Virginia · Coverage Guide

Virginia health plans for families and employers.

Individual and family plans, employer-sponsored group coverage, and Medicaid context — all under one roof. ACA-compliant, network-friendly, and tailored to Virginia's enrollment and eligibility rules.

ACA-compliant plans Group plans for employers No-cost consultation
Marketplace
Virginia's Insurance Marketplace
State-based exchange launched plan year 2024. marketplace.virginia.gov
Medicaid program
Cardinal Care
Unified Medicaid + FAMIS brand, administered by DMAS. cardinalcare.virginia.gov
Carrier regulator
SCC Bureau of Insurance
Virginia State Corporation Commission. scc.virginia.gov
Uninsured rate
~7.1%
Virginia non-elderly uninsured rate (KFF, 2023 ACS). National average ~10.3%.
What Benefitra covers in Virginia

Four pillars. One platform.

Benefitra is the parent platform for benefits brokerage, HR SaaS, marketing, and decision-support tools. Virginia employers can adopt one pillar or stack them.

Insurance

Health, dental, vision, life, disability. Individual, family, group.

Funding strategies →

Employee Benefits

Seven funding paths: fully-insured, level-funded, self-funded, ICHRA, PEO-integrated, captive, Taft-Hartley.

Compare paths →

Marketing & SEO

Lead-engine and rankings for growing employers. Page-2-to-page-1 in months.

See trajectories →

Business Tools / SaaS

586 free calculators: ACA, COBRA, ROI, valuation, projector.

Browse tools →
Coverage options in Virginia

Affordable, compliant, and built for the way you actually buy.

Virginia health plans give consumers and employers more options for access to dependable health insurance coverage. These options match different budgets and needs.

Individual and family plans. Virginia health insurance includes individual and family plans bought through Virginia's Insurance Marketplace, the state-based exchange launched for plan year 2024 (replacing HealthCare.gov for Virginians). Plans are ACA-compliant and regulated by the Virginia State Corporation Commission Bureau of Insurance. Coverage depends on household income, county of residence, plan year, and eligibility — confirm complete details before enrolling.

Qualified health plans and subsidies. Marketplace plans meet the federal standard and include essential health benefits: doctor visits, hospital care, pharmacy, preventive, and maternity services. Most Virginia enrollees qualify for premium tax credits based on household income, and many also qualify for cost-sharing reductions on silver plans. Open enrollment runs annually (Nov 1 – Jan 15 historically), with special enrollment periods for qualifying life events such as losing coverage, marriage, birth, or move.

Cardinal Care: Virginia's Medicaid. Cardinal Care is the unified name for Virginia's Medicaid and FAMIS programs, administered by the Department of Medical Assistance Services (DMAS). It covers low-income adults, children, pregnant individuals, seniors, and people with disabilities. Virginia expanded Medicaid under the ACA in 2019, raising the income limit for adults to 138% of the federal poverty level. Medicare remains available for members eligible by age or disability.

Pairing a plan with an HSA. HSA-eligible high-deductible Virginia health plans let employees pay eligible medical expenses with pre-tax dollars, with 2026 contribution limits at $4,400 individual / $8,750 family per the IRS. Supplemental plans (accident, dental, vision, disability) cover gaps the primary medical plan doesn't.

Employer group plans in Virginia. Virginia employers with 2 or more employees can offer group health insurance year-round. Small groups (fewer than 25 employees) may qualify for the federal Small Business Health Care Tax Credit. Mid-market employers in the Hampton Roads, Richmond, and Northern Virginia corridors increasingly use level-funded, self-funded, or ICHRA designs to control renewals — Benefitra's Funding-Fit Discovery models the math across all seven arrangements.

Individuals

Individual & family plans

ACA-compliant plans with essential health benefits, network access, and subsidy eligibility based on income.

Employers

Group health insurance

Small-business and mid-market plans, level-funded and self-funded options, premium-stability strategies.

Public programs

Medicaid & Medicare

State-administered Medicaid for eligible Virginians; Medicare access by age or disability.

What Virginia clients say

Real outcomes, real Virginia employers.

Sam worked with us to decrease our health costs by nearly 50% without raising deductibles or limiting the doctor network. The savings let us add valuable benefits and he was always willing to take a call.

— Virginia employer, services

Without changing payroll or going through underwriting, we saved over 50% while upgrading to a PPO and improving benefits. The savings funded dental, vision, and a new full-time hire.

— Mid-Atlantic small business

The Benefitra plan lowered my family's cost substantially while improving coverage. I've been so happy with it that friends and family have since joined the plan as well.

— Virginia family plan member
Funding arrangements in Virginia

Six ways Virginia employers fund health benefits.

Funding arrangement is the financial structure underneath a health plan — who holds the claims risk, how premium flows, and which regulators apply. Virginia employers operate under the State Corporation Commission Bureau of Insurance for fully insured products and under federal ERISA for self-funded products. Each arrangement below has its own page covering mechanics, fit profile, and Virginia-specific context.

Frequently asked questions

Virginia health insurance — answered.

Marketplace, Medicaid, group plans, and ICHRA. Common Virginia-specific questions for families and employers.

Where do Virginians enroll in ACA health plans in 2026?
As of plan year 2024, Virginia operates its own state-based exchange — Virginia's Insurance Marketplace — instead of HealthCare.gov. Open enrollment runs annually with special enrollment for qualifying life events. Plans on the Marketplace are ACA-compliant qualified health plans, and most enrollees qualify for premium tax credits based on household income.
What is Cardinal Care and who qualifies?
Cardinal Care is the unified brand name for Virginia's Medicaid and FAMIS programs, administered by the Virginia Department of Medical Assistance Services (DMAS). It covers eligible low-income adults, children, pregnant individuals, seniors, and people with disabilities. Eligibility is based on household size and income relative to the federal poverty level. Virginia expanded Medicaid in 2019 to cover adults up to 138% FPL.
Who regulates Virginia health insurance carriers?
The Virginia State Corporation Commission Bureau of Insurance licenses carriers and brokers and reviews plan filings. Complaints, license verification, and rate filings flow through the Bureau. Brokers selling on Virginia's Insurance Marketplace are also separately registered with the Marketplace.
Can a Virginia small business offer group health insurance?
Yes. Small-group plans are available year-round for Virginia employers with 2 or more employees. Group plans guarantee issue regardless of medical history. Small businesses with fewer than 25 full-time-equivalent employees, average annual wages under the federal threshold, and contributions of at least 50% of employee premium may qualify for the Small Business Health Care Tax Credit.
What is ICHRA and is it allowed in Virginia?
ICHRA (Individual Coverage Health Reimbursement Arrangement) lets Virginia employers reimburse employees tax-free for individual ACA plans they buy on Virginia's Insurance Marketplace. ICHRA is federally permitted and fully available in Virginia. It is often used by employers who want a defined-contribution benefits budget while giving employees plan choice. Benefitra's Discovery tool models ICHRA against six other funding paths in 12 questions.

Find your Virginia funding fit in five minutes.

Answer twelve short questions. We grade your fit across the seven funding arrangements — fully-insured, level-funded, self-funded, captive, ICHRA, PEO-integrated, and Taft-Hartley.

Start the discovery →