Rates & Forms

Insurance Sub-term

Property & Casualty

Welcome to the Property and Casualty page for the Department of Financial Regulations Rates and Forms section.  Please use the links below to assist you with filings and visit our "What's New?" section to see updates on department policies and positions on future and current filings.

 

Life & Annuities

Welcome to the Department’s Rates and Forms Section Life and Annuities page.  Please use the links provided below to find Department policies and information on life filings.

Health

Welcome to the Department’s Rates and Forms Section Health page.  Please use the links provided below to find Department policies and information on health filings.

Travel Insurance Regulatory Requirements

The Regulatory filing requirements provided under this section are for your guidance only; all insurers/filers have the responsibility to read and correctly apply the laws as they pertain to each filing.
 

Exclusion not permitted. Acts committed under the influence of alcohol may not be excluded. The exclusion of acts committed under the influence of drugs must be limited to illegal drugs or legal drugs illegally used.
Regulatory Reference or Source: Department requirement

 

Cannot be both binding and mandatory. If the parties cannot agree on the amount of loss, either may demand an appraisal. A decision agreed upon by any two appraisers will set the amount of loss or coverage. Binding appraisal is not permitted if the process can be demanded unilaterally, as it may deprive the insured access to the judiciary system. Binding appraisal is approvable only if both parties agree to the appraisal process.
Regulatory Reference or Source: Department Requirement

 

Cannot be both binding and mandatory. Binding arbitration is not permitted if the process can be demanded unilaterally, since it may deprive the insured of access to the court system.
Regulatory Reference or Source: Department requirement

 

The Department cannot approve any claims provision where an autopsy may be required as we feel this could potentially be an infringement of a person's religious beliefs and/or rights. However, if the following statement is added, then it would be acceptable: "....unless the law or your religion forbids it."
Regulatory Reference or Source: Department Requirement

 

If the term “spouse” or “family member” is used in the forms, the Civil Union amendatory endorsement must be attached to the policy in conformance with Vermont Regulation IH-2000-01 and Bulletin 127. Please note that inclusion of Domestic Partner is not a substitute for our Civil Union requirement.
Regulatory Reference or Source: Regulation IH-2000-01 and Bulletin 127

 

We suggest using the following verbiage: Expected or Intended Injury: "Bodily injury" or "property damage" which is intended or reasonably expected by an "insured", even if the resulting "bodily injury" or "property damage" a) Is of a different kind, quality or degree than a reasonable person would have expected or intended,; or b) Is sustained by a different person, entity or property than a reasonable person would have expected or intended. However, this exclusion does not apply to "bodily injury; or "property damage: resulting from the use of reasonable force by an "insured" to protect persons or property.

 

If a policy is obtained through fraud or material misrepresentation, that policy may be voided. If this occurs after the effective date, the company may only deny the claim on that basis, however, has grounds for cancellation.
Regulatory Reference or Source: Title 8, §3879 and §4205
http://legislature.vermont.gov/statutes/

 

We require that the interest of any uninvolved insured be protected. We recommend the following language:"We do not provide coverage for an Insured who commits or directs an act with the intent to cause a loss." It is not acceptable to exclude loss due to the failure to foresee logical consequences that cause accidents. We will allow the exclusion of willful or malicious acts intended to cause bodily injury or property damage.
Regulatory Reference or Source: Department requirement

 

Vermont requires that "Legal Action Against Us" / "Suit Against Us" specifically exempt the Appraisal condition from this requirement. Acceptable is: "However, your right to bring legal action against us is not conditioned upon your compliance with the provisions of the Appraisal Condition.
Regulatory Reference or Source: Title 8 § 3663
http://legislature.vermont.gov/statutes/

 

Vermont does not allow a restriction to “usual and / or customary” expenses. At the time of a motor vehicle accident or other type of medical loss, an injured person usually has no choice in where they are to be treated, and is certainly in no position to research the amount for which they may be personally liable. The Department accepts a “reasonable and necessary” medical expense standard. Also, Med Pay coverage shall always be provided as primary on all policies regardless if there is other similar insurance.

 

The Department finds this exclusion unacceptable. Vermont policyholders have come to expect that insurers do not differentiate between these types of conditions. In Vermont, we require insurers to all types of insurance to provide parity between medical conditions in general and medical conditions caused by emotional or mental disorders regardless of the type of insurance being provided.

 

If there is other insurance that covers any loss, we will pay only our share of the loss. Our share is our proportion of the total insurance collectible for the loss.

 

No insurance policy or certificate shall use a definition of ""pre-existing condition"" which is more restrictive than the following: "’Pre-existing condition’" means a condition for which medical advice or treatment was recommended by or received from a physician within 6 months preceding the effective date of coverage of an insured person.” • No pre-existing condition exclusion can be applied unless it directly relates to a filed claim for an accident, injury or illness. (s/a: cannot deny a claim for a broken leg due to a pre-existing kidney condition)"

 

Exclusions for "racing" or "contests" can apply only to "organized" events of this type.
Regulatory Reference or Source: Department requirement

 

After settlement has been agreed upon, the insurer shall mail payment in the agreed amount to the claimant and/or loss payee within 10 working days.
Regulatory Reference or Source: Regulation 79-2

 

Vermont does not allow the "terrorist incident" definition to include the phrase "that is deemed terrorism by the United States government". The lines of property and casualty insurance defined within TRIA do not include travel insurance so it is not appropriate to apply that definition to this line of insurance. Additionally, TRIA is limited to events that occur within the United States; most customers purchasing this product are traveling outside of the United State and its territories. The US government is neither obligated nor motivated to declare a terrorist incident to the requirements of TRIA that occurs in a foreign territory.

 

 

Pet Insurance Regulatory Requirements

The Regulatory filing requirements provided under this section are for your guidance only; all insurers/filers have the responsibility to read and correctly apply the laws as they pertain to each filing.
 

Carriers may not terminate and issue a new a policy when a customer increases or decreases his or her coverage. Such practices are in violation of Title 8 Section 3879. http://legislature.vermont.gov/statutes/

 

Mandatory binding arbitration is not permitted if the process can be demanded unilaterally, as it deprives the Insured access to the judiciary system. Both parties must agree to arbitration at the onset or beginning of the arbitration process. In addition, Vermont requires that if carriers rely on the American Arbitration Association, they must use the Consumer Arbitration Rules to settle any and all disputes.

 

Please review the provisions regarding notice of cancellation, notice of non-renewal and revise to comply with Title 8, § 3879 – 3881, effective September 1, 1990 if necessary. http://legislature.vermont.gov/statutes/

 

Currently, the Department requests that you review and replace your policy language for the following language if necessary: Any provision of this policy, which is in direct conflict with the laws, regulations and statutes of the state of Vermont, will be governed by the laws, regulations and statutes of the state of Vermont as of the effective date of this policy.

 

Coverage for new or existing claims may not be suspended due to nonpayment of premium. Coverage is considered in place until the policy cancels or non-renews.

 

Pursuant to Title 8 § 3542 The commissioner shall disapprove any form(s) filed under this subchapter…(2) If it contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract. http://legislature.vermont.gov/statutes/

 

Any pet insurance filing must include an explanation of how coverages and exclusions are disclosed to consumers prior to purchase.

 

If an Insured obtains a policy through fraud or material misrepresentation, that policy may be voided. See 8 V.S.A. § 4205; see also McAllister v. AVEMCO Insurance Co., 148 Vt. 110 (1987). For fraud or material misrepresentation in the presentation of a claim, the company may only deny the claim on that basis, but has grounds for cancellation under the statutory provisions of Title 8, § 3879, § 4223 and § 4711. See language found on ISO form IL0170. http://legislature.vermont.gov/statutes/

 

Vermont does not allow a fraud warning to state that a person who makes false statements on an application “commits” a fraudulent insurance act since the question of guilt is a determination for a court. As an alternative, it would be acceptable to use the following warning: “Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties under state law.”

 

Please review and revise your "Legal Action Against Us" / "Suit Against Us" clause to specifically exempt the Appraisal condition from this requirement if necessary. See Title 8 § 3663. Acceptable is: "However, your right to bring legal action against us is not conditioned upon your compliance with the provisions of the Appraisal Condition.

 

The Department does not allow the exclusion of fees such as medical waste fees or, in other words, those that might not be directly a result of the medical treatment of the covered animal for a covered loss.

 

If there is other insurance that covers any loss, we will pay only our share of the loss. Our share is our proportion of the total insurance collectible for the loss.

 

While the department does allow the total exclusion of breeding for commercial purposes or pregnancy in general, we do require that the carrier show that prior to the purchase of insurance that disclosure has been provided that this condition will not be covered on the base policy. An example of acceptable disclosure is a notice on the application.

 

Definitions of pre-existing conditions cannot include injuries or illnesses that were not discovered, diagnosed or treated by a veterinarian. Also, pre-existing conditions cannot include signs or evidence of potential manifestation or injury and/or illness masked or controlled by medication beyond 6 months prior to the policy effective date.

 

Insurers may not deduct unpaid premiums from any claim payments owed to the insured for a covered loss.

 

The Department does not allow insurers to include automatic trend factors in their rate manuals.

 

See our Regulation 79-2 Fair Claims Practices, Section 6.G. After settlement has been agreed upon, the insurer shall mail payment in the agreed amount to the claimant and/or loss payee within 10 working days.

 

 

Personal Lines (other than Auto) Regulatory Requirements

Sexual abuse exclusion permitted. The Department does not allow “physical abuse” to be excluded. We do allow the absolute exclusion of sexual abuse and molestation of a sexual nature. Also, the exclusion of corporal punishment or physical and/or mental abuse must be limited to that inflicted upon an insured by an insured.
Regulatory Reference or Source: Department requirement http://legislature.vermont.gov/statutes/

 

Exclusion not permitted. Acts committed under the influence of alcohol may not be excluded. The exclusion of acts committed under the influence of drugs must be limited to illegal drugs or legal drugs illegally used.
Regulatory Reference or Source: Department requirement

 

We do not allow blanket animal exclusions. We do allow limited canine exclusions in which specific dogs (Emma, Spot, Bella, Jackson, for example) are named and listed and the exclusion form is signed and dated by the insured(s). We do not allow the blanket exclusion of entire canine breeds.
Regulatory Reference or Source: Department Requirement

 

Limit of liability may be waived. The Company has unlimited liability should they appeal a case without the insured's consent. The policy must include a statement that the limits of liability are waived if the company appeals a judgment without the consent of the insured.
Regulatory Reference or Source: Title 8, §4203 http://legislature.vermont.gov/statutes/

 

No filing requirement for applications (unless made part of the policy). Incorrect statements on the application shall not bar the right to recovery unless it was meant to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer.
Regulatory Reference or Source: Title 8, §3541 and §4205 http://legislature.vermont.gov/statutes/

 

Cannot be both binding and mandatory. If the parties cannot agree on the amount of loss, either may demand an appraisal. A decision agreed upon by any two appraisers will set the amount of loss or coverage. Binding appraisal is not permitted if the process can be demanded unilaterally, as it may deprive the insured access to the judiciary system. Binding appraisal is approvable only if both parties agree to the appraisal process.
Regulatory Reference or Source: Department Requirement

 

Cannot be both binding and mandatory. Binding arbitration is not permitted if the process can be demanded unilaterally, since it may deprive the insured of access to the court system.
Regulatory Reference or Source: Department requirement

 

May not be excluded. May be approved by submitting an Individual Risk "Consent to Rate Application" where a known hazard exists.
Regulatory Reference or Source: Bulletin 111

 

The Department cannot approve any claims provision where an autopsy may be required as this could potentially be an infringement.
Regulatory Reference or Source: Department Requirement

 

Bankruptcy of the Insured cannot relieve the company of their liability. Regulatory Reference or Source: Title 8, §4203 http://legislature.vermont.gov/statutes/

 

Blank general endorsements are not acceptable as they could result in an unfiled policy wording amendment to policy forms and/or conditions. However, a change endorsement limited to administrative purposes, like changes to items on declarations pages or adding/removing endorsements or coverage parts, is acceptable.
Regulatory Reference or Source: Department Requirement

 

Extensive use of [brackets] throughout a form is not approvable as it would allow for substantive changes to approved policy language.
Regulatory Reference or Source: Department Requirement

 

Days' Notice and Cancellation/Nonrenewal Reasons 15 days' notice for cancellation for non-pay; 45 days notice of cancellation for other reasons Policy can be cancelled for any reason within first 59 days - specific reasons required if in force 60 days or more. 45 days' notice of non-renewal required.
Regulatory Reference or Source: Title 8, §3879-3883 http://legislature.vermont.gov/statutes/

 

If the term “spouse” or “family member” is used in the forms, the Civil Union amendatory endorsement must be attached to the policy in conformance with Vermont Regulation IH-2000-01 and Bulletin 127. Please note that inclusion of Domestic Partner is not a substitute for our Civil Union requirement.
Regulatory Reference or Source: Regulation IH-2000-01 and Bulletin 127

 

Pursuant to Title 8 § 3542 The commissioner shall disapprove any form(s) filed under this subchapter…(2) If it contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract.
Regulatory Reference or Source: Title 8, §3542 http://legislature.vermont.gov/statutes/

 

Insured must be given written notice when coverage has been modified or eliminated.
Regulatory Reference or Source: Regulation 78-1 (1)

 

May not be excluded. No exceptions.
Regulatory Reference or Source: Department requirement

 

Prior Approval. Forms must be submitted at least 30 calendar days prior to their proposed effective date.
Regulatory Reference or Source: Regulation I-2010-03

 

If a policy is obtained through fraud or material misrepresentation, that policy may be voided. If this occurs after the effective date, the company may only deny the claim on that basis, however, has grounds for cancellation.
Regulatory Reference or Source: Title 8, §3879 and §4205 http://legislature.vermont.gov/statutes/

 

Indemnity not generally permitted. Must be "Pay on Behalf of" in Coverage Grant (Indemnity may be permitted on certain specialized coverages.)
Regulatory Reference or Source: Title 8, §4203 http://legislature.vermont.gov/statutes/

 

We require that the interest of any uninvolved insured be protected. We recommend the following language: "We do not provide coverage for an Insured who commits or directs an act with the intent to cause a loss." It is not acceptable to exclude loss due to the failure to foresee logical consequences that cause accidents. We will allow the exclusion of willful or malicious acts intended to cause bodily injury or property damage. Regulatory Reference or Source: Department requirement

 

May not be excluded. We do not allow any broad intra-insured exclusion in any personal lines policy. We will consider an exclusion limited to" bodily injury to an Insured, caused by the spouse of that Insured."
Regulatory Reference or Source: Department requirement

 

May not be excluded. May be approved by submitting an Individual Risk "Consent to Rate Application" if a known hazard exists. Regulatory Reference or Source: Bulletin 111

 

The insured’s right to bring legal action against the insurer may not be conditioned upon the insured’s compliance with the provisions of the Appraisal Condition.
Regulatory Reference or Source: Title 8, § 3663

 

Not required

 

Loss Settlement and Payment Conditions Regulation 79-2; S6

 

The Insurer has 15 days to respond to a properly executed Proof of Loss. After Settlement has been agreed upon, Insurer shall mail in the agreed amount to the claimant and/or loss payee within 10 working days. We require insurers to provide parity between medical conditions in general and medical conditions caused by emotional or mental disorders. Regulatory Reference or Source: Department Requirement

 

Limited Mold Exclusion may apply. See Bulletin #141 for our Mold Exclusion Limitations Filing Guidelines. Please attach the following mandatory form(s) HO0402, HO0426 or HO0427.
Regulatory Reference or Source: Bulletin 141 Title 8 §4205 http://legislature.vermont.gov/statutes/

 

May not be excluded. Pollution Liability may not be excluded in any personal lines policies.
Regulatory Reference or Source: Department Requirement

 

May be excluded Regulatory Reference or Source: Bulletin 139

 

Exclusions for "racing" or "contests" can apply only to "organized" events of this type.
Regulatory Reference or Source: Department requirement

 

Open Competition, Use and File. Loss Costs - Bulletin 99 Filing must be received within 15 days of effective date. Rate filing must include verifying material and actuarial backup.
Regulatory Reference or Source: Title 8, §4688 http://legislature.vermont.gov/statutes/

 

Regulatory Reference or Source: Bulletin 135

 

Coverage for aggression, harassment or bullying in any manner of communication is an integral part of Personal Injury coverage both in the standard Homeowners and Personal Umbrella policies. It is unacceptable to exclude coverage for electronic or internet aggression, harassment and/or bullying in any form of communication. 
Regulatory Reference or Source: Department Requirement

 

May not be excluded. No exceptions.
Regulatory Reference or Source: Department requirement

 

Every policy which provides automobile liability coverage in the State of Vermont must include coverage for bodily injury and property damage caused by uninsured or underinsured motorists. This requirement also applies to umbrella and excess policies. The UM/UIM bodily injury limit must be provided at the same limit as the liability bodily injury limit. However, the insured must have the option to reduce the UM/UIM limit to the statutory minimum of $50,000/$100,000.
Regulatory Reference or Source: Title 23, Section 941 http://legislature.vermont.gov/statutes/

 

Mandatory wind, windstorm, hail and/or hurricane deductibles are not acceptable.

 

 

Commercial Lines (other than auto) Regulatory Requirements

The Regulatory filing requirements provided under this section are for your guidance only; all insurers/filers have the responsibility to read and correctly apply the laws as they pertain to each filing.

Applications

No filing requirement for applications (unless made part of the policy). Incorrect statements on the application shall not bar the right to recovery unless it was meant to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer.
Regulatory Reference or Source: Title 8, §3541 and §4205
http://legislature.vermont.gov/statutes/

Abuse

Sexual abuse exclusion permitted. We do not allow the exclusion of "physical" abuse or molestation. Please see that the exclusion is limited to sexual abuse and/or molestation.
Regulatory Reference or Source: Department Requirement

Alcohol/Drugs

Exclusion not permitted. Department requirement Acts committed under the influence of alcohol may not be excluded. Acts committed under the influence of drugs must be limited to illegal drugs or legal drugs used illegally.
Regulatory Reference or Source: Department Requirement

Animal Exclusion

The Department does not allow blanket canine exclusions. We do allow limited canine exclusions in which specific dogs (Emma, Spot, Bella, Jackson, for example) are named and listed and the exclusion form is signed and dated by the insured(s). We do not allow the blanket exclusion of entire canine breeds. However, we do allow the blanket exclusion of animals other than dogs.
Regulatory Reference or Source: Department Requirement

Appeals

Limit of liability may be waived. The Company has unlimited liability should they appeal a case without the insured's consent. The policy must include a statement that the limits of liability are waived if the company appeals a judgment without the consent of the insured.
Regulatory Reference or Source: Title 8, §4203
http://legislature.vermont.gov/statutes/
 

Appraisal

Appraisal cannot be both binding and mandatory. If the parties cannot agree on the amount of loss, either may demand an appraisal. A decision agreed upon by any two appraisers will set the amount of loss or coverage. Binding appraisal is not permitted if the process can be demanded unilaterally, as it may deprive the insured access to the judiciary system. Binding appraisal is approvable only if both parties agree to the appraisal process.
Regulatory Reference or Source: Department Requirement

Arbitration

Arbitration cannot be both binding and mandatory. Binding arbitration is not permitted if the process can be demanded unilaterally, since it may deprive the insured of access to the court system. Regulatory Reference or Source: Department requirement

Asbestos

May not be excluded. The Department does not allow asbestos exclusions on primary policies except by means of an Individual Risk "Consent to Rate” filing which is approvable only when there is a documented exposure to asbestos.
Regulatory Reference or Source: Bulletin 111

Assault and/or Battery

As accidental physical injuries are difficult to distinguish from assault and battery, the Department will not allow assault and battery to be excluded. Please note that any exclusion of physical and/or mental abuse must be limited to that inflicted upon an insured by an insured. We will allow absolute exclusion of sexual abuse and molestation of a sexual nature.

Bankruptcy Provision

Bankruptcy of the Insured cannot relieve the company of their liability. 
Regulatory Reference or Source: Title 8, §4203
http://legislature.vermont.gov/statutes/

Blank General Endorsements

Blank general endorsements are not acceptable as they could result in an unfiled policy wording amendment to policy forms and/or conditions. However, a change endorsement limited to administrative purposes, like changes to items on declarations pages or adding/removing endorsements or coverage parts, is acceptable.

Cancellation & Non-renewal Cancellations

15 days' notice for cancellation for non-pay 45 days’ notice of cancellation for other reasons. Policy can be cancelled for any reason within first 59 days Specific reasons required if in force 60 days’ or more. Non-renewal: 45 days’ notice of non-renewal required.
Regulatory Reference or Source: Title 8, §4711 4715, Title 8, §3879-3883
http://legislature.vermont.gov/statutes/

Chromated Copper Arsenate

The Department does not allow any chromated copper arsenate exclusions except by means of an Individual Risk “consent-to-rate” filing, which is approvable only when there is a recognized exposure to chromated copper arsenate.
Regulatory Reference or Source: Bulletin 111

Civil Union

If the term “spouse” or “family member” is used in the forms, the Civil Union amendatory endorsement must be attached to the policy. Please note that inclusion of Domestic Partner is not a substitute for our Civil Union requirement.
Regulatory Reference or Source: Regulation IH-2000-01
Bulletin 127

Claims Made Requirements

Claims made not permitted for basic CGL policy; with respect to claims made endorsements, please see the "Professional Liability" section of this document.
Regulatory Reference or Source: Department Requirement

Defense Costs

Defense Within Limits not allowed. The Department will consider a separate defense limit equal to the limit of liability.
Regulatory Reference or Source: Department requirement

Disclosure

Insured must be given written notice when coverage has been modified or eliminated. Regulatory Reference or Source: Notice Requirements Regulation. 78-1 (1)

Electromagnetic Radiation

May not be excluded. No exceptions.
Regulatory Reference or Source: Department requirement

Extended Reporting Periods

The extended reporting period must be available regardless of who cancels or why, except for nonpayment of premium or deductible. The supplemental or optional extended reporting period must either reinstate the policy limit or must have a separate limit of liability equal to that of the expiring or expired policy.
Regulatory Reference or Source: Department Requirement

Firearms

The Department does not allow broad firearms exclusions as there is an expectation of coverage by the insured especially with respect to firearms that are not owned by the insured.
Regulatory Reference or Source: Department Requirement

Forms

Prior Approval. Forms must be submitted at least 30 calendar days prior to their effective date. Regulatory Reference or Source: Regulation I-2010-03

Fraud

If a policy is obtained through fraud or material misrepresentation, that policy may be voided. If this occurs after the effective date, the company may only deny the claim on that basis, however, has grounds for cancellation.
Regulatory Reference or Source: Title 8, §3879, §4205 and §4711
http://legislature.vermont.gov/statutes/

Fraud Warning in Applications

The Department does not allow a fraud warning to state that a person who makes false statements on an application “commits” a fraudulent insurance act since the question of guilt is a determination for a court. As an alternative, it would be acceptable to use: “Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties under state law.”

Indemnity

Indemnity is not generally permitted. Must be "Pay on Behalf of" in Coverage Grant (Indemnity may be permitted on certain specialized coverages). 
Regulatory Reference or Source: Title 8, §4203
http://legislature.vermont.gov/statutes/

Lead

May not be excluded. The Department does not allow lead exclusions on primary policies except by means of an Individual Risk "Consent to Rate” filing which is approvable only when there is a documented exposure to lead.
Regulatory Reference or Source: Bulletin 111

Liberalization Clause

Not required

Loss Settlement and Payment Conditions

The Insurer has 15 days to respond to a properly executed Proof of Loss. After Settlement has been agreed upon, Insurer shall mail in the agreed amount to the claimant and/or loss payee within 10 working days.
Regulatory Reference or Source: Regulation 79-2; S6

Mental Health Parity

We require insurers to provide parity between medical conditions in general and medical conditions caused by emotional or mental disorders.

Non-cumulation Provisions

Not allowed. Non-cumulation and/or anti-stacking clauses or endorsements in some liability policies will not be approved.
Regulatory Reference or Source: Bulletin 189

Pollution

May not be excluded except as noted. All Insurers must provide coverage for pollution liability with limited exceptions. We will consider a "Consent to Rate" application for companies seeking to attach a pollution exclusion to liability coverage when there is a high probability of a pollution claim. We will approve the use of the exclusions only where there is an identifiable pollution exposure.
Regulatory Reference or Source: Bulletin 111

Punitive Damages

May be excluded.
Regulatory Reference or Source: Bulletin 139

Rate Filings

(a)rates: Unsupported (a) rates are not allowed. Rating guidelines and methodology are required. Pursuant to Title 8, § 4688 (a), simply indicating that “(a) rating applies” or "Refer to Company" is not acceptable.

Claims-made Rates: Prior Approval Rates, supplementary rate information, and supporting information must be filed at least 30 working days before the proposed effective date.
Regulatory Reference or Source: Title 8, §4688 http://legislature.vermont.gov/statutes/
Regulation I-2010-03 Section 8

Loss Costs: Bulletin 99 Occurrence Rates: Open Competition, Use and File. Filings must be received within 15 days of effective date. Rate filing must include verifying material and actuarial backup.
Regulatory Reference or Source: Title 8, §4684-4688
http://legislature.vermont.gov/statutes/
Regulation I-2010-03

Silica

The Department does not allow silica exclusions on primary policies except by means of an Individual Risk "Consent to Rate” filing which is approvable only when there is a documented exposure to silica. Regulatory Reference or Source: Bulletin 111

Tobacco

May not be excluded. No exceptions.
Regulatory Reference or Source: Department requirement

Uninsured Motorists

Every policy which provides automobile liability coverage in the State of Vermont must include coverage for bodily injury and property damage caused by uninsured or underinsured motorists. This requirement also applies to umbrella and excess policies. The UM/UIM bodily injury limit must be provided at the same limit as the liability bodily injury limit. However, the insured must have the option to reduce the UM/UIM limit to the statutory minimum of 50,000/$100,000.
Regulatory Reference or Source: Title 23, Section 941
http://legislature.vermont.gov/statutes/

Warranty Statements

The Department does not allow warranty statements.

Health Filing Requirements

The Submission requirements and the Recurring Issues checklist provided under this section are for your guidance only; all insurers/filers have the responsibility to read and correctly apply the laws as they pertain to each filing.

Submission Requirements

Health Filing Submission Requirements

Filing submission requirements in this section are provided for your guidance only.  All filers all have the responsibility to read and correctly apply the laws as they pertain to each filing.  

Actuarial Memorandum

A comprehensive actuarial memorandum must accompany all filings that include rates. The following minimum elements must be included in each actuarial memorandum

  1. Incurred premium, incurred losses, and loss ratios for Vermont and nationwide, for the past five (5) years.
  2. The number of policy holders and the number of certificates affected in Vermont and nationwide.
  3. The economic impact on Vermont policyholders and/or certificate holders (i.e. change in premium expressed in dollars and percent).
  4. Definitions of all terms and symbols and a projection of loss ratio for Vermont and nationwide. Rates must be filed 60 days before intended use.

Actuarial Memorandum and Certifications 

A Part III Actuarial Memorandum, including corresponding actuarial certifications, must be submitted with each Part I Unified Rate Review Template. Please see the links below for information and instructions for completing both Part I and III.

Links for completing the Actuarial Memorandum and Unified Rate Review Template:

Part I Unified Rate Review Template Instructions
Part III Actuarial Memorandum and Certification Instructions
Part III Actuarial Memorandum and Certification Requirements

Civil Union

To be in compliance with Vermont's civil union coverage's please refer to  Health Care Administrative Bulletin HCA-110. For underwriting and rating limitations see 8 V.S.A. § 4724 (7)(E).

Compliance Certification- Forms Only

The Supplemental Health Care Filing Compliance Certification Form must be accurately completed, signed, and submitted with all FORM filings or it will be rejected; this is a mandatory health form filing submission requirement.  The Department does NOT accept carrier created compliance certifications. This certification was added to the form filing process reduce the number of non-compliant filings the Department receives and to facilitate speed-to-market. Vermont’s “Recurring Issues: Supplemental Health Insurance” document lists the regulatory issues most frequently encountered in the review of supplemental health insurance form filings. Filers must review the Recurring Issues document and make any corrections necessary to their filing to bring it into regulatory compliance.

Flesch Score Certification

Please provide a Flesch Score Certification signed and dated by an officer of the company. Flesch readability form Documents must have a score of at least 40. Bulletin 107 § 4.

Form F-106

A completed Form F-106 is required with every submission.

Health Advertising Restrictions

Materially misleading or deceptive advertising is prohibited. 8 V.S.A. §§ 4724 & 4804.

Details of prohibited advertising activities are found in Regulation 71-1.  Any advertisement that supports or constructs forms that are not offered in Vermont or are forbidden under Vermont Statutes, regulations, or policy may not be used.

Health Application

Must include an authorization to release medical information if any such data is to be sought.

Per Title 8 V.S.A. 4724 (20) The authorization must add an exclusion similar to the following: NOTE: This authorization EXCLUDES the release of any information about previously administered tests for HIV antibodies, T-Cell counts, AIDS or ARC.

The proposed insured/applicant IS NOT authorizing the company to forward the results from any new test requested by the company to any outside, non-affiliated company or any entity not under specific contract to perform underwriting services.

In addition you may not request data on sexually transmitted diseases unless you exclude AIDS, ARC, and HIV.

Open ended questions and those relating to blood or immune disease must make exception for AIDS, ARC.

Any questions about AIDS should read "Have you been diagnosed as having or treated for AIDS by a licensed medical physician (MD or OD)?"

The fraud passage may not be more onerous than "Any person who knowingly, and with intent to injury, defraud or deceive any insurance company, files a statement of claim containing any false, incomplete or misleading information may be guilty of fraud and may be subject to criminal or civil penalties."

Rate Exhibits

Rate Exhibits must include: Vermont Experience Exhibit without interest, Vermont Experience Exhibit with interest, Nationwide Experience Exhibit without interest, Nationwide Experience Exhibit with interest, Vermont Credibility Factor with calculation, Nationwide Credibility Factor with calculation, All lifetime loss ratios clearly marked on exhibits, and rate increases for the past 5 years.

Redlined Copy

Filing must include a side by side comparison if a filing contains a form replacing a previously approved form. Please provide a redlined copy of the changes to your forms.

Statement of Variability

Filings must include a complete explanation of the range of variable material. Forms marked as entirely variable will not be approved.

Third Party Filing Authorization

Any insurer who uses a third party to submit, defend and approve contract provisions, must submit a letter of authorization which names the appointed agent, the date and duration of such authorization and any limits which the company impose on the agent. The authorization must be signed by an officer of the corporation.

 

Workers' Compensation Submission Requirements

Include actuarial memorandum for all filings that include a rate component. The actuarial memorandum should be complete and demonstrate all rating changes.

 

A filing may be amended at any time prior to the entry on SERFF of a final disposition. Filing amendments must be submitted through SERFF. A new filing is required if a filer wishes to amend a filing after the entry of a final disposition. Regulation I-2010-03 Section 5.(G).

If the only change on a form is its reference number or edition date, it is not necessary to make a filing, pursuant to Regulation I-2010-03 Section 4.(B)(1). The insurer shall maintain an updated list of policy forms that shows the current reference numbers and edition dates of the form and the Vermont SERFF State Tracking Number under which each form was approved.

 

If a form or rule replaces or modifies an existing form or rule please provide a description of the intent and effect of the changes. This should include a notation indicating whether the change results in a broadening, restriction or clarification of coverage. Please note that the "Policy Forms and Endorsements" requirement must also be completed.

 

Per Regulation I-2010-03 the filer must certify using the following language that the filing has been properly completed and is in compliance with all applicable Vermont laws, regulations and policies: "I certify that the attached filing has been completed in accordance with Vermont Regulation I-2010-03 and is in compliance with all applicable Vermont laws and regulations." The Certification Statement must be on the General Information Tab.

 

Each rate, rule and form filing (or any combination) must be accompanied by a non- refundable fee of $50.00 or the retaliatory fee whichever is greater. For rating, advisory or service organizations a non-refundable fee of $150.00. Vermont requires the Fee Calculation Explanation on the "Filing Fees" tab to be completed. It must show the following:

1. The name of each company (if there is more than one).

2. The state of domicile for each company.

3. What the state of domicile charges for a filing fee versus Vermont's filing fee.

If the Fee Calculation does not have this information then the filing will be disapproved and an objection letter will be sent. Please also review Vermont’s General Instructions.

 

All rate filings must include histograms showing the percentage and dollar changes in premium, respectively, for all existing policyholders in the filed program.

 

Please include the following forms (attached below), Reference Filing Adoption Form, Summary of Supporting Information Form, and form with variable expense constants.
LC Adoption Form
LCM with ExpCnst
LCM with no ExpCnst

 

If this filing includes any forms and/or endorsements that change or amend any previously approved forms, attach the previously approved forms here. Please note that the "Broaden, Restrict & Clarify Coverage" requirement must also be completed.

 

The Uniform experience rating plan shall be the exclusive means of providing prospective premium adjustment. Insurers may file rating plans that provide for retrospective premium adjustments based upon an insured's past experience.

Any such submission shall be submitted at least 15 working days before its proposed effective date.

Each rate filing shall include actuarial backup or supporting information which shall be comprised of: a written summary of the experience and judgment of the filer and the experience or data of other insurers or organizations relied upon by the filer, the interpretation of any statistical data relied upon by the filer; the description of methods used in making the rates or relied upon in the adoption of the rates and any other such information relied upon by the filer.

Company Financial data is required as well as the Vermont Filing Adoption Form and Summary of Supporting Information, shown as exhibits in Bulletin 99.
Regulation I-2010-03 
Bulletin 99
See: 8 VSA, Ch. 128,  4683, 4687 and 4688

 

The Commissioner shall not approve any form unless the policy or certificate is written in non-technical, readily understandable language, using words of common, every day usage. The policy text shall achieve a minimum score of 40 on the Flesch reading ease test or an equivalent score on any other approved comparable reading test per Regulation I-2010-03

 

Each filing submission shall be accompanied by a side-by-side comparison. The exhibit shall compare the new rule(s), rate(s), or form(s) with the rate(s), rule(s), or form(s) being replaced. If a filing includes forms, rules or rates that replace existing forms, rules or rates, side-by-side comparisons should be attached. The side-by-side comparison should be presented in a strikeout and underline format. See Regulation I-2010-03

 

Any insurer who uses a third party to submit, defend and approve contract provisions, must submit a letter of authorization which names the appointed agent, the date and duration of such authorization and any limits which the company impose on the agent. The authorization must be signed by an officer of the corporation.

 

Attach Vermont amendatory endorsements for all products that require the endorsements and are used with the policy. If a filer meets this requirement through the adoption of Vermont amendatory endorsements filed by their Advisory Service Organization (e.g. ISO, AAIS), it will be sufficient to attest to this fact.

 

 

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