Bill Text: VA HB33 | 2014 | Regular Session | Comm Sub

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Pediatric oral health; essential health benefits.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Passed) 2014-03-27 - Governor: Acts of Assembly Chapter text (CHAP0307) [HB33 Detail]

Download: Virginia-2014-HB33-Comm_Sub.html

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14103562D
HOUSE BILL NO. 33 AMENDMENT IN THE NATURE OF A SUBSTITUTE (Proposed by the House Committee on Commerce and Labor on January 16, 2014) (Patron Prior to Substitute--Delegate Habeeb) A BILL to amend and reenact §38.2-3451 of the Code of Virginia, relating to essential health benefits; pediatric oral health benefits.

Be it enacted by the General Assembly of Virginia:

1. That §38.2-3451 of the Code of Virginia is amended and reenacted as follows:

§38.2-3451. Essential health benefits.

A. Notwithstanding any provision of §38.2-3431 or any other section of this title to the contrary, a health carrier offering a health benefit plan providing individual or small group health insurance coverage shall provide that such coverage includes the essential health benefits as required by §1302(a) of the PPACA. The essential health benefits package may also include associated cost-sharing requirements or limitations. No qualified health insurance plan that is sold or offered for sale through an exchange established or operating in the Commonwealth shall provide coverage for abortions, regardless of whether such coverage is provided through the plan or is offered as a separate optional rider thereto, provided that such limitation shall not apply to an abortion performed (i) when the life of the mother is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, or (ii) when the pregnancy is the result of an alleged act of rape or incest.

B. The provisions of subsection A regarding the inclusion of the PPACA-required minimum essential pediatric oral health benefits shall be deemed to be satisfied for health benefit plans made available in the small group market or individual market in the Commonwealth outside an exchange, as defined in §38.2-3455, issued on or after January 1, 2015, that do not include the PPACA-required minimum essential pediatric oral health benefits if the health carrier has obtained reasonable assurance that such pediatric oral health benefits are provided to the purchaser of the health benefit plan.  The health carrier shall be deemed to have obtained reasonable assurance that such pediatric oral health benefits are provided to the purchaser of the health benefit plan if:

1. At least one qualified dental plan, as defined in § 38.2-3455, (i) offers the minimum essential pediatric oral health benefits that are required under the PPACA and (ii) is available for purchase by the small group or individual purchaser; and

2. The health carrier prominently discloses, in a form approved by the Commission, at the time that it offers the health benefit plan that the plan does not provide the PPACA-required minimum essential pediatric oral health benefits.