38.2-3424 - Disclosure of extent and elements of coverage. - Virginia Statutes

§ 38.2-3424. Disclosure of extent and elements of coverage.

A. Any agent, agency, administrator, or other person that advertises, sells,transacts, or administers coverage for health care services in thisCommonwealth where that coverage is provided by any person subject to theprovisions of this article shall inform any purchaser, prospective purchaser,or covered person of (i) the lack of insurance or other coverage, unless thatcoverage is fully insured or otherwise fully covered by an admitted lifeinsurer, accident and sickness insurer, health services plan, dental oroptometric services plan, or health maintenance organization and (ii) if thecoverage is fully insured or otherwise fully covered, the terms, coverages,limits, and deductibles including the amount of "stop-loss" insurance ineffect.

B. No person, including an administrator, insurer, agent, or affiliate of aninsurer shall make, publish, disseminate, circulate, or place before thepublic, or cause, directly or indirectly, to be made, published,disseminated, circulated, or placed before the public, in any newspaper,magazine or other publication, or in the form of a notice, circular,pamphlet, letter or poster, or over any radio station or television station,or in any other way, any advertisement, announcement, or statement solicitingmembership, offering coverage, or evidencing coverage in any health care planor arrangement which is subject to regulation by the Commission under thisarticle and not otherwise regulated by this title, unless such advertisement,announcement, or statement contains the following disclosure:

Your plan of coverage is not protected under the Virginia Life, Accident andSickness Insurance Guaranty Association Act. Therefore:

1. In the event of an insolvency of your plan, you may be unable to collectany amount you are owed for covered claims, regardless of the coverageprovided under the plan;

2. The payment of premiums into your plan does not guarantee payment ofclaims under your plan, regardless of the coverage provided under the plan.

When such disclosure is contained in print, it shall be no smaller thanboldfaced ten-point type.

(1983, c. 417, § 38.1-43.11; 1986, c. 562; 1990, c. 477.)