CODE OF VIRGINIA

NOTICE OF PREMIUM OR DEDUCTIBLE INCREASES (§ 38.2-3407.14)

A. Each (i) insurer issuing individual or group accident and sickness insurance
policies providing hospital, medical and surgical or major medical coverage on
an expense-incurred basis, (ii) corporation providing individual or group
accident and sickness subscription contracts, and (iii) health maintenance
organization providing a health care plan for health care services, shall
provide in conjunction with the proposed renewal of coverage under any such
policies, contracts, or plans, prior written notice of intent to increase by
more than 35 percent the annual premium charged for coverage thereunder.

B. Effective with policy, contract, or plan year renewals beginning on or after
January 1, 2015, each health carrier providing individual health insurance
coverage shall provide in conjunction with the proposed renewal of individual
health insurance coverage prior written notice of intent to increase the annual
premium charge for coverage or any deductible required thereunder. As used in
this section, “deductible” means the annual dollar amount of covered
items or services that the insured, subscriber, or enrollee is obligated to pay
before benefits are payable under the health benefit plan.

C. Notice required by this section shall be provided in writing at least 60 days
prior to the proposed renewal of coverage under any such policy, contract, or
plan described in subsection A and effective with policy, contract, or plan year
renewals beginning on or after January 1, 2015, at least 75 days prior to the
proposed renewal of individual health insurance coverage described in subsection
B. In either case, notice shall be provided to the policyholder, contract
holder, or subscriber, or to the designated consultant or other agent of the
group policyholder, contract holder, or subscriber if requested in writing by
the group policyholder, contract holder, or subscriber, as appropriate.

D. The time frames specified in subsection C for the provision of notices may be
adjusted by the Commission’s Bureau of Insurance to account for delays in
product or rate approval by the Bureau of Insurance that result from filing
requirements established by the United States Department of Health and Human
Services.

HISTORY: 1999, cc. 643, 649; 2005, c. 399; 2014, c. 511.