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 Virginia Administrative Code (Last Updated: January 10, 2017)
 Title 14. Insurance
 Agency 5. State Corporation Commission, Bureau of Insurance
 Chapter 190. Rules Governing the Reporting of Cost and Utilization Data Relating to Mandatedbenefits and Mandated Providers

  Section 40. Reporting requirements  

Latest version.

  • A. Full report required. Except as set forth in subsections B and C of this section, all insurers, health services plans and health maintenance organizations licensed to issue policies of accident and sickness insurance or subscription contracts in the Commonwealth of Virginia must file a full and complete Form MB-1 report in accordance with the provisions of 14VAC5-190-50.

    B. Exemption: No report required. Any insurer, health services plan or health maintenance organization whose total Virginia annual written premiums for all accident and sickness policies or subscription contracts, as reported to the commission on its Annual Statement for a particular reporting period is less than $500,000 shall, for that reporting period, be exempt from filing a report as required by these rules, and shall not be required to notify the commission of such exemption other than through the timely filing of its Annual Statement.

    C. Eligibility to file abbreviated report. Any insurer, health services plan or health maintenance organization that does not qualify for an exemption under subsection B of this section may file an abbreviated report, as described in subsection D of this section if its Virginia annual written premiums for applicable policies or contracts, as defined in 14VAC5-190-30 of these rules, that were subject to the requirements of § 38.2-3408 or § 38.2-4221, and the requirements of §§ 38.2-3409 through 38.2-3419 of the Code of Virginia during the reporting period total less than $500,000.

    D. Abbreviated report defined. The abbreviated report shall include a completed first page of the Form MB-1 report format prescribed by the commission in Appendix A of this chapter, or as later modified pursuant to 14VAC5-190-60, along with a breakdown of the insurer's, health services plan's, or health maintenance organization's Virginia written premiums for all accident and sickness policies or contracts for the reporting period by policy type (e.g., Medicare supplement, major medical, disability income, limited benefit) and by situs (e.g., Virginia, Illinois).

Historical Notes

Derived from Regulation 38, Case No. INS910044, § 4, eff. October 1, 1991; amended, Case No. INS940147, Volume 11, Issue 08, eff. December 7, 1994.

Statutory Authority

§§ 12.1-13, 38.2-223 and 38.2-3419.1 of the Code of Virginia.