Vermont Statutes
Chapter 107 - Health Insurance
§ 4089d. Coverage; dependent children

§ 4089d. Coverage; dependent children
(a) As used in this section, “health insurance plan” has the same meaning as “group health plan” and shall be subject to the same excepted benefits, in each case, as set forth in 45 C.F.R. § 146.145, as in effect as of December 31, 2017.
(b) A health insurance plan that provides dependent coverage of children shall continue to make that coverage available for an adult child until the child attains 26 years of age, provided that this subsection shall not apply to a plan providing coverage for a specified disease or other limited benefit coverage, and further provided that nothing in this subsection shall require a plan to make coverage available for the child of a child receiving dependent coverage.
(c)(1) A health insurance plan that provides for terminating the coverage of a dependent child upon attainment of the limiting age for dependent children specified in the policy shall not limit or restrict coverage with respect to an unmarried child who:
(A) is incapable of self-sustaining employment by reason of a mental or physical disability that has been found to be a disability that qualifies or would qualify the child for benefits using the definitions, standards, and methodology in 20 C.F.R. Part 404, Subpart P;
(C) is chiefly dependent upon the employee, member, subscriber, or policyholder for support and maintenance.
(2) Coverage under subdivision (1) of this subsection shall not be denied any person based upon the existence of such a condition; however a health insurance plan may require reasonable periodic proof of a continuing condition no more frequently than once every year.
(B) became so incapable prior to attainment of the limiting age; and
(d) A health insurance plan that covers dependent children who are full-time college students beyond 18 years of age shall include coverage for a dependent’s medically necessary leave of absence from school for a period not to exceed 24 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy or coverage, whichever comes first, except that coverage may continue under subsection (b) of this section as appropriate. To establish entitlement to coverage under this subsection, documentation and certification by the student’s treating physician of the medical necessity of a leave of absence shall be submitted to the insurer or, for self-insured plans, the health plan administrator. The health insurance plan may require reasonable periodic proof from the student’s treating physician that the leave of absence continues to be medically necessary. (Added 1975, No. 237 (Adj. Sess.), § 1, eff. April 7, 1976; amended 1983, No. 165 (Adj. Sess.), § 2; 2005, No. 199 (Adj. Sess.), § 1; 2019, No. 63, § 5, eff. Jan. 1, 2020; 2019, No. 103 (Adj. Sess.), § 27.)

Structure Vermont Statutes

Vermont Statutes

Title 8 - Banking and Insurance

Chapter 107 - Health Insurance

§ 4061. Definition

§ 4062. Filing and approval of policy forms and premiums

§ 4062a. Filing fees

§ 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

§ 4069. Third party ownership

§ 4070. Requirements of other jurisdictions

§ 4071. Regulations on filing policies

§ 4072. Nonconforming policies

§ 4073. Applications for insurance

§ 4074. Notice as waiver

§ 4075. Age limits

§ 4076. Policies not affected

§ 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

§ 4080g. Grandfathered plans

§ 4081. Blanket health insurance

§ 4082. Blanket insurance; policy contents

§ 4083. Discrimination prohibited

§ 4084. Advertising practices

§ 4084a. Short-term, limited-duration health insurance

§ 4085. Rebates and commissions prohibited for nongroup and small group policies and plans offered through the Vermont Health Benefit Exchange

§ 4085a. Rebates prohibited for group insurance policies

§ 4086. Exemption from attachment and trustee process

§ 4087. Penalties for violations

§ 4088. Appeal

§ 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

§ 4088f. Prosthetic parity

§ 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

§ 4089c. Diabetes treatment

§ 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

§ 4090d. Right of conversion

§ 4090e. Conversion; notice; terms

§ 4090f. Exemptions; termination

§ 4090g. Options required

§ 4091a. Definitions

§ 4091b. Policies and contracts covered

§ 4091c. Termination for nonpayment of premium or subscription charges

§ 4091d. Notice of termination

§ 4091e. Extension of benefits

§ 4091f. Replacement coverage

§ 4092. Newborn infants; coverage

§ 4095. Definitions

§ 4096. Home health care; insurance

§ 4099c. Reproductive health equity in health insurance coverage

§ 4099d. Midwifery coverage; home births

§ 4100a. Mammograms; coverage required

§ 4100b. Coverage of children

§ 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

§ 4100k. Coverage of health care services delivered through telemedicine and by store-and-forward means

§ 4100l. Coverage of health care services delivered by audio-only telephone