- Report Published -
|The Financial Impact of Mandated Health Insurance Benefits and Providers Pursuant to Section 38.2-3419.1 of the Code of Virginia: 1996 Reporting Period|
|State Corporation Commission|
|Section 38.2-3419.1 of the Code of Virginia and the State Corporation Commission's "Rules Governing the Reporting of Cost and Utilization Data Relating to Mandated Benefits and Mandated Providers" (14 VAC 5-190-10 et seq.) require every insurer, health services plan, and health maintenance organization (HMO) from which a report is deemed necessary to report annually to the Commission cost and utilization information for each of the mandated benefits and mandated providers identified in §§ 38.2-3408 through 38.2-3419, and 38.2-4221 of the Code of Virginia. This document is the Commission's consolidation of reports submitted by affected companies for the 1996 calendar year reporting period.|
Of the 902 companies licensed to issue accident and sickness policies or subscription contracts in Virginia, or licensed as HMOs in Virginia in 1996, 74 were required to file full reports for the 1996 reporting period. Information presented in this report reflects data reported by 47 insurers, exclusive of HMOs, that provided credible data. Of these companies, 8 issued only individual, 24 issued only group, and 15 issued both individual and group health insurance policies or subscription contracts in Virginia in 1996. This report reflects data reported by companies representing 48.7% of the Virginia accident and sickness insurance market and 761,048 units of coverage (single and family individual policies and group certificates) subject to Virginia's mandated benefit and provider requirements. The credible reports of 25 HMOs, representing an additional 29.9% of the Virginia accident and sickness market and 703,029 contracts or certificates (units of coverage), were also used in the preparation of this report. Because HMOs are not subject to most of the mandated benefit and mandated provider requirements of Title 38.2 of the Code of Virginia and are regulated by the Commission's "Rules Governing Health Maintenance Organizations" (14 VAC 5-210-10 et seq.) with regard to the services they must provide, the data reported by these companies has been analyzed separately from data reported by insurers and health services plans.