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Health Insurance Exchanges in Vermont

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Green Mountain Care is Vermont’s universal health care program.1 The Department of Vermont Health Access must establish the state’s health insurance exchange.2 The state’s health care reform efforts and the Green Mountain Care board must follow statutory principles to provide affordable, high-quality health care to Vermont residents.3

The Green Mountain Care board is established to oversee Vermont’s health care reform efforts.4 The director of health care reform in the Agency of Administration is responsible for the coordination of health care system reform efforts among executive branch agencies and the Green Mountain Care board.5 The secretary of administration must ensure that the Green Mountain Care board has access to data and analysis held by any state agency which is necessary to carry out the board’s duties.6

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.7 Every health insurance policy and premium rates must be approved by the Green Mountain Care board.8 A health insurance plan must be consistent with the Blueprint for Health.9

The Vermont health benefit exchange must establish a navigator program to assist individuals and employers in enrolling in a qualified health benefit plan offered under the exchange.10

The director of health care reform must oversee the development of a current health care workforce development strategic plan that focuses on ensuring that Vermont has the health care workforce necessary to provide care to all state residents.11 The Green Mountain Care board must review the draft strategic plan and approve the final plan.

A Medicaid and exchange advisory committee is created to advise the commissioner of Vermont health access regarding policy development and program administration for the Vermont health benefit exchange, Medicaid, and Medicaid-funded programs.12

 

Footnotes

  • 1. 18 Vermont Statutes §9373
  • 2. 33 Vermont Statutes §1803
  • 3. 18 Vermont Statutes §§9371; 9372; 9376; 33 Vermont Statutes §1805
  • 4. 18 Vermont Statutes §§9374; 9375; 9375a;  9377; 9378; 9381; 9456; 33 Vermont Statutes §1801
  • 5. 3 Vermont Statutes §2222a
  • 6. 18 Vermont Statutes §9379
  • 7. 33 Vermont Statutes §1806
  • 8. 8 Vermont Statutes §4062; 5104
  • 9. 8 Vermont Statutes §4088
  • 10. 33 Vermont Statutes §1807
  • 11. 18 Vermont Statutes §9491
  • 12. 33 Vermont Statutes §402(a)

 

Health Insurance Exchanges in Vermont

Subtopic Statute/Regulation Description
Health Insurance Exchanges Vermont Administrative Code §80 280 001 “Rate review under the green mountain care board regulations” The Green Mountain Care Board must review requests for health insurance...
Vt. Stat. Ann. tit. 18, § 9371 - Principles for health care reform under the health law “Principles for health care reform under the health law” The state legislature adopts the following principles as a framework for...
Vt. Stat. Ann. tit. 18, § 9372 - Green Mountain Care Board purpose under the health law “Purpose under the health law” The Green Mountain Care board is established to promote the general good of the state by: improving...
Vt. Stat. Ann. tit. 18, § 9373 - Definitions under the health law “Definitions under the health law” (3) “Chronic care management” means a system of coordinated health care...
Vt. Stat. Ann. tit. 18, § 9374 - Green Mountain Care Board membership; authority under the health law “Board membership; authority under the health law” The Green Mountain Care board is created and consists of a chair and four members. The...
Vt. Stat. Ann. tit. 18, § 9375 - Green Mountain Care Board duties under the health law “Duties under the health law” (b) The Green Mountain Care board is responsible for the following: Oversee the development and...
Vt. Stat. Ann. tit. 18, § 9375a - Green Mountain Care Board expenditure analysis; unified health care budget under the health law “Expenditure analysis; unified health care budget under the health law” The Green Mountain Care board must develop a unified health care...
Vt. Stat. Ann. tit. 18, § 9376 - Payment amounts; methods under the health law “Payment amounts; methods under the health law” The state legislature intends to ensure payments to health care professionals that are...
Vt. Stat. Ann. tit. 18, § 9377 - Payment reform; pilots under the health law “Payment reform; pilots under the health law” The Green Mountain Care Board is responsible for payment and delivery system reform,...
Vt. Stat. Ann. tit. 18, § 9378 - Green Mountain Care Board public process under the health law “Public process under the health law” The Green Mountain Care Board must have a process for soliciting public input, including receiving...
Vt. Stat. Ann. tit. 18, § 9381 - Green Mountain Care Board appeals under the health law “Appeals under the health law” The Green Mountain Care board must adopt procedures for administrative appeals of its actions. Related...
Vt. Stat. Ann. tit. 18, § 9405 - State health plan; health resource allocation plan under the health law “State health plan; health resource allocation plan under the health law” The secretary of human services must adopt a state health plan...
Vt. Stat. Ann. tit. 18, § 9405a - Public participation and strategic planning under the health law “Public participation and strategic planning under the health law” Each hospital must have a process for meaningful public participation...
Vt. Stat. Ann. tit. 18, § 9405b - Hospital community reports “Hospital community reports under the health law” The commissioner of health must adopt rules establishing a standard format and content...
Vt. Stat. Ann. tit. 18, § 9408 - Common claims forms and procedures under the health law “Common claims forms and procedures under the health law” The commissioner of financial regulation must promulgate rules adopting uniform...
Vt. Stat. Ann. tit. 18, § 9410 - Health care database “Health care database under the health law” The commissioner of Vermont health access must establish a unified health care database to...
Vt. Stat. Ann. tit. 18, § 9416 - Vermont program for quality in health care under the health law “Vermont program for quality in health care under the health law” The commissioner must contract with the Vermont Program for Quality in...
Vt. Stat. Ann. tit. 18, § 9456 - Green Mountain Care Board budget review under the health law “Budget review under the health law” The Green Mountain Care board must conduct reviews of each hospital’s budget, utilization of...
Vt. Stat. Ann. tit. 18, § 9462 - Health care workforce; strategic plan under the health law “Health care workforce; strategic plan under the health law” The Green Mountain Care Board must consider the results of any quality...
Vt. Stat. Ann. tit. 18, § 9491 - Health care workforce; strategic plan under the health law “Health care workforce; strategic plan under the health law” The director of health care reform must oversee the implementation of the...
Vt. Stat. Ann. tit. 2, § 2222a - Health care system reform; improving quality and affordability under the executive law “Health care system reform; improving quality and affordability under the executive law” The director of health care reform in the Agency...
Vt. Stat. Ann. tit. 33, § 1803 - Vermont health benefit exchange Vermont health benefit exchange The Department of Vermont Access must establish the Vermont Health Benefit Exchange, to be administered by the...
Vt. Stat. Ann. tit. 33, § 1803 - Vermont health benefit exchange “Vermont health benefit exchange under the human services law” The Vermont health access must establish the Vermont health benefit...
Vt. Stat. Ann. tit. 33, § 1804 - Qualified employers for health benefit exchange purposes under the human services law “Qualified employers under the human services law” A qualified employer is an employer which employs up to 50 employees.  A...
Vt. Stat. Ann. tit. 33, § 1805 - Duties and responsibilities regarding the health benefit exchange under the human services law “Duties and responsibilities under the human services law” The Vermont health benefit exchange has the following duties consistent with...
Vt. Stat. Ann. tit. 33, § 1807 - Health benefit exchange navigators under the human services law “Navigators under the human services law” The Vermont health benefit exchange must establish a navigator program to assist individuals...
Vt. Stat. Ann. tit. 33, § 1808 - Health benefit exchange financial integrity under the human services law “Financial integrity under the human services law” The Vermont health benefit exchange must keep an accurate accounting of all activities...
Vt. Stat. Ann. tit. 33, § 1809 - Health benefit exchange publication of costs and satisfaction surveys under the human services law “Publication of costs and satisfaction surveys under the human services law” The Vermont health benefit exchange must publish the average...
Vt. Stat. Ann. tit. 33, § 1821 - Green Mountain Care purpose under the human services law “Purpose under the human services law” Green Mountain Care must provide comprehensive, affordable, high-quality publicly financed health...
Vt. Stat. Ann. tit. 33, § 1824 - Health benefit exchange eligibility under the human services law “Eligibility under the human services law” All Vermont residents must be eligible for Green Mountain Care regardless of whether an...
Vt. Stat. Ann. tit. 33, § 1825 - Green mountain care health benefits under the human services law “Health benefits under the human services law” Green Mountain Care must include primary care, preventive care, chronic care, acute...
Vt. Stat. Ann. tit. 33, § 1826 - Blueprint for health under the human services law “Blueprint for health under the human services law” Within 5 years following the implementation of Green Mountain Care, each individual...
Vt. Stat. Ann. tit. 33, § 1827 - Health benefit exchange administration; enrollment under the human services law “Administration; enrollment under the human services law” The agency of human services must solicit bids and award contracts to public or...
Vt. Stat. Ann. tit. 33, § 1828 - Health benefit exchange budget proposal under the human services law “Budget proposal under the human services law” The Green Mountain Care board is responsible for developing each year a 3 year Green...
Vt. Stat. Ann. tit. 33, § 1829 - Green Mountain Care fund under the human services law “Green Mountain Care fund under the human services law” The Green Mountain Care fund is established to finance health care coverage for...
Vt. Stat. Ann. tit. 33, § 1831 - Health benefit exchange public process under the human services law “Public process under the human services law” The agency of human services must provide a process for soliciting public input on the...
Vt. Stat. Ann. tit. 33, § 401 - Composition of Vermont health access department under the human services “Composition of department under the human services” The Department of Vermont Health Access must consist of the commissioner of Vermont...
Vt. Stat. Ann. tit. 33, § 402 - Medicaid and exchange advisory committee under the human services law “Medicaid and exchange advisory committee under the human services law”  (a) A Medicaid and exchange advisory committee is created...
Vt. Stat. Ann. tit. 8, § 4062 - Filing and approval of policy forms and premiums under the banking and insurance law “Filing and approval of policy forms and premiums under the banking and insurance law” Every policy of health insurance offered by a...
Vt. Stat. Ann. tit. 8, § 4088 - Appeal under the banking and insurance law “Appeal under the banking and insurance law” Any person, partnership, or corporation aggrieved by any action of the commissioner of...
Vt. Stat. Ann. tit. 8, § 5104 - Filing and approval of rates and forms; supplemental orders under the banking and insurance law “Filing and approval of rates and forms; supplemental orders under the banking and insurance law” A health maintenance organization that...
Vt. Stat. Ann. tit. § 18, 9409 - Health care provider bargaining groups under the health law “Health care provider bargaining groups under the health law” The commissioner of financial regulation may approve the creation of one or...
Vt. Stat. Ann. tit. § 18, 9414 - Quality assurance for managed care organizations under the health law “Quality assurance for managed care organizations under the health law” The commissioner of financial regulation must review a managed...
Vt. Stat. Ann. tit. § 18, 9414a - Annual reporting by health insurers under the health law “Annual reporting by health insurers under the health law” Health insurers that offer insurance through the Vermont health benefit...
Vt. Stat. Ann. tit. § 33, 1806 - Qualified health benefit plans under the human services law “Qualified health benefit plans under the human services law” Prior to contracting with a health insurer to offer a qualified health...
Vt. Stat. Ann. tit.18, § 9379 - Agency cooperation under the health law “Agency cooperation under the health law” The secretary of administration must ensure that the Green Mountain Care board has access to...
Vt. Stat. Ann. tit.33, § 1801 - Health benefit exchange purpose under the human services law “Purpose under the human services law” The state’s health benefit exchange, Green Mountain Care, is established to facilitate the...
Click on the individual state law in the table above to see our summary of the individual law.


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