The purpose of this Bulletin is to clarify the Department's position on the effective dates for specific sections of long-term care regulation H 2009-01. The Commissioner is authorized to issue this Bulletin pursuant to 8 V.S.A. § 15.
Transacting insurance business in Vermont without a certificate of authority or license from the Commissioner of Banking, Insurance, Securities, and Health Care Administration in violation of 8 V.S.A. § 3361 and § 3368. Issuing and delivering certificates of coverage that were not filed with and approved by the Commissioner in violation of 8 V.S.A. § 4062.
Action taken was:
Administrative penalty payment of $100,000.00
Payment of the Department’s costs of $3,663.00
Cease and Desist from entering into any master group policy contract to cover Vermont residents that would require it to have a Vermont certificate of authority or license, unless it holds such license.
Failure to fully and/or timely submit required health care claims data, eligibility data, provider files and other information relating to health care services provided to Vermont residents, pursuant to the authority in 18 V.S.A. $9410(g) and Regulation H-2008-001.
United Health Group payment of an administrative penalty of Forty Five Thousand ($45,000) Dollars plus Five Thousand Dollars ($5,000) in costs.
The purpose of this regulation is to set forth rules for the enrollment of registered non-group carriers, requirements for the sale of individual insurance, requirements for the filing of rates, and standards and the process for approval of common health care plans.
The purpose of this regulation is to promote efficiency and cost savings in the payment of health insurance claims by the use of common claim forms and procedures and to improve the availability and consistency of health services information.
The purpose of this regulation is to set forth the rules for registration of small group carriers, requirements for the sale of individual insurance and the standards and process for approval of common health care plans.