These documents are not legal documents but are placed here for reference purposes only. For a legal copy please contact the department.
|Printer-friendly version of HCA Bulletin 123||71.38 KB|
HCA Bulletin 123: Obligations of exempt associations and small group carriers in
connection with association health benefit plans
Introduction and Purpose :
The Department finds that the association health insurance market is subject to unusual uncertainty at this time as a result of association members’ efforts to secure affordable health insurance before January 1, 2007, and as a result of health insurance carriers competing for the business of association members. This competitive environment is not in itself harmful to the association market, provided that carriers and associations comply with their legal obligations.
The Department further finds that the association and small group markets may be adversely affected if small employers enroll in health benefit plans offered by associations with which the member small employer has little in common other than the purchase of insurance. The association and small group markets may also be adversely affected if carriers develop premium rates for products offered through associations without adequate adherence to appropriate rate development and actuarial standards.
The Department is charged with the responsibility of supervising health insurance companies and health insurance offered to exempt associations in order to maintain the stability and affordability of the association market and the small group market. 8 V.S.A. § 10 and 18 V.S.A. § 9401. The Commissioner is authorized to issue this Bulletin pursuant to 8 V.S.A. § 15, and 8 V.S.A. §§ 4079, and 4080a(h)(3) and (4).
Obligations of Exempt Associations :
The legal obligations of an exempt associations include, but are not limited to, the following:
Obligations of Small Group Carriers with respect to Exempt Associations :
The legal obligations of a small group carrier with respect to an exempt association include, but are not limited to, the following:
Failure to comply with applicable legal obligations may be enforced as to associations pursuant to revocation of the association exemption upon proper determinations by the Commissioner. 8 V.S.A. § 4080a(h). Failure to comply with applicable legal obligations may be enforced as to carriers pursuant to Title 8.
Dated at Montpelier, Vermont this _14th__ day of December, 2006.