§ 4091c. Termination for nonpayment of premium or subscription charges
§ 4091c. Termination for nonpayment of premium or subscription charges (a) If a group health insurance policy or subscriber contract provides for automatic termination of the policy or contract after a premium or subscription charge has remained unpaid through the grace period allowed for such payment, the carrier shall be liable for valid claims for […]
§ 4089j. Retail pharmacies; filling of prescriptions
§ 4089j. Retail pharmacies; filling of prescriptions (a) As used in this section: (1) “Health insurer” shall have the same meaning as in 18 V.S.A. § 9402 and shall also include Medicaid and any other public health care assistance program. (2) “Pharmacy benefit manager” means an entity that performs pharmacy benefit management. “Pharmacy benefit management” […]
§ 4090a. Continuation of group
§ 4090a. Continuation of group (a) All group health insurance policies, including dental policies, issued by an insurance company or a nonprofit hospital or medical service corporation; self-insured group plans; and prepaid health insurance plans, delivered or issued for delivery in this State, which insure employees or members for dental insurance or hospital and medical […]
§ 4090b. Continuation; notice; terms
§ 4090b. Continuation; notice; terms (a) A person electing continuation shall notify the insurer, or the policyholder, or the contractor, or agent for the group if the policyholder did not contract for the policy directly with the insurer, of such election in writing within 60 days after receiving notice following the occurrence of a qualifying […]
§ 4090c. Termination of coverage
§ 4090c. Termination of coverage Continuation of insurance under the group policy shall terminate upon the occurrence of any of the following: (1) The date 18 months after the date that insurance under the policy would have terminated due to a qualifying event, as defined in subsection 4090a(b) of this title. (2) The person fails […]
§ 4090d. Right of conversion
§ 4090d. Right of conversion All group health insurance policies, issued by an insurance company, a nonprofit hospital or medical service corporation, a self-insured group plan, and prepaid health insurance plans delivered or issued for delivery in this State which insure employees or members for hospital and medical insurance on an expense incurred, service or […]
§ 4090e. Conversion; notice; terms
§ 4090e. Conversion; notice; terms (a) Written application and the first premium payment for the converted policy shall be made to the insurer not later than 30 days prior to the date termination of the continuation of the group policy under section 4090a of this title would have occurred due to the death or termination […]
§ 4090f. Exemptions; termination
§ 4090f. Exemptions; termination (a) The insurer shall not be required to issue a converted policy if: (1) termination under the group policy occurred because the person: (A) was not entitled to continuation of group coverage under section 4090a of this title; or (B) failed to elect continuation as provided in section 4090b of this […]
§ 4090g. Options required
§ 4090g. Options required (a) If the group policy from which conversion is made provides basic hospital and medical insurance, the person shall be entitled to obtain a converted policy providing, at his or her option, coverage similar to the coverage provided by the group policy or lesser coverage at lesser premiums. (b) If the […]
§ 4091a. Definitions
§ 4091a. Definitions As used in this subchapter: (1) “Carrier” means an insurance company, a nonprofit medical or hospital service corporation, or a health maintenance organization which issues or provides a group health insurance policy or subscriber contract. (2) “Group health insurance policy or subscriber contract” means a policy or contract which meets the following […]