SB 335

  • Virginia Senate Bill
  • 2022 Regular Session
  • Introduced in Senate Jan 11, 2022
  • Passed Senate Jan 28, 2022
  • Passed House Feb 25, 2022
  • Signed by Governor Apr 11, 2022

Health insurance; association health plan for real estate salespersons.

Abstract

Health insurance; association health plan for real estate salespersons. Provides that a licensed insurer may issue a policy of group accident and sickness insurance to an association of real estate salespersons (association), which association shall be deemed the policyholder, and that such association health plan is not considered to be insurance and is not subject to the existing requirements for insurance if certain requirements are met. The bill requires that (i) all members of the association be eligible for coverage and membership, including employer members with at least one employee that is domiciled in the Commonwealth or self-employed individuals; (ii) membership in the association not be conditioned on any health status–related factor; (iii) the coverage offered through the association be available to all members regardless of any health status–related factor; (iv) the association not make health insurance coverage offered through the association available other than in connection with a member of the association; and (v) premiums for the policy be paid from funds contributed by the association or associations, or by employer members, or by both, or from funds contributed by the covered persons or from both the covered persons and the association, associations, or employer members. The bill also requires that the association (a) has at the outset a minimum of 25,000 members; (b) has been organized and maintained in good faith for purposes other than that of obtaining insurance; (c) has been in active existence for at least five years; and (d) has a constitution and bylaws that provide that the association hold regular meetings not less than annually to further purposes of the members, that the association collects dues or solicits contributions from members, and that the members have voting privileges and representation on the governing board and committees.The bill provides that any such policy shall (1) be considered a large group market plan subject to all coverage mandates applicable to a large group market plan, (2) be subject to the group health plan coverage requirements under the federal Patient Protection and Affordable Care Act, (3) be prohibited from denying coverage under the policy on the basis of a pre-existing condition, (4) be guaranteed issue and guaranteed renewable, (5) provide essential health benefits and cost-sharing requirements, and (6) offer a minimum level of coverage designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan.The bill requires an insurer issuing such policy to an association to (A) treat all of the members and employees of employer members who are enrolled in coverage under the policy as a single risk pool; (B) set premiums on the basis of the collective group experience of the members and employees of employer members who are enrolled in coverage under the policy; (C) not vary premiums by age, except that the rate shall not vary by more than four to one for adults; (D) not vary premiums on the basis of gender; (E) not vary premiums on the basis of the health status of an individual employee of an employer member or a self-employed individual member; and (F) not establish discriminatory rules based on the health status of an employer member, an individual employee of an employer member, or a self-employed individual for eligibility or contribution.Finally, the bill provides that a policy that meets certain requirements of the bill is considered to be compliant with the large group market insurance regulations under the federal Public Health Service Act and, as such, the Commonwealth is considered to be substantially enforcing the federal Patient Protection and Affordable Care Act with regard to such policy. The bill requires the State Corporation Commission to regulate the policy in a manner that is consistent with such provisions. The bill provides that, in any case in which a federal agency renders a decision that is contrary to such provisions, notwithstanding any other provision of law, the Attorney General may resolve any difference between federal law and the laws of the Commonwealth. This bill incorporates SB 397 and is identical to HB 768.

Health insurance; association health plan for real estate salespersons. Provides that a licensed insurer may issue a policy of group accident and sickness insurance to an association of real estate salespersons (association), which association shall be deemed the policyholder, and that such association health plan is not considered to be insurance and is not subject to the existing requirements for insurance if certain requirements are met. The bill requires that (i) all members of the association be eligible for coverage and membership, including employer members with at least one employee that is domiciled in the Commonwealth or self-employed individuals; (ii) membership in the association not be conditioned on any health status–related factor; (iii) the coverage offered through the association be available to all members regardless of any health status–related factor; (iv) the association not make health insurance coverage offered through the association available other than in connection with a member of the association; and (v) premiums for the policy be paid from funds contributed by the association or associations, or by employer members, or by both, or from funds contributed by the covered persons or from both the covered persons and the association, associations, or employer members. The bill also requires the association (a) has at the outset a minimum of 100 members; (b) has been organized and maintained in good faith for purposes other than that of obtaining insurance; (c) has been in active existence for at least five years; and (d) has a constitution and bylaws that provide that the association hold regular meetings not less than annually to further purposes of the members, that the association collects dues or solicits contributions from members, and that the members have voting privileges and representation on the governing board and committees.The bill provides that any such policy shall (1) be considered a large group market plan subject to all coverage mandates applicable to a large group market plan, (2) be subject to the group health plan coverage requirements under the federal Patient Protection and Affordable Care Act, (3) be prohibited from denying coverage under the policy on the basis of a pre-existing condition, (4) shall be guaranteed issue and guaranteed renewable, (5) provide essential health benefits and cost-sharing requirements, and (6) offer a minimum level of coverage designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan.The bill requires an insurer issuing such policy to an association to (A) treat all of the members and employees of employer members who are enrolled in coverage under the policy as a single risk pool; (B) set premiums on the basis of the collective group experience of the members and employees of employer members who are enrolled in coverage under the policy; (C) not vary premiums by age, except that the rate shall not vary by more than four to one for adults; (D) not vary premiums on the basis of gender; (E) not vary premiums on the basis of the health status of an individual employee of an employer member or a self-employed individual member; and (F) not establish discriminatory rules based on the health status of an employer member, an individual employee of an employer member, or a self-employed individual for eligibility or contribution.Finally, the bill provides that a policy that meets certain requirements of the bill is considered to be compliant with the large group market insurance regulations under the federal Public Health Service Act and, as such, the Commonwealth is considered to be substantially enforcing the federal Patient Protection and Affordable Care Act with regard to such policy. The bill requires the State Corporation Commission to regulate the policy in a manner that is consistent with such provisions. The bill provides that, in any case in which a federal agency renders a decision that is contrary to such provisions, notwithstanding any other provision of law, the Attorney General may resolve any difference between federal law and the laws of the Commonwealth. This bill incorporates SB 397.

Health insurance; association health plan for real estate salespersons. Provides that a licensed insurer may issue a policy of group accident and sickness insurance to an association of real estate salespersons (association), which association shall be deemed the policyholder, and that such association health plan is not considered to be insurance and is not subject to the existing requirements for insurance if certain requirements are met. The bill requires that (i) all members of the association be eligible for coverage and membership, including employer members with at least one employee that is domiciled in the Commonwealth or self-employed individuals; (ii) membership in the association not be conditioned on any health status–related factor; (iii) the coverage offered through the association be available to all members regardless of any health status–related factor; (iv) the association not make health insurance coverage offered through the association available other than in connection with a member of the association; and (v) premiums for the policy be paid from funds contributed by the association or associations, or by employer members, or by both, or from funds contributed by the covered persons or from both the covered persons and the association, associations, or employer members. The bill also requires the association (a) has at the outset a minimum of 100 members; (b) has been organized and maintained in good faith for purposes other than that of obtaining insurance; (c) has been in active existence for at least five years; and (d) has a constitution and bylaws that provide that the association hold regular meetings not less than annually to further purposes of the members, that the association collects dues or solicits contributions from members, and that the members have voting privileges and representation on the governing board and committees. The bill provides that any such policy shall (1) be considered a large group market plan subject to all coverage mandates applicable to a large group market plan, (2) be subject to the group health plan coverage requirements under the federal Patient Protection and Affordable Care Act, (3) be prohibited from denying coverage under the policy on the basis of a pre-existing condition, (4) shall be guaranteed issue and guaranteed renewable, (5) provide essential health benefits and cost-sharing requirements, and (6) offer a minimum level of coverage designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan. The bill requires an insurer issuing such policy to an association to (A) treat all of the members and employees of employer members who are enrolled in coverage under the policy as a single risk pool; (B) set premiums on the basis of the collective group experience of the members and employees of employer members who are enrolled in coverage under the policy; (C) not vary premiums by age, except that the rate shall not vary by more than four to one for adults; (D) not vary premiums on the basis of gender; (E) not vary premiums on the basis of the health status of an individual employee of an employer member or a self-employed individual member; and (F) not establish discriminatory rules based on the health status of an employer member, an individual employee of an employer member, or a self-employed individual for eligibility or contribution. Finally, the bill provides that a policy that meets certain requirements of the bill is considered to be compliant with the large group market insurance regulations under the federal Public Health Service Act and, as such, the Commonwealth is considered to be substantially enforcing the federal Patient Protection and Affordable Care Act with regard to such policy. The bill requires the State Corporation Commission to regulate the policy in a manner that is consistent with such provisions. The bill provides that, in any case in which a federal agency renders a decision that is contrary to such provisions, notwithstanding any other provision of law, the Attorney General may resolve any difference between federal law and the laws of the Commonwealth.

Bill Sponsors (11)

Votes


Actions


Apr 11, 2022

Office of the Governor

Approved by Governor-Chapter 350 (effective 7/1/22)

Mar 11, 2022

Office of the Governor

Governor's Action Deadline 11:59 p.m., April 11, 2022

Senate

Enrolled Bill Communicated to Governor on March 11, 2022

Mar 07, 2022

Senate

Impact statement from SCC (SB335ER)

Mar 04, 2022

Senate

Enrolled

House

Signed by Speaker

Senate

Signed by President

Mar 01, 2022

Senate

House amendments agreed to by Senate (40-Y 0-N)

Feb 25, 2022

House

House committee, floor amendments and substitutes offered

House

VOTE: Passage (97-Y 2-N)

House

Passed House with amendments (97-Y 2-N)

House

Engrossed by House as amended

House

Amendment by Delegate Hodges agreed to

House

Committee amendments agreed to

House

Read third time

Feb 24, 2022

House

Read second time

Feb 22, 2022

House

Reported from Commerce and Energy with amendment(s) (22-Y 0-N)

House

House committee, floor amendments and substitutes offered

Feb 21, 2022

House

Referred to Committee on Commerce and Energy

House

Read first time

House

Placed on Calendar

Jan 31, 2022

Senate

Impact statement from SCC (SB335S1)

Jan 28, 2022

Senate

Read third time and passed Senate (39-Y 0-N)

Jan 27, 2022

Senate

Read second time

Senate

Engrossed by Senate - committee substitute SB335S1

Senate

Committee substitute agreed to 22105198D-S1

Senate

Reading of substitute waived

Jan 26, 2022

Senate

Constitutional reading dispensed (38-Y 0-N)

Jan 24, 2022

Senate

Reported from Commerce and Labor with substitute (15-Y 0-N)

Senate

Incorporates SB397 (Cosgrove)

Senate

Committee substitute printed 22105198D-S1

Jan 23, 2022

Senate

Impact statement from SCC (SB335)

Jan 11, 2022

Senate

Referred to Committee on Commerce and Labor

Senate

Prefiled and ordered printed; offered 01/12/22 22104136D

Bill Text

Bill Text Versions Format
Prefiled and ordered printed; offered 01/12/22 22104136D PDF HTML
Committee substitute printed 22105198D-S1 PDF HTML
SB335ER PDF HTML
CHAP0350 PDF HTML

Related Documents

Document Format
Fiscal Impact Statement: SB335FER171.PDF PDF
Fiscal Impact Statement: SB335FS1171.PDF PDF
Fiscal Impact Statement: SB335F171.PDF PDF
Amendment: SB335AHE HTML
Amendment: SB335AH HTML

Sources

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