| Rule Number: |
20P010 |
| Title: |
Health Benefits Eligibility and Enrollment Rule, State Fair Hearings and Expedited Eligibility Appeals (Part 8). |
|
Type:
|
Standard |
|
Status:
|
Proposed |
| Agency: |
Agency of Human Services
|
| Legal Authority: |
3 V.S.A. § 801(b)(11); and 33 V.S.A. §§ 19019(a)(1), and 1810. |
| Summary:
| This proposed rulemaking amends Parts 1, 5, 7 and 8 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 5, and 7 were last amended effective January 15, 2019. Part 8 was last amended effective July 1, 2019. The changes align HBEE with federal and state guidance and law, provide clarification, correct information, improve clarity and make technical corrections. The majority of changes result from the transitioning of Qualified Health Plan (QHP) premium processing functions from the Agency of Human Services to QHP issuers, as contemplated in 2018 1 (Sp. Sess.) Acts and Resolves No. 11, Sec. C.102(a)(3). |
| Persons Affected:
| Medicaid applicants/enrollees; Individuals who wish to purchase health coverage including those who apply for premium and cost-sharing assistance; Health insurance issuers (including standalone dental issuers); Eligibility and enrollment assisters, including agents and brokers; Health care providers; Human Services Board; Health law, policy and related advocacy and community-based organizations and groups including the Office of the Health Care Advocate; Agency of Human Services including its departments; and Department of Financial Regulation. |
| Economic Impact:
| The rule does not increase or lessen an economic burden on any person or entity including no impact on the State's gross annualized budget in fiscal year 2021. The majority of the changes in Part 7 as well as changes in Parts 1 and 8 result from the removal of Qualified Health Plan (QHP) premium processing functions from the Agency of Human Services (AHS). The transition of premium processing from AHS to the QHP issuers is a legislative initiative, contemplated in 2018 1 (Sp. Sess.) Acts and Resolves No. 11, Sec. C.102(a)(3), to be codified at 33 V.S.A. § 1805. The revisions to the HBEE rule implement this legislative directive by eliminating AHS's administrative rules related to QHP premium processing. The other changes in Parts 1, 5, 7 and 8 align the rule with federal and state guidance and law, provide clarification, correct information, improve clarity, and make technical corrections. These changes conform the rule with current practice and also do not carry an economic impact. |
| Posting date: |
Mar 04,2020 |
