism for voiding an adverse determination in a claim made pursuant to Chapter 919 of the 2006 Acts of Assembly where a party was denied the opportunity to confront and cross-examine witnesses against him. In order to have the adverse determination voided, the party is required to file a petition on or before July 1, 2009. Any new review would be de novo. HB 222 is identical.
Patron - Edwards

P SB403

Ethics and fairness in carrier business practices; payment of claims for pharmacy benefits. Requires contracts between a health insurance carrier and its administrator of pharmacy benefits to make payments of clean claims electronically to the participating provider or its designee if the contract with the provider requires claims to be submitted electronically. The measure applies to contracts entered into, amended, extended or renewed on or after January 1, 2009.
Patron - Puckett

P SB612

P SB697

P SB785

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. The similar requirement in the state employee's health insurance program is also deleted.
Patron - Blevins

Failed

F HB83

Mandated coverage for habilitative services for children. Requires insurance companies to provide coverage for habilitative services for children.
Patron - Marshall, R.G.

F HB222

F HB237

Health insurance; mandated coverage for hearing aids for minors. Requires health insurers, health maintenance organizations, and corporations providing health care coverage subscription contracts to provide coverage for hearing aids and related services for children from birth to age 18 when a licensed audiologist prescribes such hearing aids and related services. The coverage shall include one hearing aid per hearing-impaired ear, up to a cost of $1,500, every 24 months.
Patron - Cosgrove

F HB250

Managed Care Health Insurance Plans. Allows a new health maintenance organization to obtain its HMO license contingent upon the Department of Health's issuance of a certificate of quality assurance. Other revisions streamline and update procedures for obtaining MCHIP licenses.
Patron - O'Bannon

F HB252

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 HB318

Hospitalization insurance; balance billing by nonparticipating physicians. Prohibits a physician who does not participate in a health insurance carrier's provider panel from balance billing an enrollee for the difference between his charges and the amount paid by the carrier for covered services performed at a participating hospital, unless the hospitalized enrollee has consented in writing, prior to receiving the services, to the use of the nonparticipating physician.
Patron - Cox

F HB615

Health insurance; required coverage for medically necessary amino acid-based elemental formulas. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the provision of medically necessary amino acid-based elemental formulas, regardless of delivery method, for the treatment of Immunoglobulin E and non-Immunoglobulin E mediated allergies to multiple food proteins, food protein-induced enterocolitis syndrome, eosinophilic disorders, and impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, and motility of the gastrointestinal tract. Coverage is also required for the diagnosis of such conditions.
Patron - Amundson

F HB667

Health insurance; coverage for alternatives to surgery. Requires health insurers, corporations providing accident and sickness subscription contracts, and health maintenance organizations whose policies, contracts or plans cover surgical treatment of a medical condition or disease to also cover a nonsurgical treatment for the condition or disease if it is (i) less expensive, (ii) less dangerous, (iii) not experimental or investigational, (iv) generally recognized by the regional medical community as an appropriate treatment for the condition or disease, and (v) not less efficacious than the surgical treatment.
Patron - Marshall, R.G.

F HB668

Individual health insurance; statements regarding grounds for refusal to cover. Requires health insurers, health care subscription plans, and health maintenance organizations to file with the State Corporation Commission statements that identify, with respect to each policy, contract, or plan that offers individual health insurance coverage to residents of the Commonwealth, (i) medical conditions that are used as the basis for decisions to refuse to issue or offer a policy, contract, or plan providing coverage for an applicant and (ii) the sources of the information regarding an applicant's condition and medical history that the insurer, corporation, or health maintenance organization relies upon in determining whether an applicant has or has had such a medical condition.
Patron - Marshall, R.G.

F HB669

Accident and sickness insurance; coverage for amino-acid-based formulas. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the expense of amino-acid-based formulas whose protein source has been extensively or completely hydrolyzed. This benefit is to be available if the formula is required to treat either a diagnosed inborn error of amino acid or organic acid metabolism or a diagnosed disease or disorder of the gastrointestinal tract that leads to malnutrition or malabsorption due to inflammation, protein sensitivity, or inborn errors of digestion, and is the primary source of nutrition as certified by the treating physician by diagnosis.
Patron - Marshall, R.G.

F HB865

Group life insurance coverage. Allows coverage under a group life insurance policy to be extended to insure any class of persons as may mutually be agreed upon by the insurer and the group policyowner.
Patron - Ebbin

F HB919

Underinsured motorist insurance coverage. Establishes a mechanism by which a liability insurer insuring the owner, operator, or maintainer of an underinsured motor vehicle may, following approval of the court, pay all of its applicable limits of liability. Upon paying its limits under the policy, the insurer will be released from further liability and its obligation to participate in the defense of the proceeding. The measure applies to policies issued or renewed on or after July 1, 2008.
Patron - Joannou

F HB1306

Virginia Birth-Related Neurological Injury Compensation Program. Increases the annual assessment for physicians who participate in the Virginia Birth-Related Neurological Injury Compensation Program from its current level of $5,300 to $5,600, which amount will increase thereafter to a maximum of $6,200. The annual participating hospital assessment will increase from $50 per live birth to $52.50 per live birth in 2008, which amount will increase each year thereafter by $2.50 per live birth to a maximum of $55 per live birth. The assessment on nonparticipating physicians will apply to all physicians licensed in the Commonwealth other than participating physicians; currently, only such physicians practicing in Virginia are required to pay an assessment. The composition of the board of directors of the Program is revised to allow a parent or guardian of a child in the Program to be a member, and a certified public accountant replaces one of the members with investment experience. Other provisions (i) establish limits on reimbursement for nursing care and certain other medical services, (ii) revise the provisions regarding review of cases by panels of physicians, (iii) address the timing of filing the Program's response to the panel's report, and (iv) allow the State Corporation Commission to use the loss reserve methodology employed in Florida when conducting its actuarial evaluation the Program.
Patron - Morgan

F HB1340

Fire Programs Fund. Increases the rate of the assessment for the Fire Programs Fund from one to 1.5 percent of the total direct gross premium income for fire and related lines of insurance. This bill is incorporated into HB 1225.
Patron - Barlow

F HB1462

Motor vehicle insurance; accident prevention courses. Repeals the requirement that motor vehicle accident reduction classes provide actual classroom instruction. Insurers are required to provide premium reductions to persons age 55 and over who complete a Department of Motor Vehicles-approved course.
Patron - Ware, R.L.

F SB13

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. This bill is incorporated into SB 645.
Patron - Edwards

F SB416

Insurance agent license examinations; demographic data. Requires insurance licensing examination applications to ask applicants to disclose information regarding age, gender, race or ethnicity, native language, and education level. The State Corporation Commission or its designee shall annually prepare a report to be available to the public that sorts the demographic data provided with information regarding examination results.
Patron - Puckett

F SB568

Virginia Birth-Related Neurological Injury Compensation Program. Increases the annual assessment for physicians who participate in the Virginia Birth-Related Neurological Injury Compensation Program from its current level of $5,300 to $5,600, which amount will increase thereafter to a maximum of $6,200. The annual participating hospital assessment will increase from $50 per live birth to $52.50 per live birth in 2008, which amount will increase each year thereafter by $2.50 per live birth to a maximum of $55 per live birth. The assessment on nonparticipating physicians will apply to all physicians licensed in the Commonwealth other than participating physicians; currently, only such physicians practicing in Virginia are required to pay an assessment. The composition of the board of directors of the Program is revised to allow a parent or guardian of a child in the Program to be a member, and a certified public accountant replaces one of the members with investment experience. Other provisions (i) establish limits on reimbursement for nursing care and certain other medical services, (ii) revise the provisions regarding review of cases by panels of physicians, (iii) address the timing of filing the Program's response to the panel's report, and (iv) allow the State Corporation Commission to use the loss reserve methodology employed in Florida when conducting its actuarial evaluation the Program. This bill is incorporated into SB 211.
Patron - Saslaw

F SB631

Accident and sickness insurance; coverage for the treatment of infertility. Requires health insurers, health maintenance organizations, and corporations providing accident and sickness subscription contracts to provide coverage for the treatment of infertility.
Patron - Ticer

F SB688

Carried Over

C HB253

Bureau of Health Insurance and Commissioner of Health Insurance. Establishes a division within the State Corporation Commission, named the Bureau of Health Insurance, to administer the Commonwealth's health insurance laws. The new division is headed by a Commissioner of Health Insurance. The SCC's Bureau of Insurance, which currently administers the health insurance laws, will continue to be responsible for administering other insurance laws.
Patron - O'Bannon

C HB364

Hospital-Emergency Treatment Reimbursement Fund. Requires employers to withhold from wages payable to employees who are not covered by a health insurance policy an amount equal to two percent of their wages. The withheld moneys are to be remitted to the State Corporation Commission, which will allocate the funds among the licensed hospitals that have provided emergency care for which they have not been paid, based on the ratio of each hospital's unpaid costs to the statewide total. The Health Commissioner is required to collect information from licensed hospitals regarding the amount of their unpaid emergency care. Only hospitals that provide the requested data are eligible to receive distributions from the Fund.
Patron - Purkey

C HB636

Electronic delivery of insurance notices. Authorizes property, casualty, life, and certain other types of insurers to electronically transmit notices to insureds if the insured consents.
Patron - May

C HB648

Health reimbursement arrangements. Prohibits health insurers from canceling or refusing to issue an individual health insurance policy on grounds that the policyowner's employer funds the premium for the policy, if the funding is made through an employer-funded health reimbursement arrangement.
Patron - Hogan

C HB1225

Fire Programs Fund. Increases the rate of the assessment for the Fire Programs Fund from one to 1.5 percent of the total direct gross premium income for fire and related lines of insurance. HB 1340 is incorporated into this bill.
Patron - Bowling

C HB1419

Coordination of health insurance benefits. Prohibits an insurer issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis, a corporation providing individual or group accident and sickness subscription contracts, or a health maintenance organization providing a health care plan for health care services from delaying or refusing to make payment to a provider for covered expenses as a consequence of a failure or delay of the insured, subscriber, or member in responding to any coordination of benefits questionnaire or similar periodic inquiry from the insurer, corporation, or health maintenance organization regarding whether the insured, subscriber, or member or other family members enrolled with the insured, subscriber, or member are covered under another health insurance plan that may have primary responsibility for covered expenses. A similar prohibition is established with respect to the health insurance plan for state employees.
Patron - Nutter

C SB264

Fire insurance; family day homes. Prohibits an insurer or agent from refusing to issue or renew a policy written to insure an owner-occupied dwelling solely because the insured operates a licensed or registered family day home. The policy shall not provide liability coverage for losses arising out of, or in connection with, the operation of the family day home, which coverage shall only be provided by a separate endorsement or insurance policy.
Patron - Deeds

C SB318

Virginia Wind Underwriting Association. Establishes the Virginia Wind Underwriting Association consisting of all insurers licensed to write property insurance in the Commonwealth. The Association is created to provide insurance against loss to property in Accomack and Northampton Counties and the Cities of Chesapeake, Hampton, Norfolk, and Virginia Beach from the risk of windstorm, in accordance with a plan of operation to be approved by the Commission.
Patron - Wagner

C SB412

Fire Programs Fund. Increases the rate of the assessment for the Fire Programs Fund from one to 1.5 percent of the total direct gross premium income for fire and related lines of insurance.
Patron - Puckett

C SB645

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. SB 13 is incorporated into this bill.
Patron - Ticer

C SB692

Insurance agents; limited burial insurance authorities. Expands the definition of a limited burial insurance authority to include the authority of a person who is licensed to engage in the practice of funeral service, preneed funeral planning, funeral directing, embalming, or operating a funeral service establishment to solicit applications for life insurance in amounts of $10,000 or less in connection with the funding of a preneed funeral contract.
Patron - Edwards

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General Assembly>Division of Legislative Services>Publications>Session Summaries>2008>Insurance

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