Vermont Statutes
Chapter 107 - Health Insurance
§ 4091f. Replacement coverage

§ 4091f. Replacement coverage
(a) General. When the group health insurance policy or subscriber contract of a carrier replaces a policy or contract providing similar benefits of another carrier, the liability of both carriers shall be as provided in this section and rules adopted pursuant to this section.
(b) Liability of prior carrier. A prior carrier remains liable after termination of its policy or contract only to the extent of its accrued liabilities and extensions of benefits.
(c) Liability of succeeding carrier.
(1) A succeeding carrier shall offer a group health insurance policy or subscriber contract to replace a prior carrier’s policy or contract in accordance with the provisions of this subsection.
(2) A succeeding carrier shall offer a policy or contract to cover all persons who:
(A) are covered or are a member of a class eligible for coverage under the prior carrier’s policy or contract on the date of termination of the prior carrier’s policy or contract; or
(B) are a member of a class eligible for coverage under the succeeding carrier’s policy or contract on the date of termination of the prior carrier’s policy or contract.
(3) The succeeding carrier is not liable under this subsection for benefits required to be paid by the prior carrier.
(4) When replacing a prior carrier’s plan that is not subject to section 4091e of this title, the succeeding carrier shall, in addition to the coverage required to be offered under subdivision (2) of this subsection, offer a policy or contract that provides a level of benefit equal to the lesser of:
(A) the extension of benefits that would have been required if the prior carrier’s policy or contract was subject to section 4091e of this title; or
(B) the extension of benefits required for the succeeding carrier’s policy or contract, except that any such benefits may be reduced by benefits actually payable under the prior carrier’s plan.
(5) The preexisting condition limitation of a succeeding carrier’s policy or contract shall provide a level of benefits equal to the lesser of:
(A) the benefits of the succeeding carrier’s policy or contract determined without application of the preexisting conditions limitation; or
(B) the benefits of the prior carrier’s policy or contract.
(6) The succeeding carrier, in applying a deductible or waiting-period provision in its policy or contract, shall give credit for the satisfaction of the same or similar provisions under the prior carrier’s policy or contract.
(7) At the succeeding carrier’s request the prior carrier shall furnish all information needed to determine the benefits available under the prior carrier’s policy or contract.
(d) Rules. The Commissioner shall adopt rules necessary to carry out the purposes of this section. (Added 1989, No. 113, § 2; amended 2019, No. 14, § 10, eff. April 30, 2019.)

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