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Vt. Stat. Ann. tit. § 33, 1806 - Qualified health benefit plans under the human services law

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“Qualified health benefit plans under the human services law”

Prior to contracting with a health insurer to offer a qualified health benefit plan, the commissioner of Vermont health access must determine whether offering a health plan through the exchange is in the best interest of individuals and qualified employers.

A qualified health benefit plan must provide the following benefits: the essential benefits packaged required by the Affordable Care Act; at least the silver level of coverage and cost-sharing limitations for individuals as defined by the Affordable Care Act; and for qualified health benefit plans offered to employers, a deductible that meets the limitations of the Affordable Care Act.

A qualified health benefit plan must meet prevention, quality, and wellness requirements.

A health insurer must use the uniform enrollment and descriptions of covered provided by the commissioner of Vermont health access and the commissioner of financial regulation.   

A qualified health benefit plan must have standards for network at adequacy, essential community providers in underserved areas, and appropriate services to enable access for underserved individuals or populations.

 

 


Current as of June 2015