Search Rules

Deadline For Public Comment

Deadline: Oct 07, 2013

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

Rule Details

Rule Number: 13P030
Title: Rule 2.000: Health Insurance Rate Review.
Type: Standard
Status: Adopted
Agency: Green Mountain Care Board
Legal Authority: 8 V.S.A. § 4062 (as amended by Sec. 5c of Act 79 of 2013); 18 V.S.A. § 9375(b)(6); and 18 V.S.A. § 9380
Summary: Under current Vermont law, the Department of Financial Regulation (DFR)reviews each request filed by an insurer to change the rates charged for health insurance. DFR makes a recommendation to the Green Mountain Care Board (GMCB), which then has 30 days to approve, modify, or disapprove the rate request. 8 V.S.A. § 4062; 18 V.S.A. § 9375(b)(6). In Act 79 of 2013, the Legislature changed the process. As of January 1, 2014, insurers will file rate requests with the GMCB, which will have 90 days to approve, modify, or disapprove. 8 V.S.A. § 4062( as amended by Act 79, § 65c). DFR will continue to review rate requests for the sole purpose of providing the GMCB with an analysis and opinion about the impact of proposed rates on insurer solvency and reserves. Act 79 also introduces statutory changes aimed at enhancing transparency in the rate review process. This proposed rule revises the GMCB's current rule to match the Act's structural changes to the review process and implements the Act's transparency measures.
Persons Affected: The proposed rule governs the process by which the GMCB reviews health insurance rate requests from insurers. The adoption of the rule thus affects the health insurance companies, the Vermont Office of Health Care Ombudsman (which may elect to become a party representing the interests of consumers in all rate review cases before the GMCB), and health insurance policy holders and ratepayers. The GMCB's rate review process does not directly affect the Medicaid programs administered by the Department of Vermont Health Access.
Economic Impact: The Vermont Legislature created the GMCB to improve the health of Vermonters; reduce growth in health care spending; and promote health care accessibility, affordability, and quality. 18 V.S.A. § 9372. The proposed rule is intended to create a procedural framework that enables the GMCB to further these objectives. The rate review process will be revenue-neutral to State government in execution, in that it will be accomplished with existing personnel and resources. It will have an economic impact on the regulated health insurance companies by impacting the premiums charges by those companies, which in turn could affect their revenue. Further, the GMCB's rate review decisions will affect the premiums paid by the relevant insurance policy holders. Finally, the Vermont Office of Health Care Ombudsman, who may elect to participate as a party representing ratepayers in all rate review cases before the GMCB, is also affected.
Posting date: Aug 21,2013

Hearing Information

Information for Hearing # 1
Hearing date:
09-30-2013 10:00 AM   
Location: Department of Financial Regulation, Large Conference Room
Address: 89 Main Street, 3rd Floor
City: Montpelier
State: VT
Zip: 05620
Hearing Notes:

Contact Information

Information for Contact # 1
Level: Primary    
Name: Michael Donofrio, General Counsel    
Agency: Green Mountain Care Board    
Address: 89 Main Street, 3rd Floor    
City: Montpelier    
State: VT    
Zip: 05620    
Telephone: 802-828-4892    
Fax:    
Email: 
Michael.Donofrio@state.vt.us
     
 
   
Website Address:  http://www.gmcboard.vermont.gov/rules
     
 
   
Information for Contact # 2
Level: Secondary    
Name: Janet Richard    
Agency: Green Mountain Care Board    
Address: 89 Main Street, 3rd Floor    
City: Montpelier    
State: VT    
Zip: 05620    
Telephone: 802-828-4892    
Fax:    
Email: 
janet.richard@state.vt.us
     
 
   
       

Keyword Information

Keywords:

health insurance rate review
rate review
Green Mountain Care Board
A Vermont Government Website   Copyright 2014 State of Vermont