Agencies | Governor
Virginia Regulatory Town Hall
Agency
Department of Human Resource Management
Board
Department of Human Resource Management
chapter
Commonwealth of Virginia Health Benefits Program [1 VAC 55 ‑ 20]
Action:
Amends section 1VAC55-20 et seq. to assure that it is in compliance with legislation that has been passed on the state and federal level.
 
General Information
Action Summary These amendments bring 1 VAC55-20 et seq. into compliance with legislation that has been passed on the state and federal level. The program is required by the Code of Virginia to incorporate an independent medical review program. The Code has changed the name of the Department of Personnel and Training to the Department of Human Resource Management; and the Code has extended active coverage for surviving spouses of employees. Legislation has been passed which removes authority for a Health Benefits Advisory Council and a Local Advisory Council On the federal level, the Health Insurance Portability and Accountability Act (HIPAA) has required the plan to change the way it sets coverage effective dates. HIPAA has caused the plan to eliminate any pre-existing condition or evidence of insurability provisions. IRS section 125 regulations now require plan participants to make plan election changes on a prospective basis. The administration of the program is moving into the electronic age. The plan now uses electronic enrollment over the web and the regulations needed to reflect this paperless method of administration. During the 2000 session of the General Assembly, SB 1235 and HB 871 became law. These bills required the health benefits program for state employees to contract with one or more impartial health entities to review adverse medical claim decisions. These regulations set standards to assure that the impartial health entity conducting the reviews have adequate credentials and experience.
Chapters Affected Only affects this chapter.
Exempt from APA No, this action is not exempt from Article II of the APA and executive branch review.
RIS Project No project yet assigned to this action
New Periodic Review This action will not be used to conduct a new periodic review.
 
Stages
Stages associated with this regulatory action.
Stage ID Stage Type Status
1419 NOIRA Stage complete. Comment period ended 08/14/2002.
1556 NOIRA Stage complete. Comment period ended 08/14/2002.
1957 Proposed Stage withdrawn on 11/14/2002 before DPB completed its review.
2053 Proposed Stage withdrawn on 12/04/2002 before DPB completed its review.
2060 Proposed Stage complete. Comment period ended 10/31/2003.
2065 Emergency Stage complete. Emergency regulation expired on 10/01/2004.
2621 Final Stage complete. This regulation became effective on 07/16/2004.
 
Contact Information
Name / Title: Charles Reed  / Associate Director
Address: 101 N. Fourteenth St.
Richmond , VA 23219
Email Address: creed@dhrm.state.va.us
Phone: (804)786-3124    FAX: (804)371-0231