§ 38.2-6112. Licensing of agents
Dental benefit contracts may be solicited only through health insurance agents and limited lines life and health agents licensed in accordance with Chapter 18 (§ 38.2-1800 et seq.) of this title. Home office salaried officers whose principal duties and responsibilities do not include the negotiation or solicitation of dental benefit contracts shall not be required […]
§ 38.2-6113. Application of other laws
A. Except to the extent that such application would be inconsistent with any provision of this chapter, the provisions of Chapter 5 (§ 32.1-123 et seq.) of Title 32.1 and of other chapters of this title, and regulations promulgated thereunder, that are applicable to (i) an insurer licensed pursuant to § 38.2-1024, (ii) a carrier […]
§ 38.2-6108. Plan dentist contracts; preferred providers; assignment of benefits
A. Each contract with a plan dentist shall contain the following provisions: 1. A hold harmless clause that satisfies the requirements of subdivision C 9 of § 38.2-5805. 2. A provision specifying when the contract becomes effective. 3. A provision specifying the date the contract terminates. 4. A provision specifying the renewal terms. 5. Provisions […]
§ 38.2-6109. Delivery of contract forms
The dental plan organization: 1. Shall provide a written dental benefit contract to each group contract holder within 15 days of acceptance of the group’s application by the dental plan organization; 2. Shall provide a written evidence of coverage to each individual covered under a group dental benefit contract within 15 days of acceptance of […]
§ 38.2-6110. Filing requirements for premium rates and subscription fees
A. The filing with the Commission of any dental benefit contract or rider or endorsement by a dental plan organization shall be accompanied by the filing of premium rates or subscription fees. B. A subsequent change in premium rates or subscription fees shall be filed with supporting data at least 30 days before the change […]
§ 38.2-6111. Examinations
A. The Commission shall examine the affairs of each dental plan organization as provided for in § 38.2-1317. B. Instead of making its own examination, the Commission may accept the report of an examination of a foreign dental plan organization certified by the insurance supervisory official, similar regulatory agency, or the state health commissioner of […]
§ 38.2-6105. Required dental benefit contract provisions
A. Each dental benefit contract shall contain the following provisions: 1. An effective date of the contract; 2. A provision describing the payment of required subscription fees or premiums; 3. A grace period provision that complies with § 38.2-6107; 4. For group dental benefit contracts, the eligibility requirements and effective date of coverage for subscribers […]
§ 38.2-6106. Optional provisions
Dental benefit contracts may contain the following provisions: 1. A provision including the dental plan organization’s intention to charge a specified missed appointment fee. The fee shall be reasonable in relation to the nature of the procedure for which the missed appointment had been made. Neither the plan dentist nor the dental plan organization may […]
§ 38.2-6107. Grace period requirements
The contract holder shall be given a 31-day grace period for the payment of any premium falling due after the first premium during which coverage remains in effect. If payment is not received within the 31 days, coverage may be cancelled after the thirty-first day and the contract holder may be held liable for the […]
§ 38.2-6102. License application
A. No person shall establish or operate a dental plan organization in the Commonwealth without first obtaining a license from the Commission. Any business entity, which is neither an individual nor a sole proprietorship, may apply to the Commission for a license to establish and operate a dental plan organization in compliance with this chapter. […]