{"data":{"id":"us-va/14vac5-135-50","jurisdiction":"us-va","citation":"14VAC5-135-50","heading":"Prohibitions, limitations, and disclosures","body":"A. A health carrier shall not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, gender expression, sexual orientation, or status as a transgender individual. Nothing in this section shall be construed to prevent a health carrier from appropriately utilizing reasonable medical management techniques including medical necessity.\n\nB. If a health carrier offers an optional benefit to a health benefit plan, the health carrier may file a separate schedule that includes the additional benefit and identify the health benefit plan to which the schedule applies. A different plan identification is necessary to distinguish the health benefit plan with the additional benefit.\n\nC. A health carrier may offer a health benefit plan that does not include pediatric oral health benefits if:\n\n1. The health carrier is reasonably assured that pediatric oral health benefits are available to the purchaser of the health benefit plan in accordance with § 38.2-3451 B of the Code of Virginia, and\n\n2. The plan contains the following statement on the first page of the policy and bold:\n\n\"This policy does not provide the ACA-required pediatric oral health benefits.\"\n\nD. If an individual policy contains a military service exclusion or a provision that suspends coverage during military service, the policy shall provide for a refund of unearned premium upon receipt of written notice of the military service.\n\nE. A policy application shall not contain questions about any health-status related factors other than age and tobacco use.\n\nF. A policy shall only be rated on age, tobacco use, geographic location, plan category, and whether the policy covers dependents in accordance with § 38.2-3447 of the Code of Virginia.\n\nG. No policy shall contain a provision that allows for increase in premium or change in deductible except during renewal.\n\nH. A health benefit plan shall not impose any preexisting condition exclusion.\n\nI. Policy exclusions may be no more restrictive than allowed by the state-selected essential health benefits benchmark plan.","path":["Title 14. Insurance","Agency 5. State Corporation Commission, Bureau of Insurance","Chapter 135. Rules Governing Individual and Small Group Market Health Benefit Plans"],"source_url":"https://law.lis.virginia.gov/admincode/title14/agency5/chapter135/section50/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:51:51Z","sha256":"f7ef90698cde123fd68952b0890bfa3048e4da11349f92d6c5a94ee479e39e55","source_id":"us-va-vac","stale":false,"prev":"us-va/14vac5-135-40","next":"us-va/14vac5-135-60"},"notice":"GroundRules: Original legal text. Not legal advice."}