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Deadline For Public Comment

Deadline: Jun 21, 2013

The deadline for public comment has expired. Contact the agency or primary contact person listed below for assistance.

Rule Details

Rule Number: 13P013
Title: Health Benefits Eligibility and Enrollment.
Type: Standard
Status: Adopted
Agency: Agency of Human Services
Legal Authority: 3 V.S.A. § 3053; 33 V.S.A. §§ 105(c)(2), and 1901(a); Act No. 48 of 2011; Act No. 171 of 2012.
Summary: This rule implements the provisions of the federal Affordable Care Act (ACA) and Vermont Act No. 48 of 2011, and 171 of 2012. The ACA expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance Programs (CHIP) and the establishment of Health-Benefits Exchanges (Exchanges). Vermont's Exchange -- Vermont Health Connect (VHC) – will provide a marketplace for individuals and small employers to shop for and purchase private health insurance options. It will also provide Vermonters with the opportunity to apply for and enroll in Vermont's public health-benefits programs. This rule proposes to codify policy and procedural changes to the Medicaid and CHIP programs related to eligibility, enrollment, renewals, public availability of program information, and coordination across health-benefits programs. This rule also revises and consolidates Economic Service Division (ESD)'s Medicaid and CHIP program eligibility rules into a single, integrated, and updated code.
Persons Affected: Medicaid applicants and enrollees; Individuals who lack access to government-sponsored minimum essential coverage and wish to purchase health coverage; small employers who wish to offer health coverage to their employees; Health Insurance Issuers; Health Insurance Brokers; Health Care Providers; Agency of Human Services; Department for Children and Families, Economic Services Division; Department of Vermont Health Access, Exchange Division; Department of Financial Regulation; Department of Disabilities, Aging and Independent Living; Vermont Department of Health; Health-Benefits Advocacy Groups; Vermont Office of Health Care Ombudsman; Interested members of the public.
Economic Impact: The January 2013 financing plan submitted to the Vermont Legislature summarizes the SFY2014 impact: The funds to establish Vermont Health Connect have been secured through federal grants. Full operational costs become the responsibility of the State in 2015. Additional funding of $400,000 will be necessary in SFY2014 for the Navigator program, which will provide assistance to insurance purchasers in the Exchange. The Affordable Care Act provides significant subsidies for low- and middle- income Vermonters. The Administration recommends an additional $10.5 million in SFY 2014 to assure affordability of coverage through VHC. The funds will assist Vermonters with premium costs, deductibles, and total out-of-pocket expenses. Overall, the Admin
Posting date: May 15,2013

Hearing Information

Information for Hearing # 1
Hearing date:
06-14-2013 10:00 AM   
Location: Agency of Human Services Secretary's Conference Room
Address: 208 Hurricane Lane
City: Williston
State: VT
Zip: 05495
Hearing Notes:

Contact Information

Information for Contact # 1
Level: Primary    
Name: Michele Betit, Economic Services Division    
Agency: Department for Children and Families, Agency of Human Services    
Address: 103 South Main Street    
City: Waterbury    
State: VT    
Zip: 05671-1201    
Telephone: 802-279-3895    
Fax: 802-769-2186    
Website Address:
Information for Contact # 2
Level: Secondary    
Name: Afsar Sultana, Economic Services Division    
Agency: Department for Children and Families, Agency of Human Services    
Address: 103 S. Main Street    
City: Waterbury    
State: VT    
Zip: 05671-1201    
Telephone: 802-769-6279    
Fax: 802-769-2186    

Keyword Information


Vermont Health Connect
Health Benefits
Health Benefits Exchange
Small employer health benefits
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