§ 4088h. Health insurance and the Blueprint for Health
(a)(1) A health insurance plan shall be offered, issued, and administered consistent with the Blueprint for Health established in 18 V.S.A. chapter 13, as determined by the Commissioner.
(2) As used in this section, “health insurance plan” means any individual or group health insurance policy, any hospital or medical service corporation or health maintenance organization subscriber contract, or any other health benefit plan offered, issued, or renewed for any person in this State by a health insurer, as defined in 18 V.S.A. § 9402. The term shall include the health benefit plan 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. The term shall not include benefit plans providing coverage for specific disease or other limited benefit coverage unless so directed by the Commissioner.
(b) Health insurers as defined in 18 V.S.A. § 701 shall participate in the Blueprint for Health as specified in 18 V.S.A. § 706. In consultation with the Director of the Blueprint for Health and the Director of Health Care Reform, the Commissioner may establish procedures to exempt or limit the participation of health insurers offering a stand-alone dental plan or specific disease or other limited-benefit coverage. A health insurer shall be exempt from participation if the insurer offers only benefit plans which are paid directly to the individual insured or the insured’s assigned beneficiaries and for which the amount of the benefit is not based upon potential medical costs or actual costs incurred. (Added 2007, No. 204 (Adj. Sess.), § 2; amended 2009, No. 128 (Adj. Sess.), § 15.)
Structure Vermont Statutes
Title 8 - Banking and Insurance
Chapter 107 - Health Insurance
§ 4062. Filing and approval of policy forms and premiums
§ 4062b. Medicare supplemental health insurance
§ 4062c. Compliance with federal law
§ 4062e. Compliance with Medicaid recovery provisions
§ 4062f. Discretionary clauses prohibited
§ 4063. Form and contents of policy
§ 4063a. Coverage for civil unions
§ 4063b. Coverage for employees of an employer domiciled outside Vermont
§ 4064. Provisions applying to policies delivered in another state
§ 4065. Required standard policy provisions
§ 4066. Optional standard policy provisions
§ 4067. Omission of inapplicable or inconsistent standard provisions
§ 4068. Order of standard policy provisions
§ 4070. Requirements of other jurisdictions
§ 4071. Regulations on filing policies
§ 4072. Nonconforming policies
§ 4073. Applications for insurance
§ 4077. Termination; comprehensive major medical policies; grace period
§ 4079. Group insurance policies; definitions
§ 4079a. Association health plans
§ 4080. Required policy provisions
§ 4080d. Coordination of insurance coverage with Medicaid
§ 4080e. Medicare supplemental health insurance policies; community rating; disability
§ 4081. Blanket health insurance
§ 4082. Blanket insurance; policy contents
§ 4083. Discrimination prohibited
§ 4084a. Short-term, limited-duration health insurance
§ 4085a. Rebates prohibited for group insurance policies
§ 4086. Exemption from attachment and trustee process
§ 4087. Penalties for violations
§ 4088a. Chiropractic services
§ 4088b. Clinical trials for cancer patients
§ 4088c. Chemotherapy treatment
§ 4088d. Coverage for covered services provided by naturopathic physicians
§ 4088e. Notice of preferred drug list changes
§ 4088g. Coverage for covered services provided by athletic trainers
§ 4088h. Health insurance and the Blueprint for Health
§ 4088i. Coverage for diagnosis and treatment of early childhood developmental disorders
§ 4088j. Choice of providers for vision care and medical eye care services
§ 4088k. Physical therapy co-payments for certain plans
§ 4088l. Coverage for hearing aids [Effective January 1, 2024]
§ 4089. Services for victims of sexual assault
§ 4089a. Mental health care services review
§ 4089b. Health insurance coverage, mental health, and substance use disorder
§ 4089d. Coverage; dependent children
§ 4089e. Treatment of inherited metabolic diseases
§ 4089f. Independent external review of health care service decisions
§ 4089g. Craniofacial disorders
§ 4089h. Cancellation or nonrenewal of health insurance coverage
§ 4089i. Prescription drug coverage
§ 4089j. Retail pharmacies; filling of prescriptions
§ 4090a. Continuation of group
§ 4090b. Continuation; notice; terms
§ 4090c. Termination of coverage
§ 4090e. Conversion; notice; terms
§ 4090f. Exemptions; termination
§ 4091b. Policies and contracts covered
§ 4091c. Termination for nonpayment of premium or subscription charges
§ 4091d. Notice of termination
§ 4091e. Extension of benefits
§ 4092. Newborn infants; coverage
§ 4096. Home health care; insurance
§ 4099c. Reproductive health equity in health insurance coverage
§ 4099d. Midwifery coverage; home births
§ 4100a. Mammograms; coverage required
§ 4100c. Adopted child coverage
§ 4100d. Child vaccine benefits
§ 4100e. Required coverage for off-label use
§ 4100f. Prostate screenings; coverage required
§ 4100g. Colorectal cancer screening, coverage required
§ 4100h. Orally administered anticancer medication; coverage required
§ 4100i. Anesthesia coverage for certain dental procedures
§ 4100j. Coverage for tobacco cessation programs
§ 4100l. Coverage of health care services delivered by audio-only telephone