38.2-3525 - Group accident and sickness insurance coverages of spouses, dependent children or other persons.
§ 38.2-3525. Group accident and sickness insurance coverages of spouses,dependent children or other persons.
A. Coverage under a group accident and sickness insurance policy, except apolicy issued pursuant to subsection B of § 38.2-3521.1, may be extended toinsure:
1. The spouse and any child who is (i) under the age of 19 years, (ii) who isa dependent and under the age of 25 years, or (iii) who is a dependent and afull-time student under 25 years of age, without regard to whether such childresides in the same household as the insured group member, or any class ofspouse and dependent children, of each insured group member who so elects; and
2. Any other class of persons as may mutually be agreed upon by the insurerand the group policyholder.
B. The amount of accident and sickness insurance for the spouse, dependentchild or other person shall not exceed the amount of accident and sicknessinsurance for the insured group member.
C. At the insurer's option and subject to the policyholder's election, thecoverage for children of the insured group member may be extended beyond theages established in subsection A. Any such extension of coverage shall be asmutually agreed upon by the insurer and the group policyholder.
D. Notwithstanding the provisions of § 38.2-3538, one certificate may beissued for each insured group member if a statement concerning any spouse's,dependent child's, or other person's coverage is included in the certificate.
E. When a policy provides coverage for a dependent child who is enrolledbased upon the child's status as a full-time student and such child is unabledue to a medical condition to continue as a full-time student, coverage underthe policy for such child nevertheless shall continue in force provided thechild's treating physician certifies to the insurer at the time the childwithdraws as a full-time student that the child's absence is medicallynecessary. Coverage for such child shall continue in force until the earlierof (i) the date that is 12 months from the date the child ceases to be afull-time student or (ii) the date the child no longer qualifies as adependent child under the terms of the group policy. A child's status as afull-time student shall be determined in accordance with the criteriaspecified by the institution in which the child is enrolled.
(1986, c. 562; 1993, c. 306; 1998, c. 154; 2004, c. 771; 2005, c. 871; 2007,c. 428; 2008, c. 209.)