§ 4061. Definition
§ 4061. Definition The term “health insurance” as used herein includes any policy or contract covering the kind or kinds of insurance described in subdivision 3301(a)(2) of this title.
§ 4062. Filing and approval of policy forms and premiums
§ 4062. Filing and approval of policy forms and premiums (a)(1) No policy of health insurance or certificate under a policy filed by an insurer offering health insurance as defined in subdivision 3301(a)(2) of this title, a nonprofit hospital or medical service corporation, a health maintenance organization, or a managed care organization and not exempted […]
§ 4062a. Filing fees
§ 4062a. Filing fees Each filing of a policy, contract, or document form or premium rates or rules, submitted pursuant to section 4062 of this title, shall be accompanied by payment to the Commissioner or the Green Mountain Care Board, as appropriate, of a nonrefundable fee of $150.00. (Added 1985, No. 236 (Adj. Sess.), § […]
§ 4062b. Medicare supplemental health insurance
§ 4062b. Medicare supplemental health insurance (a) Within five days of receiving a request for approval of any composite average rate increase in excess of three percent, or any other coverage changes which the Commissioner determines will have a comparable impact on cost or availability of coverage for a Medicare supplemental insurance policy issued by […]
§ 4062c. Compliance with federal law
§ 4062c. 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 coverage in Vermont shall comply with the requirements of the Health Insurance Portability and Accountability Act of 1996, as amended from time […]
§ 4062e. Compliance with Medicaid recovery provisions
§ 4062e. Compliance with Medicaid recovery provisions A health insurer as defined in 33 V.S.A. § 1900 that issues, sells, renews, or offers health insurance coverage in Vermont or who is required to be licensed or registered with the Department shall comply with the requirements of 33 V.S.A. §§ 1907, 1908, 1909, and 1910. The […]
§ 4062f. Discretionary clauses prohibited
§ 4062f. Discretionary clauses prohibited (a) The purpose of this section is to ensure that health insurance benefits, disability income protection coverage, and life insurance benefits are contractually guaranteed and to avoid the conflict of interest that may occur when the carrier responsible for providing benefits has discretionary authority to decide what benefits are due. […]
§ 4063. Form and contents of policy
§ 4063. Form and contents of policy No policy of individual health insurance shall be delivered or issued for delivery to any person in this State unless: (1) the entire money and other considerations therefor are expressed therein; (2) the time at which the insurance takes effect and terminates is expressed therein; (3) it purports […]
§ 4063a. Coverage for civil unions
§ 4063a. Coverage for civil unions (a) As used in this section: (1) “Dependent coverage” means family coverage or coverage for one or more persons. (2) “Party to a civil union” is defined for purposes of this section as under 15 V.S.A. § 1201. (3) “Insurer” shall mean a health insurer as defined in 18 […]
§ 4063b. Coverage for employees of an employer domiciled outside Vermont
§ 4063b. Coverage for employees of an employer domiciled outside Vermont (a) As used in this section: (1) “Health insurance” shall have the same meaning as “group health insurance policy or subscriber contract” in section 4091a of this title. (2) “Marriage” shall have the same meaning as in 15 V.S.A. § 8. (3) “Party to […]
§ 4064. Provisions applying to policies delivered in another state
§ 4064. Provisions applying to policies delivered in another state If any policy is issued by an insurer domiciled in this State for delivery to a person residing in another state, and if the official having responsibility for the administration of the insurance laws of such other state shall have advised the Commissioner that any […]
§ 4065. Required standard policy provisions
§ 4065. Required standard policy provisions Except as provided in section 4067 of this title, each such policy delivered or issued for delivery to any person in this State shall contain the provisions specified in this section in the words in which the same appear in this section; provided, however, that the insurer may, at […]
§ 4066. Optional standard policy provisions
§ 4066. Optional standard policy provisions Except as provided in section 4067 of this title, no such policy delivered or issued for delivery to any person in this State shall contain provisions respecting the matters set forth below unless such provisions are in the words in which the same appear in this section; provided, however, […]
§ 4067. Omission of inapplicable or inconsistent standard provisions
§ 4067. Omission of inapplicable or inconsistent standard provisions If any provision of sections 4065 and 4066 of this title is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy the insurer, with the approval of the Commissioner, shall omit from such policy any inapplicable […]
§ 4068. Order of standard policy provisions
§ 4068. Order of standard policy provisions The provisions which are the subject of sections 4065 and 4066 of this title, or any corresponding provisions which are used in lieu thereof in accordance with such sections, shall be printed in the consecutive order of the provisions in such sections or, at the option of the […]
§ 4069. Third party ownership
§ 4069. Third party ownership The word “insured,” as used in this chapter, shall not be construed as preventing a person other than the insured with proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits, and rights provided […]
§ 4070. Requirements of other jurisdictions
§ 4070. Requirements of other jurisdictions (a) Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this State, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by […]
§ 4071. Regulations on filing policies
§ 4071. Regulations on filing policies The Commissioner may make such reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to sections 4063-4066 of this title as are necessary, proper, or advisable to the administration of these sections. This provision shall not abridge any other authority granted the Commissioner […]
§ 4072. Nonconforming policies
§ 4072. Nonconforming policies (a) No policy provision which is not subject to section 4065 or 4066 of this title shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to these sections. (b) A policy delivered or issued […]
§ 4073. Applications for insurance
§ 4073. Applications for insurance (a) The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part thereof. If any such policy delivered or issued for delivery to any person in […]