CODE OF VIRGINIA

SPECIAL RULES FOR NETWORK PLANS (§ 38.2-3430.4)

A health insurance issuer that offers health insurance coverage in the
individual market may:

   1.  Limit the eligible individuals who may be enrolled under such coverage to
   those who live, reside, or work within the service area for such network plan;

   2.  Within the service area of such plan, deny such coverage to such
   individuals if the health insurance issuer has demonstrated to the Commission
   that: (i) it will not have the capacity to deliver services adequately to
   additional individual enrollees because of its obligations to existing group
   contract holders, enrollees and enrollees covered under individual contracts;
   and (ii) it is applying this section uniformly to individuals without regard
   to any health status-related factor of such individuals and without regard to
   whether the individuals are eligible individuals;

   3.  A health insurance issuer, upon denying health insurance coverage in any
   service area in accordance with subdivision 2, may not offer coverage in the
   individual market within such service area for a period of 180 days after such
   coverage is denied.

HISTORY: 1997, cc. 807, 913; 1998, c. 24.