38.2-3407.13:1 - Coordination of benefits; notice of priority of coverage
§ 38.2-3407.13:1. Coordination of benefits; notice of priority of coverage.
Each (i) insurer issuing individual or group accident and sickness insurancepolicies providing hospital, medical and surgical or major medical coverageon an expense-incurred basis, (ii) corporation providing individual or groupaccident and sickness subscription contracts, and (iii) health maintenanceorganization providing a health care plan for health care services, whosepolicy, contract or plan, including any certificate or evidence of coverageissued in connection with any such policy, contract or plan, contains acoordination of benefits provision shall provide written notification to theinsured, subscriber or member as a prominent part of its enrollment materialsthat if such insured, subscriber or member is covered under another groupaccident and sickness insurance policy, group accident and sicknesssubscription contract, or group health care plan for health care services,that insurance policy, subscription contract or health care plan may haveprimary responsibility for the covered expenses of other family membersenrolled with the insured, subscriber or member. Such written notificationshall describe generally the conditions upon which the other coverage wouldbe primary for dependent children enrolled under the insured's, subscriber's,or member's coverage and the method by which the insured, subscriber ormember may verify from the insurer, corporation or health maintenanceorganization which coverage would have primary responsibility for the coveredexpenses of each family member. The provisions of this section shall not beconstrued to abrogate any coordination of benefits provision authorizedpursuant to subsection B of § 38.2-3405.
(2000, c. 149.)