Administrative Code

Creating a Report: Check the sections you'd like to appear in the report, then use the "Create Report" button at the bottom of the page to generate your report. Once the report is generated you'll then have the option to download it as a pdf, print or email the report.

Virginia Administrative Code
Title 14. Insurance
12/3/2020

14VAC5. State Corporation Commission, Bureau Of Insurance

VAC AGENCY NUMBER 5

STATE CORPORATION COMMISSION, BUREAU OF INSURANCE

AGENCY SUMMARY

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; accident and sickness insurers; burial societies; insurance agents; surplus lines brokers; insurance consultants; public adjusters; managing general agents; reinsurance intermediaries; title insurance companies;  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, 40, 41, 46, 47 and 48. It may also license plans for health services, prepaid legal services, dental plan organizations, and dental and optometric services. Id., Chapters 42, 44, 45, and 61. It licenses health maintenance organizations. Id., Chapter 43.

The Commission regulates Medicare supplement and long-term care insurance policies. Id., Chapters 36 and 52. It registers 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. It administers 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 approves forms for insurance policies, contracts, certificates, application endorsements, riders, and forms for premium finance agreements, prescribes 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, Medicare supplement, health maintenance organization, 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 assigns risks for motor vehicle liability and workers' compensation insurance and establishes rates for such assigned risk policies. Title 46.2, Chapter 3, Art. 16; Title 65.2, Chapter 8. It also approves and supervises industry plans for distribution of risks as to certain fire and extended property insurance. It may 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 appealing a denial issued by a Managed Care Health Insurance Plan (MCHIP).  Title 38.2, Chapters 58 and 59.  A covered person or his authorized representative may ask the Bureau of Insurance for an External Review of an adverse decision concerning a denied health service in accordance with regulations promulgated by the Commission.  Title 38.2, Chapter 35.1.

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 the collection of certain assessments imposed on insurance companies, measured by premium income. The Commission may order refunds or additions and review and correct erroneous assessments. Title 38.2, Chapter 4; Title 58.1, Chapter 20.

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

The Commission also regulates title settlement agents who provide escrow, closing, or other settlement services in connection with a transaction related to real estate.  Title 55, Chapter 27.3

Regulations are available at the Bureau of Insurance offices, 1300 East Main Street, Sixth Floor, Post Office Box 1157, Richmond, VA 23218-1157. Internet address:     http://www.scc.virginia.gov/boi/  .

Rev. 08/2019

 

 

Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader's convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.