Virginia Administrative Code
Title 14 - INSURANCE
Agency 5 - STATE CORPORATION COMMISSION, BUREAU OF INSURANCE

The Commission is vested with supervision of all companies transacting the business of insurance and execution of all laws respecting insurance. Title 38.2, Chapter 2. It is authorized to license insurance companies; captive insurers; reciprocals; surety companies; mutual assessment property and casualty insurers; home protection companies; cooperative nonprofit life benefit companies; mutual assessment life, health, and sickness insurers; burial societies; insurance agents; surplus lines brokers; insurance consultants; managing general agents; reinsurance intermediaries; insurance premium finance companies; fraternal benefit societies and their agents; rate service organizations; and persons soliciting subscriptions for an insurance company in process of organization and to register insurer members of insurance holding companies. Certain insurance agents are required to furnish to the Commission evidence that the continuing education requirements prescribed by statute are met, and the Commission is authorized to approve a plan of operation for the insurance continuing education advisory board. Id., Chapters 10, 11, 12, 13, 18, 19, 20, 24, 25, 26, 38, 39, 40, 41, 46, 47 and 48. It may also license plans for health services, prepaid legal services, and dental and optometric services. Id., Chapters 42, 44, 45, and 61. It may license health maintenance organizations. Id., Chapter 43.

The Commission regulates Medicare supplement policies. Id., Chapter 36. It may register continuing care providers. Id., Chapter 49. It is authorized to approve a plan of operation for the Virginia Birth-Related Neurological Injury Compensation Fund. Id., Chapter 50. It is charged with administration of risk retention groups and purchasing groups. Id., Chapter 51. The Commission may adopt regulations to establish specific standards for policy provisions of long-term care insurance policies. Id., Chapter 52. The Commission may license automobile clubs. Title 13.1, Chapter 3.1. It is authorized to administer statutory requirements and restrictions respecting insurance companies corporate structure, reporting, securities, capital, reserves, reinsurance, investments, and statutes prohibiting unfair trade practices by insurers or relating to insurance. Title 38.2, Chapters 5, 6, 10, 11, 12, 13, 14, 26 and 46. It may approve forms for insurance policies, contracts, certificates, application endorsements, riders, and forms for premium finance agreements, may prescribe standard forms for motor vehicle insurance, and may establish guidelines and standards for readability of fire and automobile insurance policies, standards for the content of fire insurance policies, and standards for coverages and terms of life insurance, annuity, accident and sickness, credit life and credit accident and sickness insurance policies. Id., Chapters 3, 21, 22, 33, 34, 35, 36, 37.1, 43 and 47. Rates and rating schedules for certain types of insurance are subject to advance approval by the Commission; for other types, advance filing is required, subject to its disapproval. Id., Chapters 3, 19, 20, and 37.1. The Commission may assign risks for motor vehicle liability and workers compensation insurance- and fix rates for such assigned risk policies. Title 46.2, Chapter 3, Art. 16; Title 65.2, Chapter 8. It may also approve and supervise industry plans for distribution of risks as to certain fire and extended property insurance, or establish joint underwriting associations for compulsory distribution. Title 38.2, Chapter 27. It may fix maximum interest rates and service charges of insurance premium finance companies. Id., Chapter 47. It may review the application of a rating system to an insured by an insurer or rating organization and the cancellation of, refusal to renew, or points charged under, a motor vehicle liability policy. Id., Chapters 2, 19, 20 and 22. It is also vested with supervision of the Virginia Life, Accident and Sickness Insurance Guaranty Association, created by statute to enable guaranty of payment of benefits and continuation of coverages in event of insurers impairment or insolvency (Id., Chapter 17) and of the Virginia Property and Casualty Insurance Guaranty Association, created by statute to handle claims against insolvent carriers of property and casualty insurance (Id., Chapter 16). It may also activate a commercial liability insurance joint underwriting association. Id., Chapter 29. In addition, the Commission has promulgated regulations governing insurers practices with regard to Acquired Immunodeficiency Syndrome or the presence of the Human Immunodeficiency Virus. Id., Chapters 31 and 34. The Commission is authorized to promulgate such regulations as may be necessary or appropriate to ensure that applicants for life or accident and sickness insurance coverage or for modifications to existing coverage are notified of test results whenever insurers require such applicants to submit to testing for Human Immunodeficiency Viruses (HIV). Id., Chapter 6. For purposes of the insurance statutes, the Commission may require reports, inspect records, make examinations, and order discontinuance of unlawful acts or the taking of affirmative action to achieve compliance, and its approval is required for a variety of transactions. It is further authorized to make general or special exemptions from and to suspend or vary numerous provisions in Title 38.2 of the Code of Virginia. The Commission has authority, along with the Department of Taxation, to amend the Medical Savings Account Plan to the Virginia Health Savings Account Plan. Title 38.2, Chapter 56.

The Office of the Managed Care Ombudsman responds to inquiries and questions from consumers and other individuals and can formally assist consumers appeal a denial issued by a Managed Care Health Insurance Plan (MCHIP). Title 38.2, Chapters 58 and 59. A covered person or treating health care provider may ask the Bureau of Insurance for an External Review of a final adverse decision concerning a denied health service in accordance with regulations promulgated by the Commission. Title 38.2, Chapters 35.1 and 59.

The Commission is authorized to promulgate rules and regulations as it may deem necessary to implement the Viatical Settlements Act, Code of Virginia, Title 38.2, Chapter 60. The Commission is authorized to issue, deny, suspend, or revoke a license of any viatical settlement provider or broker. Id., Chapter 60.

The Commonwealth of Virginia is authorized to enter into the Interstate Insurance Product Regulation Compact. Title 38.2, Chapter 62. Chapter 63 directs that a health care sharing ministry is not insurance for purposes of this title. Title 38.2, Chapter 63. The Commission is authorized jointly with the Virginia Workers Compensation Commission to prescribe minimum standards of service for insurers writing workers compensation policies. Title 65.2, Chapter 8. Regulations under this provision are listed under the Virginia Workers Compensation Commission. The State Corporation Commission is authorized to license group associations of employers for workers compensation purposes and to establish standards therefor. Ibid.

The Commission is also responsible for assessment and collection of annual fees and license taxes imposed on insurance companies, measured by premium income. Companies are required to file returns and declarations of estimated tax, and the Commission may order refunds or additions and review and correct erroneous assessments. Title 38.2, Chapter 4; Title 58.1, Chapters 20 and 25.

The Commission has the authority to issue rules and regulations for the administration and enforcement of Title 38.2. Title 38.2, Chapter 2.Chapters 20 and 25.

Rev. 9/2012