Vermont Statutes
Chapter 107 - Health Insurance
§ 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 insurance on an expense incurred, service basis, or prepaid basis, other than policies covering specific diseases or accidental injuries only, shall provide that any person whose insurance under the group policy would terminate because of the occurrence of a qualifying event as defined in subsection (b) of this section shall be entitled to continue his or her health insurance under that group policy.
(b) For purposes of this subchapter, “qualifying event” means:
(1) loss of employment, including a reduction in hours that results in ineligibility for employer-sponsored coverage;
(2) divorce, dissolution, or legal separation of the covered employee from the employee’s spouse or civil union partner;
(3) a dependent child ceasing to qualify as a dependent child under the generally applicable requirements of the policy; or
(4) death of the covered employee or member.
(c) The provisions of this section shall not apply if:
(1) The deceased person or employee was not insured under the group policy on the date of the qualifying event.
(2) The person is covered by Medicare.
(3) The person is covered by any other group insured or uninsured arrangement which provides dental coverage or hospital and medical coverage for individuals in a group and under which the person was not covered immediately prior to such qualifying event, and no preexisting condition exclusion applies; provided, however, that the person shall remain eligible for continuation coverages which are not available under the insured or uninsured arrangement.
(4) The person has a loss of employment due to misconduct as defined in 21 V.S.A. § 1344.
(d) The continuation required by this section only applies to dental, hospital, and medical benefits.
(e) Notice of the continuation privilege shall be included in each certificate of coverage and shall be provided by the employer to the employee within 30 days following the occurrence of any qualifying event. (Added 1983, No. 165 (Adj. Sess.), § 1; amended 1985, No. 184 (Adj. Sess.), § 1; 2001, No. 121 (Adj. Sess.), § 3, eff. June 5, 2002; 2009, No. 61, § 14, eff. June 2, 2009.)

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