HB12: Group health insurance; allows coverage to be extended to full-time students under age 27.
Be it enacted by the General Assembly of Virginia:
1. That § 38.2-3525 of the Code of Virginia is amended and reenacted as follows:
§ 38.2-3525. Group accident and sickness insurance coverages of spouses, children, and other persons.
A. Coverage under a group accident and sickness insurance policy, except a policy issued pursuant to subsection B of § 38.2-3521.1, may be extended to insure:
1. The spouse and any child who is
under the age of 19 27 years ,
(ii) who is a dependent and under the age of 25 years, or (iii) who is a
dependent and a full-time student under 25 years of age,
without regard to whether such child resides in the same household as the
insured group member, or any class of spouse and dependent children, of each insured group member who so
2. Any other class of persons as may mutually be agreed upon by the insurer and the group policyholder.
B. The amount of accident and sickness insurance for the
dependent child, or other person shall not
exceed the amount of accident and sickness insurance for the insured group
C. At the insurer's option and subject to the policyholder's
election, the coverage for children of the insured group member may be extended
established in subsection A. Any such extension of coverage shall be as
mutually agreed upon by the insurer and the group policyholder.
D. Notwithstanding the provisions of § 38.2-3538, one
certificate may be issued for each insured group member if a statement
concerning any spouse's,
child's, or other person's coverage is included in the certificate.
E. When a policy provides coverage for a
dependent child age 27 or older pursuant
to subsection C who is enrolled based upon the child's status as a
full-time student and such child is unable due to a medical condition to
continue as a full-time student, coverage under the policy for such child
nevertheless shall continue in force provided the child's treating physician
certifies to the insurer at the time the child withdraws as a full-time student
that the child's absence is medically necessary. Coverage for such child shall
continue in force until the earlier of (i) the date that is 12 months from the
date the child ceases to be a full-time student or (ii) the date the child no
longer qualifies as a dependent
child under the terms of the group policy. A child's status as a full-time
student shall be determined in accordance with the criteria specified by the
institution in which the child is enrolled.