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2021 SESSION
21101071DBe it enacted by the General Assembly of Virginia:
1. That § 38.2-4310 of the Code of Virginia is amended and reenacted as follows:
§ 38.2-4310. Protection against insolvency.
A. Each
health maintenance organization shall deposit and maintain acceptable
securities with the State Treasurer in amounts prescribed by § 38.2-4310.1. The
deposit shall be held as a special fund in trust, as a guarantee that the
obligations to the enrollees who are residents of this Commonwealth will be
performed. The securities shall be deposited pursuant to a system of book-entry
evidencing ownership interests of the securities with transfers of ownership
interests effected on the records of a depository and its participants pursuant
to rules and procedures established by the depository. Upon a determination of
insolvency or action by the Commission pursuant to §
38.2-4317 Chapter 15 (§ 38.2-1500
et seq.),
the deposit shall be an asset
subject to the provisions of Chapter 15 and
shall be used to protect the interests of the health maintenance organization's
enrollees and to assure continuation of covered services to enrollees. If a health
maintenance organization is placed in receivership, the deposit shall be an
asset subject to the provisions of Chapter 15 (§
38.2-1500 et seq.) of this title.
B. The Commission
may require that each health maintenance organization have a plan for handling
insolvency which allows for continuation of benefits for the duration of the
contract period for which premiums have been paid and continuation of benefits
to members who are confined on the date of insolvency in an inpatient facility
until their discharge or expiration of benefits. In considering such a plan,
the Commission may require:
1. Insurance
satisfactory in form and content to the Commission to cover the expenses to be
paid for continued benefits after an insolvency;
2. Provisions in
provider contracts that obligate the provider to provide services for the
duration of the period after the health maintenance organization's insolvency
for which premium payment has been made and until the enrollees' discharge from
inpatient facilities;
3. Acceptable
letters of credit; or
4. Any other
arrangements to assure that benefits are continued as specified above.