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2021 SPECIAL SESSION I
Be 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
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 17 (§ 38.2-1700 et seq.).
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.