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Virginia Administrative Code

Agency 5 - STATE CORPORATION COMMISSION, BUREAU OF INSURANCE

Chapter 10	ACCIDENT AIRTRIP INSURANCE
Chapter 20	VARIABLE CONTRACT REGULATIONS
Chapter 30	RULES GOVERNING LIFE INSURANCE AND ANNUITY REPLACEMENTS
Chapter 40	RULES GOVERNING LIFE INSURANCE AND ANNUITY MARKETING PRACTICES [REPEALED]
Chapter 41	RULES GOVERNING ADVERTISEMENT OF LIFE INSURANCE AND ANNUITIES
Chapter 43	RULES GOVERNING USE OF SENIOR-SPECIFIC CERTIFICATIONS AND PROFESSIONAL DESIGNATIONS IN SALE OF LIFE OR ACCIDENT AND SICKNESS INSURANCE OR ANNUITIES
Chapter 45	RULES GOVERNING SUITABILITY IN ANNUITY TRANSACTIONS
Chapter 50	RULES GOVERNING NEW ANNUITY MORTALITY TABLES FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES
Chapter 60	RULES PERMITTING SMOKER/NONSMOKER MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NONFORFEITURE BENEFITS
Chapter 70	RULES GOVERNING ACCELERATED BENEFITS PROVISIONS
Chapter 71	RULES GOVERNING VIATICAL SETTLEMENT PROVIDERS AND VIATICAL SETTLEMENT BROKERS
Chapter 80	RULES GOVERNING VARIABLE LIFE INSURANCE
Chapter 90	RULES GOVERNING ADVERTISEMENT OF ACCIDENT AND SICKNESS INSURANCE
Chapter 100	RULES GOVERNING THE SUBMISSION FOR APPROVAL OF LIFE, ACCIDENT AND SICKNESS, ANNUITY, CREDIT LIFE AND CREDIT ACCIDENT SICKNESS POLICY FORMS
Chapter 110	RULES AND REGULATIONS FOR SIMPLIFIED AND READABLE ACCIDENT AND SICKNESS INSURANCE POLICIES
Chapter 120	RULES GOVERNING THE IMPLEMENTATION OF THE INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE MINIMUM STANDARDS ACT WITH RESPECT TO SPECIFIED DISEASE POLICIES
Chapter 130	RULES GOVERNING THE FILING OF RATES FOR INDIVIDUAL AND CERTAIN GROUP ACCIDENT AND SICKNESS INSURANCE POLICY FORMS
Chapter 140	RULES GOVERNING THE IMPLEMENTATION OF THE INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE MINIMUM STANDARDS ACT
Chapter 150	RULES TO IMPLEMENT TRANSITIONAL REQUIREMENTS FOR THE CONVERSION OF MEDICARE SUPPLEMENT INSURANCE BENEFITS AND PREMIUMS TO CONFORM TO MEDICARE ...
Chapter 160	RULES TO IMPLEMENT TRANSITIONAL REQUIREMENTS FOR THE CONVERSION OF MEDICARE SUPPLEMENT INSURANCE BENEFITS AND PREMIUMS TO CONFORM TO REPEAL OF THE ...
Chapter 170	RULES GOVERNING MINIMUM STANDARDS FOR MEDICARE SUPPLEMENT POLICIES
Chapter 180	RULES GOVERNING UNDERWRITING PRACTICES AND COVERAGE LIMITATIONS AND EXCLUSIONS FOR ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)
Chapter 190	RULES GOVERNING THE REPORTING OF COST AND UTILIZATION DATA RELATING TO MANDATED BENEFITS AND MANDATED PROVIDERS
Chapter 200	RULES GOVERNING LONG-TERM CARE INSURANCE
Chapter 210	RULES GOVERNING HEALTH MAINTENANCE ORGANIZATIONS [REPEALED]
Chapter 211	RULES GOVERNING HEALTH MAINTENANCE ORGANIZATIONS
Chapter 215	RULES GOVERNING INDEPENDENT EXTERNAL REVIEW OF FINAL ADVERSE UTILIZATION REVIEW DECISIONS
Chapter 216	RULES GOVERNING INTERNAL APPEAL AND EXTERNAL REVIEW
Chapter 220	RULES GOVERNING PRIVATE REVIEW AGENTS [REPEALED]
Chapter 230	RULES GOVERNING CREDIT LIFE INSURANCE AND CREDIT ACCIDENT AND SICKNESS INSURANCE [REPEALED]
Chapter 232	[RESERVED]
Chapter 234	RULES GOVERNING ESSENTIAL AND STANDARD HEALTH BENEFIT PLAN CONTRACTS
Chapter 240	RULES AND REGULATIONS REGARDING PROXIES, CONSENTS AND AUTHORIZATIONS OF DOMESTIC STOCK INSURERS
Chapter 250	RULES, REGULATIONS AND FORMS RELATING TO RESTRICTIONS ON THE PURCHASE AND SALE OF EQUITY SECURITIES OF DOMESTIC STOCK INSURANCE COMPANIES
Chapter 260	RULES GOVERNING INSURANCE HOLDING COMPANIES
Chapter 270	RULES GOVERNING ANNUAL FINANCIAL REPORTING
Chapter 280	RULES ESTABLISHING STANDARDS FOR LIFE, ANNUITY, AND ACCIDENT AND SICKNESS REINSURANCE AGREEMENTS
Chapter 290	RULES ESTABLISHING STANDARDS FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION
Chapter 300	RULES GOVERNING CREDIT FOR REINSURANCE
Chapter 310	RULES GOVERNING ACTUARIAL OPINIONS AND MEMORANDA
Chapter 319	LIFE INSURANCE RESERVES
Chapter 320	RULES ESTABLISHING MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP ACCIDENT AND SICKNESS INSURANCE CONTRACTS
Chapter 321	USE OF THE 2001 CSO MORTALITY TABLE IN DETERMINING RESERVE LIABILITIES AND NONFORFEITURE BENEFITS
Chapter 322	USE OF THE 2001 CSO PREFERRED CLASS STRUCTURE MORTALITY TABLE IN DETERMINING RESERVE LIABILITIES
Chapter 323	RULES GOVERNING PRENEED LIFE INSURANCE MINIMUM STANDARDS FOR DETERMINING RESERVE LIABILITIES AND NONFORFEITURE VALUES
Chapter 330	REPORTING OF SALVAGE AND SUBROGATION RECOVERIES [REPEALED]
Chapter 335	RULES GOVERNING CLAIMS-MADE LIABILITY INSURANCE POLICIES
Chapter 340	RULES GOVERNING STANDARDS FOR THE CONTENT OF FIRE INSURANCE OR FIRE INSURANCE IN COMBINATION WITH OTHER COVERAGES
Chapter 350	RULES GOVERNING SURPLUS LINES INSURANCE [REPEALED]
Chapter 360	RULES GOVERNING LOCAL GOVERNMENT GROUP SELF-INSURANCE POOLS
Chapter 370	RULES GOVERNING GROUP SELF-INSURERS OF LIABILITY UNDER THE VIRGINIA WORKERS' COMPENSATION ACT
Chapter 380	RULES GOVERNING UNDERGROUND STORAGE TANK OWNERS AND OPERATORS GROUP SELF-INSURANCE POOLS
Chapter 385	RULES GOVERNING ABOVEGROUND STORAGE TANK AND PIPELINE OPERATORS GROUP SELF-INSURANCE POOLS
Chapter 390	RULES GOVERNING INSURANCE PREMIUM FINANCE COMPANIES
Chapter 395	RULES GOVERNING SETTLEMENT AGENTS
Chapter 400	RULES GOVERNING UNFAIR CLAIM SETTLEMENT PRACTICES
Chapter 402	[RESERVED]
Chapter 410	RULES GOVERNING MULTIPLE EMPLOYER WELFARE ARRANGEMENTS
Chapter 420	RULES GOVERNING MILITARY SALES PRACTICES

Chapter 10

ACCIDENT AIRTRIP INSURANCE (create report)

Section 10

Location, maintenance, repair of machines, methods of advertisement

Chapter 20

VARIABLE CONTRACT REGULATIONS (create report)

Section 10	Definitions
Section 20	Delivery of variable contracts
Section 30	Separate accounts; provisions
Section 40	Filing of contracts
Section 50	Procedures
Section 60	Required reports
Section 70	Foreign companies
Section 80	Agents
Section 90	Examination of other persons
Section 100	Records of examination
Section 110	General

Chapter 30

RULES GOVERNING LIFE INSURANCE AND ANNUITY REPLACEMENTS (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Exemptions
Section 40	Duties of agents
Section 50	[Repealed]
Section 51	Duties of replacing insurers that use agents
Section 55	Duties of the existing insurer
Section 60	Duties of insurers that use agents
Section 70	Duties of insurers with respect to direct response solicitations
Section 80	Penalties
Section 90	Severability
Section 100	[Repealed]
Section 100:1	EXHIBIT A. [Repealed]
FORMS	FORMS (14VAC5-30)

Chapter 40

RULES GOVERNING LIFE INSURANCE AND ANNUITY MARKETING PRACTICES [REPEALED] (create report)

Section 10	[Repealed]
Section 20	[Repealed]
Section 30	[Repealed]
Section 40	[Repealed]
Section 50	[Repealed]
Section 60	[Repealed]
Section 70	[Repealed]
Section 80	[Repealed]

Chapter 41

RULES GOVERNING ADVERTISEMENT OF LIFE INSURANCE AND ANNUITIES (create report)

Section 10	Purpose and applicability
Section 20	Definitions
Section 30	Form and content of advertisements
Section 40	General disclosure requirements
Section 50	Premiums
Section 60	Nonguaranteed policy elements
Section 70	Policies and benefits
Section 80	Policy costs and cost comparisons
Section 90	Insurer identity and representations
Section 100	Testimonials, appraisals, analyses, and endorsements
Section 110	Introductory, initial, or special offers
Section 120	Policies sold to students
Section 130	Individual deferred annuity contracts or deposit funds
Section 140	Jurisdictional licensing
Section 150	Approval and records maintenance requirements
Section 160	Severability

Chapter 43

RULES GOVERNING USE OF SENIOR-SPECIFIC CERTIFICATIONS AND PROFESSIONAL DESIGNATIONS IN SALE OF LIFE OR ACCIDENT AND SICKNESS INSURANCE OR ANNUITIES (create report)

Section 10	Applicability
Section 20	Senior-specific certifications and professional designations
Section 30	Severability

Chapter 45

RULES GOVERNING SUITABILITY IN ANNUITY TRANSACTIONS (create report)

Section 10	Purpose and scope
Section 20	Definitions
Section 30	Exemptions
Section 40	Duties of insurers and agents
Section 50	Severability

Chapter 50

RULES GOVERNING NEW ANNUITY MORTALITY TABLES FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Individual annuity or pure endowment contracts
Section 40	Group annuity or pure endowment contracts
Section 41	Application of the 1994 GAR Table
Section 50	Severability

Chapter 60

RULES PERMITTING SMOKER/NONSMOKER MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NONFORFEITURE BENEFITS (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Alternate tables
Section 40	Conditions
Section 50	Prohibited provision
Section 60	Severability

Chapter 70

RULES GOVERNING ACCELERATED BENEFITS PROVISIONS (create report)

Section 10	Purpose
Section 20	Compliance with the chapter
Section 30	Applicability and scope
Section 40	Definitions
Section 50	Type of product
Section 60	Assignee/beneficiary
Section 70	Criteria for payment; lump sum settlement option; restrictions on use of proceeds; accidental death benefit provision
Section 80	Required disclosure provision; descriptive title; tax consequences; solicitations and disclosures; effect of benefit payment
Section 90	Effective date of the accelerated benefits
Section 100	Waiver of premiums
Section 110	Discrimination
Section 120	Actuarial standards; financing options; effect on cash value; effect of outstanding policy loans
Section 130	Actuarial disclosure and reserves
Section 140	Filing requirement
Section 150	Severability

Chapter 71

RULES GOVERNING VIATICAL SETTLEMENT PROVIDERS AND VIATICAL SETTLEMENT BROKERS (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	[Repealed]
Section 31	License requirements for viatical settlement providers
Section 35	Viatical settlement contracts and disclosure statements
Section 40	License requirements for viatical settlement brokers
Section 50	Other requirements for viatical settlement brokers
Section 60	Standards for evaluation of reasonable payments
Section 70	Reporting requirements
Section 80	[Repealed]
Section 90	General rules
Section 91	Advertising
Section 92	Prohibited practices
Section 93	Insurance company practices
Section 100	Severability
FORMS	FORMS (14VAC5-71)

Chapter 80

RULES GOVERNING VARIABLE LIFE INSURANCE (create report)

Section 10	Scope
Section 20	Definitions
Section 30	Licensing and approval to do business in the Commonwealth
Section 40	Filing for approval to do business in the Commonwealth
Section 50	Standards of suitability
Section 60	Use of sales materials
Section 70	Requirements applicable to contractual services
Section 80	Reports to the Commission
Section 90	Authority of Commission to disapprove
Section 100	Variable life insurance form approval; in general
Section 110	Filing of variable life insurance policies
Section 120	Mandatory policy benefit and design requirements
Section 130	Mandatory policy provisions
Section 140	Policy loan provisions
Section 150	Other policy provisions
Section 160	[Repealed]
Section 200	Establishment and administration of separate accounts
Section 210	Amounts in the separate account
Section 220	Investment by the separate account
Section 230	Limitations on ownership
Section 240	Valuation of separate account assets
Section 250	Separate account investment policy
Section 260	Charges against separate account
Section 270	Standards of conduct
Section 280	Conflicts of interest
Section 290	Investment advisory services to a separate account
Section 300	Information furnished to applicants
Section 310	Applications
Section 320	Reports to policyholders
Section 330	Foreign companies
Section 340	Qualification to sell variable life insurance
Section 350	Reports of disciplinary actions
Section 360	Refusal to qualify agent to sell variable life insurance: suspension, revocation, or nonrenewal of qualification
Section 370	Severability

Chapter 90

RULES GOVERNING ADVERTISEMENT OF ACCIDENT AND SICKNESS INSURANCE (create report)

Section 10	Purpose
Section 20	Applicability
Section 30	Definitions
Section 40	Method of disclosure of required information
Section 50	Form and content of advertisements
Section 55	Form and content of invitations to inquire
Section 60	Requirements applicable to advertisements of covered benefits; disclosures relating to exceptions, reductions, limitations; and pre-existing ...
Section 70	Necessity for disclosing policy provisions relating to renewability, cancellability, and termination
Section 80	Testimonials or endorsements by third parties
Section 90	Use of statistics
Section 100	Identification of plan or number of policies
Section 110	Disparaging comparisons and statements
Section 120	Jurisdictional licensing and status of insurer
Section 130	Identity of insurer
Section 140	Group or quasi-group implications
Section 150	Introductory, initial or special offers
Section 160	Statements about an insurer
Section 170	Enforcement procedures; advertising file; corrective advertising
Section 180	Severability
FORMS	[Repealed]

Chapter 100

RULES GOVERNING THE SUBMISSION FOR APPROVAL OF LIFE, ACCIDENT AND SICKNESS, ANNUITY, CREDIT LIFE AND CREDIT ACCIDENT SICKNESS POLICY FORMS (create report)

Section 10	General considerations
Section 20	Source of filing
Section 30	Filing date
Section 40	Transmittal letter
Section 50	Form requirements
Section 60	Continuing responsibility of insurers
Section 70	Individual accident and sickness rate information
Section 80	Credit life/accident and sickness rate information

Chapter 110

RULES AND REGULATIONS FOR SIMPLIFIED AND READABLE ACCIDENT AND SICKNESS INSURANCE POLICIES (create report)

Section 10	Purpose
Section 20	Effective date and other provisions
Section 30	Scope
Section 40	Definitions
Section 50	Readable policy requirements; general rules; format; legibility; readability
Section 60	Certification
Section 70	Powers of the Commission
Section 80	Severability

Chapter 120

RULES GOVERNING THE IMPLEMENTATION OF THE INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE MINIMUM STANDARDS ACT WITH RESPECT TO SPECIFIED DISEASE POLICIES (create report)

Section 10	Purpose
Section 20	Effective date and other provisions
Section 30	Scope
Section 40	Policy definitions
Section 50	General policy requirements
Section 60	Prohibited policy provisions
Section 70	Specified disease minimum benefit standards
Section 80	Required disclosure provisions
Section 90	Requirements for replacement
Section 100	Severability

Chapter 130

RULES GOVERNING THE FILING OF RATES FOR INDIVIDUAL AND CERTAIN GROUP ACCIDENT AND SICKNESS INSURANCE POLICY FORMS (create report)

Section 10	Purpose
Section 20	[Reserved]
Section 30	Scope
Section 40	Definitions
Section 50	General rules on rate filing; experience records and data
Section 60	Filing of rates for a new policy form
Section 70	Filing of a rate increase
Section 80	Special considerations relating to new forms and rate increases
Section 90	Monitoring of experience
Section 100	Severability

Chapter 140

RULES GOVERNING THE IMPLEMENTATION OF THE INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE MINIMUM STANDARDS ACT (create report)

Section 10	Purpose
Section 20	Compliance with chapter
Section 30	Scope
Section 40	Policy definitions
Section 50	General policy requirements
Section 60	Prohibited policy provisions
Section 70	Accident and sickness minimum standards for benefits
Section 80	Required disclosure provisions
Section 90	Requirements for replacement
Section 100	Severability

Chapter 150

RULES TO IMPLEMENT TRANSITIONAL REQUIREMENTS FOR THE CONVERSION OF MEDICARE SUPPLEMENT INSURANCE BENEFITS AND PREMIUMS TO CONFORM TO MEDICARE ... (create report)

Section 10	Purpose
Section 20	[Reserved]
Section 30	Applicability and scope
Section 40	Definitions
Section 50	Benefit conversion requirements
Section 60	Requirements for new policies and certificates
Section 70	Buyer's guide
Section 80	Severability

Chapter 160

RULES TO IMPLEMENT TRANSITIONAL REQUIREMENTS FOR THE CONVERSION OF MEDICARE SUPPLEMENT INSURANCE BENEFITS AND PREMIUMS TO CONFORM TO REPEAL OF THE ... (create report)

Section 10	Purpose
Section 20	[Reserved]
Section 30	Applicability and scope
Section 40	Definitions
Section 50	Benefit conversion requirements
Section 60	Form and rate filing requirements
Section 70	Offer of reinstitution of coverage
Section 80	Requirements for new policy and certificates
Section 90	Filing requirements for advertising
Section 100	Buyer's guide
Section 110	Severability
Section 110:1	APPENDIX A. NOTICE OF CHANGES IN MEDICARE AND YOUR MEDICARE SUPPLEMENT COVERAGE-1990

Chapter 170

RULES GOVERNING MINIMUM STANDARDS FOR MEDICARE SUPPLEMENT POLICIES (create report)

Section 10	Purpose
Section 20	Applicability and scope
Section 30	Definitions
Section 40	Policy definitions and terms
Section 50	Policy provisions
Section 60	Minimum benefit standards for prestandardized Medicare supplement benefits plan policies or certificates issued for delivery prior to July 30, 1992
Section 70	Benefit standards for 1990 Medicare supplement policies delivered on or after July 30, 1992 and prior to June 1, 2010
Section 75	Benefit standards for 2010 Medicare supplement policies delivered on or after June 1, 2010
Section 80	Standard plans for 1990 Medicare supplement policies delivered on or after July 30, 1992, and prior to June 1, 2010
Section 85	Standard plans for 2010 standardized Medicare supplement policies delivered on or after June 1, 2010
Section 90	Medicare select policies and certificates
Section 100	Open enrollment
Section 105	Guaranteed issue for eligible persons
Section 110	Standards for claims payment
Section 120	Loss ratio standards and refund or credit of premium; annual filing; public hearing
Section 130	Filing and approval of policies and certificates and premium rates
Section 140	Permitted compensation arrangements
Section 150	Required disclosure provisions
Section 160	Requirements for application forms and replacement coverage
Section 170	Filing requirements for advertising
Section 180	Standards for marketing
Section 190	Appropriateness of recommended purchase and excessive insurance
Section 200	Reporting of multiple policies
Section 210	Prohibition against preexisting conditions, waiting periods, elimination periods and probationary periods in replacement policies or certificates
Section 215	Prohibition against use of genetic information and requests for genetic testing
Section 220	Severability
Section 220:1	APPENDIX A. MEDICARE SUPPLEMENT REFUND CALCULATION FORM
Section 220:2	APPENDIX B. FORM FOR REPORTING MEDICARE SUPPLEMENT POLICIES
Section 220:3	APPENDIX C. DISCLOSURE STATEMENTS
Section 220:4	APPENDIX D. NOTICE ABOUT ATTAINED AGE RATED MEDICARE SUPPLEMENT POLICIES

Chapter 180

RULES GOVERNING UNDERWRITING PRACTICES AND COVERAGE LIMITATIONS AND EXCLUSIONS FOR ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) (create report)

Section 10	Purpose
Section 20	Effective date
Section 30	Scope
Section 40	Definitions
Section 50	Underwriting procedures
Section 60	Coverage limitations and exclusions
Section 70	Severability

Chapter 190

RULES GOVERNING THE REPORTING OF COST AND UTILIZATION DATA RELATING TO MANDATED BENEFITS AND MANDATED PROVIDERS (create report)

Section 10	Purpose
Section 20	Scope
Section 30	Definitions
Section 40	Reporting requirements
Section 50	Procedures
Section 60	Annual notification and modification of reporting form
Section 70	Penalties
Section 80	Severability
Section 80:1	APPENDIX A. FORM MB-1 INSTRUCTIONS AND INFORMATION
Section 80:2	APPENDIX B. CPT-4, ICD-9CM, AND UB-82 REFERENCES

Chapter 200

RULES GOVERNING LONG-TERM CARE INSURANCE (create report)

Section 10	Purpose
Section 20	Contracts effective prior to April 1, 2003
Section 30	Applicability and scope
Section 40	Definitions
Section 50	Policy definitions
Section 60	Policy practices and provisions
Section 65	Unintentional lapse
Section 70	Required disclosure provisions
Section 75	Required disclosure of rating practices to consumer
Section 77	Initial filing requirements
Section 80	Prohibition of post-claims underwriting
Section 90	Minimum standards for home health care benefits in long-term care insurance policies
Section 100	Requirement to offer inflation protection
Section 110	Requirements for application forms and replacement coverage
Section 120	Reporting requirements
Section 130	Discretionary powers of commission
Section 140	Reserve standards
Section 150	Loss ratio
Section 153	Premium rate schedule increases
Section 155	Filing requirement
Section 160	Filing requirements for advertising
Section 170	Standards for marketing
Section 175	Suitability
Section 180	[Repealed]
Section 181	Availability of new services or providers
Section 183	Right to reduce coverage and lower premiums
Section 185	Nonforfeiture benefit requirement
Section 187	Standards for benefit triggers
Section 190	Prohibition against preexisting conditions and probationary periods in replacement policies or certificates
Section 200	Standard format outline of coverage
Section 201	Requirement to deliver shopper's guide
Section 205	State Long-Term Care Insurance Partnership Program
Section 210	Severability
FORMS	FORMS (14VAC5-200)

Chapter 210

RULES GOVERNING HEALTH MAINTENANCE ORGANIZATIONS [REPEALED] (create report)

Section 10

[Repealed]

Chapter 211

RULES GOVERNING HEALTH MAINTENANCE ORGANIZATIONS (create report)

Section 10	Applicability and scope
Section 20	Definitions
Section 30	Covered and uncovered expenses
Section 40	Surplus notes
Section 50	Financial projections
Section 60	Filing requirements
Section 70	Conversion of coverage
Section 80	Coordination of benefits
Section 90	Copayments
Section 100	Deductibles
Section 110	Description of providers
Section 120	Description of service area
Section 130	Extension of benefits for total disability
Section 140	Freedom of choice
Section 150	Complaint and appeals procedure
Section 160	Basic health care services
Section 170	Supplemental health care services
Section 180	Out-of-area services
Section 190	Limited health care services
Section 200	Essential and standard benefit plans
Section 210	Disclosure requirements
Section 220	Exclusions for preexisting conditions
Section 230	Reasons for termination or rescission
Section 240	Unfair discrimination
Section 250	Conformity with state law
Section 260	Penalties
Section 270	Controversies involving contracts
Section 280	Severability
DIBR	DOCUMENTS INCORPORATED BY REFERENCE (14VAC5-211)

Chapter 215

RULES GOVERNING INDEPENDENT EXTERNAL REVIEW OF FINAL ADVERSE UTILIZATION REVIEW DECISIONS (create report)

Section 10	Scope and purpose
Section 20	Notifications
Section 30	Definitions
Section 40	Minimum appealable amount
Section 50	Appeals
Section 60	Impartial health entity
Section 70	Standard review
Section 80	Expedited review
Section 90	Reconsideration of final adverse decision
Section 100	Payment of fees
Section 110	Standards, credentials, and qualifications of the impartial health entity
Section 120	Modification of forms
Section 130	Severability
FORMS	FORMS (14VAC5-215)

Chapter 216

RULES GOVERNING INTERNAL APPEAL AND EXTERNAL REVIEW (create report)

Section 10	Scope and purpose
Section 20	Definitions
Section 30	General requirements
Section 40	Minimum appeal requirements
Section 45	Exhaustion
Section 50	Urgent care appeals
Section 60	Concurrent review decisions
Section 70	Notification requirements
Section 80	Incomplete or ineligible determinations
Section 90	Expedited external review
Section 100	Qualifications for independent review organizations
Section 110	External review reporting requirements
Section 120	Funding of external review
Section 130	Self-insured plans
FORMS	FORMS (14VAC5-216)

Chapter 220

RULES GOVERNING PRIVATE REVIEW AGENTS [REPEALED] (create report)

Section 10

[Repealed]

Chapter 230

RULES GOVERNING CREDIT LIFE INSURANCE AND CREDIT ACCIDENT AND SICKNESS INSURANCE [REPEALED] (create report)

Section 10

[Repealed]

Chapter 232

[RESERVED] (create report)

Section 10

[Reserved]

Chapter 234

RULES GOVERNING ESSENTIAL AND STANDARD HEALTH BENEFIT PLAN CONTRACTS (create report)

Section 10	Purpose
Section 20	Scope
Section 30	Definitions
Section 40	General requirements
Section 50	Minimum standards for benefits for the Essential Benefit Plan Contracts
Section 60	Minimum standards for benefits for the Standard Benefit Plan Contracts
Section 70	Limitations and exclusions
Section 80	Cost-sharing requirements
Section 90	Required disclosure provisions
Section 100	Severability
FORMS	FORMS (14VAC5-234)

Chapter 240

RULES AND REGULATIONS REGARDING PROXIES, CONSENTS AND AUTHORIZATIONS OF DOMESTIC STOCK INSURERS (create report)

Section 10	Application of regulation
Section 20	Proxies, consents and authorizations
Section 30	Disclosure of equivalent information
Section 40	Definitions
Section 50	Information to be furnished to security holders
Section 60	Requirements as to proxy and information statement
Section 70	Material required to be filed
Section 80	False or misleading statements
Section 90	Prohibition of certain solicitations
Section 100	Special provisions applicable to election contests
Section 100:1	SCHEDULE A. INFORMATION REQUIRED IN PROXY STATEMENT OR INFORMATION STATEMENT
Section 100:2	SCHEDULE B. INFORMATION TO BE INCLUDED IN STATEMENTS FILED BY OR ON BEHALF OF A PARTICIPANT (OTHER THAN THE INSURER) IN A PROXY SOLICITATION IN AN ...

Chapter 250

RULES, REGULATIONS AND FORMS RELATING TO RESTRICTIONS ON THE PURCHASE AND SALE OF EQUITY SECURITIES OF DOMESTIC STOCK INSURANCE COMPANIES (create report)

Section 10	Definitions
Section 20	Transactions exempted from the operation of subsection B of the Act
Section 30	Filing of statements
Section 40	Ownership of more than 10% of an equity security
Section 50	Disclaimer of beneficial ownership
Section 60	Exemptions from subsections A and B of the Act
Section 70	Exemption from the act of securities purchased or sold by odd-lot dealers
Section 80	Certain transactions subject to subsection A of the Act
Section 90	Ownership of securities held in trust
Section 100	Exemption for small transactions
Section 110	Exemption from subsection B of the Act of transactions which need not be reported under subsection A of the Act
Section 120	Exemption from subsection B of the Act of certain transactions effected in connection with a distribution
Section 130	Exemption from subsection B of the Act of acquisitions of shares of stock and stock options under certain stock bonus, stock option or similar plans
Section 140	Exemption from subsection B of the Act of certain transactions in which securities are received by redeeming other securities
Section 150	Exemption of long term profits incident to sales within six months of the exercise of an option
Section 160	Exemption from subsection B of the Act of certain acquisitions and dispositions of securities pursuant to merger or consolidations
Section 170	Exemption from subsection B of the Act of transactions involving the deposit or withdrawal of equity securities under a voting trust or deposit ...
Section 180	Exemption from subsection B of the Act of certain transactions involving the conversion of equity securities
Section 190	Exemption from subsection B of the Act of certain transactions involving the sale of subscription rights
Section 200	Exemption of certain securities from subsection C of the Act
Section 210	Exemption from subsection C of the Act of certain transactions effected in connection with distribution
Section 220	Exemption from subsection C of the Act of sales of securities to be acquired
Section 230	Arbitrage transactions under subsection E of the Act
Section 240	Penalty provision
FORMS	FORMS (14VAC5-250)

Chapter 260

RULES GOVERNING INSURANCE HOLDING COMPANIES (create report)

Section 10	Applicability
Section 20	[Repealed]
Section 30	Definitions
Section 40	Acquisition of control; approval of applications
Section 50	Acquisitions involving insurers not otherwise covered
Section 60	Annual registration of insurers; registration statement filings and amendments
Section 70	Disclaimers and termination of registration
Section 80	Transactions subject to prior notice filing
Section 90	Dividends and other distributions
Section 100	Management of controlled insurers and standards for transactions with affiliates
Section 110	Severability clause
FORMS	FORMS (14VAC5-260)

Chapter 270

RULES GOVERNING ANNUAL FINANCIAL REPORTING (create report)

Section 10	Purpose
Section 20	Applicability
Section 30	Scope
Section 40	Definitions
Section 50	General requirements related to filing and extensions for filing of annual Audited Financial Reports and Audit Committee appointment
Section 60	Contents of annual Audited Financial Report
Section 70	Designation of independent certified public accountant
Section 80	Qualifications of accountant
Section 90	Consolidated or combined audits
Section 100	Scope of audit and report of independent certified public accountant
Section 110	Notification of adverse financial condition
Section 120	Communicating internal control related matters noted in an audit
Section 130	Accountant's letter of qualifications
Section 140	Availability and maintenance of independent certified public accountant workpapers
Section 144	Requirements for Audit Committees
Section 146	Conduct of insurer in connection with the preparation of required reports and documents
Section 148	Management's Report of Internal Control over Financial Reporting
Section 150	Exemptions
Section 160	[Repealed]
Section 170	Canadian and British companies
Section 174	Retention of independent certified public accountant on or after January 1, 2010, and other effective dates
Section 180	Severability
FORMS	FORMS (14VAC5-270)
DIBR	DOCUMENTS INCORPORATED BY REFERENCE (14VAC5-270)

Chapter 280

RULES ESTABLISHING STANDARDS FOR LIFE, ANNUITY, AND ACCIDENT AND SICKNESS REINSURANCE AGREEMENTS (create report)

Section 10	Definitions
Section 20	Purpose
Section 30	Scope
Section 40	Accounting and actuarial requirements
Section 50	Written agreements
Section 60	Existing agreements
Section 70	Severability
Section 70:1	EXHIBIT 1. SIGNIFICANT RISKS TABLE
Section 70:2	EXHIBIT 2. SAMPLE FORMULA FOR DETERMINING RESERVE INTEREST RATE ADJUSTMENT

Chapter 290

RULES ESTABLISHING STANDARDS FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION (create report)

Section 10	Purpose
Section 20	Applicability and scope
Section 30	Standards
Section 40	Commission's authority
Section 50	Severability

Chapter 300

RULES GOVERNING CREDIT FOR REINSURANCE (create report)

Section 10	Purpose
Section 20	Severability
Section 30	Applicability and scope
Section 40	Definitions
Section 50	Credit for reinsurance generally
Section 60	Credit for reinsurance; reinsurer licensed in this Commonwealth
Section 70	Credit for reinsurance; accredited reinsurers
Section 80	Credit for reinsurance; reinsurer domiciled and licensed in another state, and neither licensed nor accredited in Virginia
Section 90	Credit for reinsurance; reinsurers maintaining trust funds
Section 100	Credit for reinsurance required by law
Section 110	Reduction from liability for reinsurance ceded to an assuming insurer not meeting the requirements of � 38.2-1316.2 or 38.2-1316.3
Section 120	Trust agreements qualified under 14VAC5-300-110 and subdivision 2 of � 38.2-1316.4 of the Act
Section 130	Letters of credit qualifying for � 38.2-1316.4 credit under 14VAC5-300-110
Section 140	Other security
Section 150	Reinsurance contract
Section 160	Contracts affected

Chapter 310

RULES GOVERNING ACTUARIAL OPINIONS AND MEMORANDA (create report)

Section 10	Purpose
Section 20	Authority; effective date
Section 30	Scope
Section 40	Definitions
Section 50	General requirements for actuarial opinions
Section 60	[Repealed]
Section 80	Statement of actuarial opinion based on an asset adequacy analysis
Section 90	Description of actuarial memorandum issued for an asset adequacy analysis and regulatory asset adequacy issues summary
Section 100	Record retention
Section 105	Notification of an opinion in error; amended opinion
Section 110	[Repealed]
Section 120	Severability

Chapter 319

LIFE INSURANCE RESERVES (create report)

Section 10	Definitions
Section 20	Purpose
Section 30	Applicability
Section 40	General calculation requirements for basic reserves and premium deficiency reserves
Section 50	Calculation of minimum valuation standard for policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits (other than ...
Section 60	Calculation of minimum valuation standard for flexible premium and fixed premium universal life insurance policies that contain provisions ...
Section 70	Twenty-year select mortality factors
Section 80	Severability

Chapter 320

RULES ESTABLISHING MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP ACCIDENT AND SICKNESS INSURANCE CONTRACTS (create report)

Section 10	Purpose
Section 20	General
Section 30	Claim reserves
Section 40	Premium reserves
Section 50	Contract reserves
Section 60	Reinsurance
Section 70	Severability
Section 70:1	APPENDIX A. SPECIFIC STANDARDS FOR MORBIDITY, INTEREST AND MORTALITY
Section 70:2	APPENDIX B. GLOSSARY OF TECHNICAL TERMS USED
Section 70:3	APPENDIX C. RESERVES FOR WAIVER OF PREMIUM

Chapter 321

USE OF THE 2001 CSO MORTALITY TABLE IN DETERMINING RESERVE LIABILITIES AND NONFORFEITURE BENEFITS (create report)

Section 10	Authority
Section 20	Definitions
Section 30	2001 CSO Mortality Table
Section 40	Conditions
Section 50	Applicability of the 2001 CSO Mortality Table to 14VAC5-319
Section 60	Gender-blended tables
Section 70	Severability clause
DIBR	DOCUMENTS INCORPORATED BY REFERENCE (14VAC5-321)

Chapter 322

USE OF THE 2001 CSO PREFERRED CLASS STRUCTURE MORTALITY TABLE IN DETERMINING RESERVE LIABILITIES (create report)

Section 10	Authority
Section 20	Definitions
Section 30	2001 CSO Preferred Class Structure Mortality Table
Section 40	Conditions
Section 50	Severability clause
DIBR	DOCUMENTS INCORPORATED BY REFERENCE (14VAC5-322)

Chapter 323

RULES GOVERNING PRENEED LIFE INSURANCE MINIMUM STANDARDS FOR DETERMINING RESERVE LIABILITIES AND NONFORFEITURE VALUES (create report)

Section 10	Authority
Section 20	Definitions
Section 30	Minimum valuation mortality standards
Section 40	Minimum valuation interest rate standards
Section 50	Minimum valuation method standards
Section 60	Transition provisions
Section 70	Severability

Chapter 330

REPORTING OF SALVAGE AND SUBROGATION RECOVERIES [REPEALED] (create report)

Section 10

[Repealed]

Chapter 335

RULES GOVERNING CLAIMS-MADE LIABILITY INSURANCE POLICIES (create report)

Section 10	Scope
Section 20	Definitions
Section 30	Insurers to offer extended reporting period coverage
Section 40	Extended reporting period requirements
Section 50	Prohibitions
Section 60	Severability

Chapter 340

RULES GOVERNING STANDARDS FOR THE CONTENT OF FIRE INSURANCE OR FIRE INSURANCE IN COMBINATION WITH OTHER COVERAGES (create report)

Section 10	Scope and purpose
Section 20	Standards for content of policies
Section 30	Certification
Section 40	Dwelling buildings and contents policy; basic form
Section 50	Dwelling buildings and contents policy; broad form
Section 60	Dwelling buildings and contents policy; special form
Section 70	Homeowners policy; basic form
Section 80	Homeowners policy; broad form
Section 90	Homeowners policy; special form
Section 100	Homeowners policy; comprehensive form
Section 110	Homeowners policy; condominium unit-owners form
Section 120	Market value policy
Section 130	Severability
Section 140	Advertisement
Section 150	Effective date
Section 150:1	EXHIBIT 1. MINIMUM STANDARDS OF CONTENT FOR A DWELLING BUILDING(S) AND CONTENTS -- BASIC FORM (SEASONAL PROPERTY SHALL BE SO DESCRIBED IN THIS POLICY)
Section 150:2	EXHIBIT 2. MINIMUM STANDARDS OF CONTENT FOR A DWELLING BUILDING(S) AND CONTENTS - BROAD FORM
Section 150:3	EXHIBIT 3. MINIMUM STANDARDS OF CONTENT FOR A DWELLING BUILDING(S) AND CONTENTS - SPECIAL FORM
Section 150:4	EXHIBIT 4. MINIMUM STANDARDS OF CONTENT FOR A HOMEOWNERS POLICY - BASIC FORM
Section 150:5	EXHIBIT 5. MINIMUM STANDARDS OF CONTENT FOR A HOMEOWNERS POLICY - BROAD FORM
Section 150:6	EXHIBIT 6. MINIMUM STANDARDS OF CONTENT FOR A HOMEOWNERS POLICY - SPECIAL FORM
Section 150:7	EXHIBIT 7. MINIMUM STANDARDS OF CONTENT FOR A HOMEOWNERS POLICY - COMPREHENSIVE FORM
Section 150:8	EXHIBIT 8. MINIMUM STANDARDS OF CONTENT FOR A HOMEOWNERS POLICY - CONDOMINIUM UNIT-OWNERS FORM
Section 150:9	EXHIBIT 9. MINIMUM STANDARDS OF CONTENT FOR A MARKET VALUE POLICY

Chapter 350

RULES GOVERNING SURPLUS LINES INSURANCE [REPEALED] (create report)

Section 10	[Repealed]
Section 20	[Repealed]
Section 30	[Repealed]
Section 40	[Repealed]
Section 85	[Repealed]
Section 90	[Repealed]
Section 95	[Repealed]
Section 100	[Repealed]
Section 110	[Repealed]
Section 150	[Repealed]
Section 155	[Repealed]
Section 160	[Repealed]
Section 165	[Repealed]
Section 170	[Repealed]
Section 190	[Repealed]
Section 200	[Repealed]
Section 210	[Repealed]
Section 220	[Repealed]
Section 230	[Repealed]
FORMS	[Repealed]

Chapter 360

RULES GOVERNING LOCAL GOVERNMENT GROUP SELF-INSURANCE POOLS (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Application for license as group self-insurance pool; requirements; approval; review
Section 40	Application for license; additional requirements
Section 45	Security deposit requirement
Section 50	Investments
Section 60	Filing of reports; examination by commission
Section 70	Reserves
Section 80	Responsibilities of members' supervisory board
Section 90	Contribution requirements
Section 100	Distribution of surplus funds
Section 110	Member agreement
Section 120	Servicing of pool
Section 130	Handling of pool deficit
Section 140	Termination of pool members
Section 150	Terms of license; voluntary dissolution of pool; mergers
Section 160	Revocation or suspension of self-insurance license
Section 170	Application of Unfair Trade Practices Act; Insurance Information and Privacy Protection Act
Section 180	Penalties
Section 190	Severability

Chapter 370

RULES GOVERNING GROUP SELF-INSURERS OF LIABILITY UNDER THE VIRGINIA WORKERS' COMPENSATION ACT (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Application for license as group self-insurance association requirements; approval; review
Section 40	Application for license as group self-insurance association; additional requirements
Section 50	Approval of members of association
Section 60	Security deposit and surety bond requirement
Section 70	Investment
Section 80	Filing of reports
Section 90	Contracts for excess insurance
Section 100	Responsibilities of members' supervisory board
Section 110	Advance contribution requirements and distribution of surplus funds
Section 120	Indemnity agreement and power of attorney
Section 130	Servicing of association
Section 140	Termination of members of association
Section 145	Mergers
Section 150	Revocation of self-insurance license
Section 160	Penalties
Section 170	Examination of association
Section 180	Severability
FORMS	FORMS (14VAC5-370)

Chapter 380

RULES GOVERNING UNDERGROUND STORAGE TANK OWNERS AND OPERATORS GROUP SELF-INSURANCE POOLS (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Application for license as group self-insurance pool; requirements; approval; review
Section 40	Application for license; additional requirements
Section 50	Security deposit and bond requirements
Section 60	Filing of reports; examination by the Commission
Section 70	Reserves
Section 80	Responsibilities of members' supervisory board
Section 90	Contribution requirements and distribution of surplus funds
Section 100	Member agreement
Section 110	Servicing of pool
Section 120	Termination of pool members
Section 130	Revocation of license; voluntary dissolution of pool; merger of pools
Section 140	Penalties
Section 150	Severability

Chapter 385

RULES GOVERNING ABOVEGROUND STORAGE TANK AND PIPELINE OPERATORS GROUP SELF-INSURANCE POOLS (create report)

Section 10	Purpose
Section 20	Definitions
Section 30	Application for license as group self-insurance pool; requirements; approval; review
Section 40	Application for license; additional requirements
Section 50	Security deposit
Section 60	Filing of reports; examination by the commission
Section 70	Reserves
Section 80	Responsibilities of members' supervisory board
Section 90	Contribution requirements and distribution of surplus funds
Section 100	Member agreement
Section 110	Servicing of pool
Section 120	Termination of pool members
Section 130	Revocation of license; voluntary dissolution of pool; merger of pools
Section 140	Penalties
Section 150	Severability

Chapter 390

RULES GOVERNING INSURANCE PREMIUM FINANCE COMPANIES (create report)

Section 10	Licensing
Section 20	Forms
Section 30	Records
Section 40	Cancellation of insurance
Section 50	Surety bond
Section 60	Annual report
Section 70	Miscellaneous
FORMS	FORMS (14VAC5-390)

Chapter 395

RULES GOVERNING SETTLEMENT AGENTS (create report)

Section 10	Purpose
Section 20	Definitions
Section 25	Lay real estate settlement agents
Section 30	Registration
Section 40	Insurance and bonding requirements
Section 50	Audits
Section 60	Separate fiduciary trust account
Section 70	Access to records
Section 80	Violations
Section 90	Severability
DIBR	DOCUMENTS INCORPORATED BY REFERENCE (14VAC5-395)

Chapter 400

RULES GOVERNING UNFAIR CLAIM SETTLEMENT PRACTICES (create report)

Section 10	Scope
Section 20	Definitions
Section 30	File and record documentation
Section 40	Misrepresentation of policy provisions
Section 50	Failure to acknowledge pertinent communications
Section 60	Standards for prompt investigation of claims
Section 70	Standards for prompt, fair and equitable settlement of claims applicable to all insurers
Section 80	Standards for prompt, fair and equitable settlements applicable to automobile insurance

Chapter 402

[RESERVED] (create report)

Section 10

[Reserved]

Chapter 410

RULES GOVERNING MULTIPLE EMPLOYER WELFARE ARRANGEMENTS (create report)

Section 10	Purpose
Section 20	Applicability and scope
Section 30	Definitions
Section 40	Licensing and filing requirements
Section 50	Licensing of persons soliciting, negotiating, procuring, or effecting applications for coverage
Section 60	Violations
Section 70	Service of process
Section 80	Severability
FORMS	FORMS (14VAC5-410)

Chapter 420

RULES GOVERNING MILITARY SALES PRACTICES (create report)

Section 10	Purpose and scope
Section 20	Definitions
Section 30	Exemptions
Section 40	Prohibited practices on a military installation
Section 50	Prohibited practices regardless of location
Section 60	Severability
FORMS	FORMS (14VAC5-420)
DIBR	DOCUMENTS INCORPORATED BY REFERENCE (14VAC5-420)