{"data":{"id":"us-va/14vac5-211-190","jurisdiction":"us-va","citation":"14VAC5-211-190","heading":"Limited health care services","body":"A. A health maintenance organization  may offer limited health care services  in either dental care or vision care services.\n\nB. A health maintenance organization shall be reasonably assured that the enrollee has obtained pediatric oral essential health benefits from an exchange-certified stand-alone dental plan for coverage purchased in the individual or small group markets outside the health insurance exchange. A health maintenance organization shall be deemed to have obtained reasonable assurance that such pediatric oral health benefits are provided to the enrollee if:\n\n1. At least one qualified dental plan, as defined in § 38.2-3455 of the Code of Virginia, (i) offers the minimum essential pediatric oral health benefits that are required under the ACA and (ii) is available for purchase by a subscriber or enrollee; and\n\n2. The health maintenance organization 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 ACA-required minimum essential pediatric oral health benefits.","path":["Title 14. Insurance","Agency 5. State Corporation Commission, Bureau of Insurance","Chapter 211. Rules Governing Health Maintenance Organizations","Part IV. Services"],"source_url":"https://law.lis.virginia.gov/admincode/title14/agency5/chapter211/section190/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:51:54Z","sha256":"b4d6938df70bb132cce184bd2b7e9e1d523e4de8679a7a41f96fdd1d259a4378","source_id":"us-va-vac","stale":false,"prev":"us-va/14vac5-211-180","next":"us-va/14vac5-211-210"},"notice":"GroundRules: Original legal text. Not legal advice."}