Vermont S 30: An act relating to the regulation of hydrofluorocarbons

Bill Text

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VT LEG #383327 v.1
No. 11. An act relating to updating and reorganizing the health insurance
statutes in 8 V.S.A. chapter 107.
(S.30)
It is hereby enacted by the General Assembly of the State of Vermont:
* * * Repeal of Existing 8 V.S.A. Chapter 107 * * *
Sec. 1. REPEAL OF EXISTING 8 V.S.A. CHAPTER 107
8 V.S.A. chapter 107 (health insurance) is repealed.
* * * Enactment of Updated and Reorganized 8 V.S.A. Chapter 107 * * *
Sec. 2. 8 V.S.A. chapter 107 is added to read:
CHAPTER 107. HEALTH INSURANCE
Subchapter 1. General Provisions
§ 4011. DEFINITIONS
As used in this chapter:
(1) “Covered individual” means an individual who is covered by a
health insurance plan, whether as the primary subscriber or policyholder or as a
dependent, employee, or employee’s dependent under the plan.
(2) “Health care services” means services for the diagnosis, prevention,
treatment, cure, or relief of a health condition, illness, injury, or disease.
(3) “Health insurance plan” means a policy or contract issued by a
health insurer, including the health benefit plan or plans offered by the State of
Vermont to its employees and any health benefit plan offered by any agency or
instrumentality of the State to its employees. Unless otherwise specified,
“health insurance” does not include Vermont Medicaid.

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VT LEG #383327 v.1
(4) “Health insurer” means an insurance company that provides health
insurance as defined in subdivision 3301(a)(2) of this title, a nonprofit hospital
or medical service corporation, a managed care organization, a health
maintenance organization, and, to the extent permitted under federal law, any
administrator of an insured, self-insured, or publicly funded health care benefit
plan offered by a public or private entity.
(5) “Major medical insurance” means a comprehensive health insurance
plan that is not specific disease, accident, hospital indemnity, dental care,
vision care, disability income, long-term care, Medicare supplement insurance,
or other limited-benefit coverage. The term does not include short-term,
limited-duration health insurance coverage or a plan under which benefits are
paid directly to a covered individual or the individual’s assigns and for which
the amount of the benefit is not based on potential medical costs or on actual
costs incurred.
§ 4012. COMPLIANCE WITH FEDERAL LAW
(a) Except as otherwise provided in this title, health insurers, hospital and
medical service corporations, and health maintenance organizations that issue,
sell, renew, or offer health insurance plans in Vermont shall comply with the
requirements of the Health Insurance Portability and Accountability Act of
1996, as amended from time to time (42 U.S.C. Chapter 6A, Subchapter
XXV), and the Patient Protection and Affordable Care Act of 2010, Pub. L.
No. 111-148, as amended by the Health Care and Education Reconciliation Act

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of 2010, Pub. L. No. 111-152. The Commissioner shall enforce such
requirements pursuant to the Commissioner’s authority under this title.
(b)(1) Health insurers, hospital and medical service corporations, health
maintenance organizations, and health care providers, as that term is defined in
18 V.S.A. § 9432, shall comply with the requirements of the No Surprises Act,
Pub. L. No. 116-260, Division BB, Title I, as amended from time to time.
(2) The Commissioner shall enforce the requirements of the No
Surprises Act as they apply to health insurers, hospital and medical service
corporations, health maintenance organizations, and health care providers, to
the extent permitted under federal law, pursuant to the Commissioner’s
authority under this title. The Commissioner may also refer cases of
noncompliance to the U.S. Department of Health and Human Services under
the terms of a collaborative enforcement agreement, or to the Office of the
Vermont Attorney General.
§ 4013. DISCRIMINATION PROHIBITED
No health insurer shall make or permit any unfair discrimination between
individuals of substantially the same hazard in the amount of premium rates
charged for any health insurance plan or in the benefits payable under the plan;
provided, however, that this section shall not be construed to prohibit different
premium rates, different benefits, or different underwriting procedure for
individuals insured under group, family expense, or blanket plans of insurance.

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VT LEG #383327 v.1
§ 4014. ADVERTISING PRACTICES
(a) No company doing business in this State, and no insurance agent or
broker, shall use in connection with the solicitation of health insurance or
pharmacy benefit management any advertising copy or advertising practice or
any plan of solicitation that is materially misleading or deceptive. An
advertising copy or advertising practice or plan of solicitation shall be
considered to be materially misleading or deceptive if by implication or
otherwise it transmits information in such