A. The terms defined in § 38.2-3431 that are used in this article shall havethe meanings set forth in that section.
B. For purposes of this article:
"Eligible individual" means an individual:
1. (i) for whom, as of the date on which the individual seeks coverage underthis section, the aggregate of the periods of creditable coverage is 18 ormore months and (ii) whose most recent prior creditable coverage was underindividual health insurance coverage, a group health plan, governmental plan,church plan, or a state plan under Title XIX of the Social Security Act (42U.S.C. § 1396 et seq.), or health insurance coverage offered in connectionwith any such plan;
2. Who is not eligible for coverage under (i) a group health plan, (ii) partA or part B of Title XVIII of the Social Security Act, or (iii) a state planunder Title XIX of such Act, or any successor program, and does not haveother health insurance coverage;
3. With respect to whom the most recent coverage within the coverage perioddescribed in subdivision 1 was not terminated based on a factor described insubdivision B 1 or B 2 of § 38.2-3430.7 relating to nonpayment of premiums orfraud;
4. If the individual had been offered the option of continuation coverageunder a COBRA continuation provision or under a similar state program, whoelected such coverage;
5. Who, if the individual elected such continuation coverage, has exhaustedsuch continuation coverage under such provision or program; and
6. In the case where individual health insurance coverage is the most recentcreditable coverage, the coverage was nonrenewed by the health insuranceissuer under the conditions allowed in subdivision C 2 of § 38.2-3430.7, inwhich case the aggregate period of creditable coverage required is reduced to12 months.
For the purposes of determining the aggregate of the periods of creditablecoverage under subdivision B 1 (i) of this section, a period of creditablecoverage shall not be counted with respect to enrollment of an individualunder a health benefit plan if, after such period, there was a 63-day periodduring all of which the individual was not covered under any creditablecoverage or was not serving a waiting period for coverage under a grouphealth plan, or for group health insurance coverage or was in an affiliationperiod. This period shall begin on the day following an individual'stermination of coverage and shall continue until the date an individualsubmits an application for coverage. In those cases where an application issubmitted by mail, the date of postmark shall be deemed to be the date theapplication is submitted.
(1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.)
A. The terms defined in § 38.2-3431 that are used in this article shall havethe meanings set forth in that section.
B. For purposes of this article:
"Eligible individual" means an individual:
1. (i) for whom, as of the date on which the individual seeks coverage underthis section, the aggregate of the periods of creditable coverage is 18 ormore months and (ii) whose most recent prior creditable coverage was underindividual health insurance coverage, a group health plan, governmental plan,church plan, or a state plan under Title XIX of the Social Security Act (42U.S.C. § 1396 et seq.), or health insurance coverage offered in connectionwith any such plan;
2. Who is not eligible for coverage under (i) a group health plan, (ii) partA or part B of Title XVIII of the Social Security Act, or (iii) a state planunder Title XIX of such Act, or any successor program, and does not haveother health insurance coverage;
3. With respect to whom the most recent coverage within the coverage perioddescribed in subdivision 1 was not terminated based on a factor described insubdivision B 1 or B 2 of § 38.2-3430.7 relating to nonpayment of premiums orfraud;
4. If the individual had been offered the option of continuation coverageunder a COBRA continuation provision or under a similar state program, whoelected such coverage;
5. Who, if the individual elected such continuation coverage, has exhaustedsuch continuation coverage under such provision or program; and
6. In the case where individual health insurance coverage is the most recentcreditable coverage, the coverage was nonrenewed by the health insuranceissuer under the conditions allowed in subdivision C 2 of § 38.2-3430.7, inwhich case the aggregate period of creditable coverage required is reduced to12 months.
For the purposes of determining the aggregate of the periods of creditablecoverage under subdivision B 1 (i) of this section, a period of creditablecoverage shall not be counted with respect to enrollment of an individualunder a health benefit plan if, after such period, there was a 63-day periodduring all of which the individual was not covered under any creditablecoverage or was not serving a waiting period for coverage under a grouphealth plan, or for group health insurance coverage or was in an affiliationperiod. This period shall begin on the day following an individual'stermination of coverage and shall continue until the date an individualsubmits an application for coverage. In those cases where an application issubmitted by mail, the date of postmark shall be deemed to be the date theapplication is submitted.
(1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.)
A. The terms defined in § 38.2-3431 that are used in this article shall havethe meanings set forth in that section.
B. For purposes of this article:
"Eligible individual" means an individual:
1. (i) for whom, as of the date on which the individual seeks coverage underthis section, the aggregate of the periods of creditable coverage is 18 ormore months and (ii) whose most recent prior creditable coverage was underindividual health insurance coverage, a group health plan, governmental plan,church plan, or a state plan under Title XIX of the Social Security Act (42U.S.C. § 1396 et seq.), or health insurance coverage offered in connectionwith any such plan;
2. Who is not eligible for coverage under (i) a group health plan, (ii) partA or part B of Title XVIII of the Social Security Act, or (iii) a state planunder Title XIX of such Act, or any successor program, and does not haveother health insurance coverage;
3. With respect to whom the most recent coverage within the coverage perioddescribed in subdivision 1 was not terminated based on a factor described insubdivision B 1 or B 2 of § 38.2-3430.7 relating to nonpayment of premiums orfraud;
4. If the individual had been offered the option of continuation coverageunder a COBRA continuation provision or under a similar state program, whoelected such coverage;
5. Who, if the individual elected such continuation coverage, has exhaustedsuch continuation coverage under such provision or program; and
6. In the case where individual health insurance coverage is the most recentcreditable coverage, the coverage was nonrenewed by the health insuranceissuer under the conditions allowed in subdivision C 2 of § 38.2-3430.7, inwhich case the aggregate period of creditable coverage required is reduced to12 months.
For the purposes of determining the aggregate of the periods of creditablecoverage under subdivision B 1 (i) of this section, a period of creditablecoverage shall not be counted with respect to enrollment of an individualunder a health benefit plan if, after such period, there was a 63-day periodduring all of which the individual was not covered under any creditablecoverage or was not serving a waiting period for coverage under a grouphealth plan, or for group health insurance coverage or was in an affiliationperiod. This period shall begin on the day following an individual'stermination of coverage and shall continue until the date an individualsubmits an application for coverage. In those cases where an application issubmitted by mail, the date of postmark shall be deemed to be the date theapplication is submitted.
(1997, cc. 807, 913; 1998, c. 24; 1999, c. 1004; 2010, cc. 225, 642.)
