Health Insurance

Health Insurance section under the Insurance Division

Health Insurers Annual Reports

Health Insurers Annual Reports as mandated by the Legislature are now available here. These reports include statistics regarding claims, appeals, marketing and advertising expenses, lobbying and legal expenses and political contibutions as well as other financial data.

Health Insurance

The Insurance Division is responsible to ensure that health insurers and health insurance plans meet all consumer protection and quality requirements under Vermont laws. The information furnished here provides regulatory information for health insurers and managed care organizations.  Information is also provided for  mental health review agent licensing, rental network contract registration, uniform provider credentialing, and health insurance statistics and performance data.

 

 

Health Insurance Regulation

Administrative requirements and technical guidance for managed care organizations, including requirements for mental health review agent licensing, rental networks registration and common provider credentialing.

REGULATIONS

Consumer Protection and Quality Requirements for MCOs (Rule H-2009-03)

Health Care Pricing and Quality Transparency (Rule H-2007-05)

Rental Network Contracts Registration

Persons conducting business in Vermont through provider rental network contracts are required to register with the commissioner of the Department of Financial Regulation. This registration requirement applies only to organizations not otherwise licensed or registered with the Department. Refer to 18 V.S.A. § 9418 and V.S.A. § 9418f.

Annual Statement Supplement Reports (ASSR) Frequently Asked Questions

Frequently Ask Questions (FAQ):

The Department of Financial Regulaton is responsible for monitoring and regulating the commercial health insurance market in Vermont. The purpose of this publication is to answer frequently asked questions (FAQ) about the Vermont health insurance market.

Mental Health Review Agents

Administrative requirements for Mental Health Review Agents regarding licensing and reporting.

Persons or entities that perform review activities for mental health care services in the State of Vermont are required under Title 8 V.S.A., §4089a, and Rule H-2011-H to obtain a Mental Health Review Agent License from the Department of Banking, Insurance, Securities and Health Care Administration.

Vermont Household Health Insurance Survey (VHHIS)

The Department of Financial Regulation conducts periodic household surveys of Vermont residents to accurately measure the uninsured rate and coverage sources for insured residents and also collects information on relevant demographic, income, and employment characteristics. The surveys support information needs of policy makers, program executives, advocates, health planners, and the general public related to identifying, designing, and evaluating health care reform programs to maintain and expand health insurance coverage in Vermont.

Annual Statement Supplement Report (ASSR) Definitions

For the Year Ending: December 31, 2012 (Report Due: March 1, 2013 or May 1, 2013 for HMO only)

Vermont law requires all Insurance Carriers, including Health Service Corporations and Fraternal companies, to submit an annual accurate and complete report of their business.  Industry analysts, policy makers and researchers use this data to understand more about Vermont’s health insurance market.

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