§ 38.2-3407.16. Requirements for obstetrical care.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense-incurred basis, (ii) corporation providingindividual or group accident and sickness subscription contracts, and (iii)health maintenance organization providing a health care plan for health careservices, whose policies, contracts, or plans, including any certificate orevidence of coverage issued in connection with such policies, contracts orplans, include coverage for obstetrical services as an inpatient in a generalhospital or obstetrical services by a physician shall provide such benefitswith durational limits, deductibles, coinsurance factors, and copayments thatare no less favorable than for physical illness generally.
B. The requirements of this section shall apply to all insurance policies,contracts, and plans delivered, issued for delivery, reissued, renewed, orextended or at any time when any term of any such policy, contract, or planis changed or any premium adjustment is made, on and after the effective dateof this section. The provisions of this section shall not apply to short-termtravel, accident only, limited or specified disease, or individual conversionpolicies or contracts, nor to policies or contracts designed for issuance topersons eligible for coverage under Title XVIII of the Social Security Act,known as Medicare, or any other similar coverage under state or federalgovernmental plans.
§ 38.2-3407.16. Requirements for obstetrical care.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense-incurred basis, (ii) corporation providingindividual or group accident and sickness subscription contracts, and (iii)health maintenance organization providing a health care plan for health careservices, whose policies, contracts, or plans, including any certificate orevidence of coverage issued in connection with such policies, contracts orplans, include coverage for obstetrical services as an inpatient in a generalhospital or obstetrical services by a physician shall provide such benefitswith durational limits, deductibles, coinsurance factors, and copayments thatare no less favorable than for physical illness generally.
B. The requirements of this section shall apply to all insurance policies,contracts, and plans delivered, issued for delivery, reissued, renewed, orextended or at any time when any term of any such policy, contract, or planis changed or any premium adjustment is made, on and after the effective dateof this section. The provisions of this section shall not apply to short-termtravel, accident only, limited or specified disease, or individual conversionpolicies or contracts, nor to policies or contracts designed for issuance topersons eligible for coverage under Title XVIII of the Social Security Act,known as Medicare, or any other similar coverage under state or federalgovernmental plans.
§ 38.2-3407.16. Requirements for obstetrical care.
A. Each (i) insurer proposing to issue individual or group accident andsickness insurance policies providing hospital, medical and surgical or majormedical coverage on an expense-incurred basis, (ii) corporation providingindividual or group accident and sickness subscription contracts, and (iii)health maintenance organization providing a health care plan for health careservices, whose policies, contracts, or plans, including any certificate orevidence of coverage issued in connection with such policies, contracts orplans, include coverage for obstetrical services as an inpatient in a generalhospital or obstetrical services by a physician shall provide such benefitswith durational limits, deductibles, coinsurance factors, and copayments thatare no less favorable than for physical illness generally.
B. The requirements of this section shall apply to all insurance policies,contracts, and plans delivered, issued for delivery, reissued, renewed, orextended or at any time when any term of any such policy, contract, or planis changed or any premium adjustment is made, on and after the effective dateof this section. The provisions of this section shall not apply to short-termtravel, accident only, limited or specified disease, or individual conversionpolicies or contracts, nor to policies or contracts designed for issuance topersons eligible for coverage under Title XVIII of the Social Security Act,known as Medicare, or any other similar coverage under state or federalgovernmental plans.
