38.2-3514.2 - Renewability of coverage.
§ 38.2-3514.2. Renewability of coverage.
A. Every individual policy, subscription contract or plan delivered, issuedfor delivery or renewal in this Commonwealth providing benefits to or onbehalf of an individual shall provide for the renewability of such coverageat the sole option of the insured, policyholder, subscriber, or enrollee. Theinsurer, health services plan or health maintenance organization issuing suchpolicy, subscription contract or plan shall be permitted to refuse to renewthe policy, subscription contract or plan only for one or more of thefollowing reasons:
1. Nonpayment of the required premiums by the insured, policyholder,subscriber, or enrollee, or such individual's representative;
2. In the event that the policy, subscription contract or plan contains aprovision requiring the use of network providers, a documented pattern ofabuse or misuse of such provision by the insured, policyholder, subscriber,or enrollee, continuing for a period of no less than two years;
3. Subject to the time limits contained in subdivision 2 of § 38.2-3503 or inregulations adopted by the Commission governing the practices of healthmaintenance organizations, for fraud or material misrepresentation by theindividual, with respect to his application for coverage;
4. Eligibility of an individual insured for Medicare, provided that suchcoverage may not terminate with respect to other individuals insured underthe same policy, subscription contract or plan and who are not eligible forMedicare; and
5. The insured, subscriber, or enrollee has not maintained a legal residencein the service area of the insurer, health services plan or healthmaintenance organization for a period of at least six months.
B. This section shall not apply to the following insurance policies,subscription contracts or plans:
1. Short-term travel;
2. Accident-only;
3. Disability income;
4. Limited or specified disease contracts;
5. Long-term care insurance;
6. Short-term nonrenewable policies or contracts of not more than six months'duration which are subject to no medical underwriting or minimalunderwriting; and
7. Individual health insurance coverage as defined in subsection B of §38.2-3431.
(1996, c. 550; 1998, c. 24.)