Vermont 2025-2026 Regular Session

Vermont House Bill H0102 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	BILL AS INTRODUCED H.102
2	2	2025 Page 1 of 8
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5	5	VT LEG #378718 v.1
6	6	H.102 1
7	7	Introduced by Representatives Casey of Montpelier, Berbeco of Winooski, 2
8	8	Black of Essex, Burke of Brattleboro, Cordes of Bristol, 3
9	9	Headrick of Burlington, McGill of Bridport, and Priestley of 4
10	10	Bradford 5
11	11	Referred to Committee on 6
12	12	Date: 7
13	13	Subject: Health; health coverage; health care sharing plan or arrangement; 8
14	14	Department of Financial Regulation; reporting 9
15	15	Statement of purpose of bill as introduced: This bill proposes to require a 10
16	16	person who is not authorized to offer health insurance in Vermont and who 11
17	17	offers or intends to offer a health care sharing plan or arrangement to facilitate 12
18	18	payment or reimbursement of health care costs or services for Vermont 13
19	19	residents to report certain information annually to the Commissioner of 14
20	20	Financial Regulation and to certify the accuracy of the information. The bill 15
21	21	would direct the Commissioner of Financial Regulation to prepare an annual 16
22	22	report summarizing the information and post it on the Department of Financial 17
23	23	Regulation’s website. 18
24	24	An act relating to annual reporting on health care sharing plans and 19
25	25	arrangements 20 BILL AS INTRODUCED H.102
26	26	2025 Page 2 of 8
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29	29	VT LEG #378718 v.1
30	30	It is hereby enacted by the General Assembly of the State of Vermont: 1
31	31	Sec. 1. 8 V.S.A. § 4078 is added to read: 2
32	32	§ 4078. HEALTH CARE SHARING PLAN OR ARRANGEMENT; 3
33	33	REPORTING AND CERTIFICATION 4
34	34	(a) A person who is not authorized by the Commissioner under chapter 5
35	35	101, 123, 125, or 139 of this title to offer insurance in this State and who offers 6
36	36	or intends to offer a plan or arrangement to facilitate payment or 7
37	37	reimbursement of health care costs or services for residents of this State, 8
38	38	regardless of whether the person is domiciled in this State or another state, 9
39	39	shall submit to the Commissioner on or after October 1, 2025 and on or after 10
40	40	March 1 each year thereafter: 11
41	41	(1) the following information: 12
42	42	(A) the total number of individuals and households that participated 13
43	43	in the plan or arrangement in this State in the immediately preceding calendar 14
44	44	year; 15
45	45	(B) the total number of employer groups that participated in the plan 16
46	46	or arrangement in this State in the immediately preceding calendar year, 17
47	47	specifying the total number of participating individuals in each participating 18
48	48	employer group; 19
49	49	(C) if the person offers a plan or arrangement in other states, the total 20
50	50	number of participants in the plan or arrangement nationally; 21 BILL AS INTRODUCED H.102
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55	55	(D) any contracts the person has entered into with providers in this 1
56	56	State who provide health care services to plan or arrangement participants; 2
57	57	(E) the total amount of fees, dues, or other payments collected by the 3
58	58	person in the immediately preceding calendar year from individuals, employer 4
59	59	groups, or others who participated in the plan or arrangement, specifying the 5
60	60	percentage of fees, dues, or other payments retained by the person for 6
61	61	administrative expenses; 7
62	62	(F) the total dollar amount of requests for reimbursement of health 8
63	63	care costs or services that were submitted in this State in the immediately 9
64	64	preceding calendar year by plan or arrangement participants or providers who 10
65	65	provided health care services to plan or arrangement participants; 11
66	66	(G) the total dollar amount of requests for reimbursement of health 12
67	67	care costs or services that were submitted in this State and were determined to 13
68	68	qualify for reimbursement under the plan or arrangement in the immediately 14
69	69	preceding calendar year; 15
70	70	(H) the total dollar amount of payments made to providers in this 16
71	71	State in the immediately preceding calendar year for health care services that 17
72	72	were provided to or received by plan or arrangement participants; 18
73	73	(I) the total dollar amount of reimbursements made to plan or 19
74	74	arrangement participants in this State in the immediately preceding calendar 20 BILL AS INTRODUCED H.102
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79	79	year for health care services provided to or received by a plan or arrangement 1
80	80	participant; 2
81	81	(J) the total number of requests for reimbursement of health care 3
82	82	costs or services submitted in this State in the immediately preceding calendar 4
83	83	year that were denied, expressed as a percentage of total reimbursement 5
84	84	requests submitted in that calendar year, and the total number of 6
85	85	reimbursement request denials that were appealed; 7
86	86	(K) the total dollar amount of health care expenses submitted in this 8
87	87	State by plan or arrangement participants or providers in the immediately 9
88	88	preceding calendar year that qualify for reimbursement pursuant to the plan or 10
89	89	arrangement criteria but that, as of the end of that calendar year, have not been 11
90	90	reimbursed, excluding any amounts that the plan or arrangement participants 12
91	91	incurring the health care costs must pay before receiving reimbursement under 13
92	92	the plan or arrangement; 14
93	93	(L) the estimated number of plan or arrangement participants the 15
94	94	person anticipates in this State in the next calendar year, specifying the number 16
95	95	of individuals, households, employer groups, and employees; 17
96	96	(M) a list of other states in which the person offers a plan or 18
97	97	arrangement; 19
98	98	(N) a list of any third parties, other than a licensed insurance 20
99	99	producer, that are associated with or assist the person in offering or enrolling 21 BILL AS INTRODUCED H.102
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103	103	VT LEG #378718 v.1
104	104	participants in this State in the plan or arrangement, copies of any training 1
105	105	materials provided to a third party, and a detailed accounting of any 2
106	106	commissions or other feeds or remuneration paid to a third party in the 3
107	107	immediately preceding calendar year for: 4
108	108	(i) marketing, promoting, or enrolling participants in a plan or 5
109	109	arrangement offered by the person in this State; or 6
110	110	(ii) operating, managing, or administering a plan or arrangement 7
111	111	offered by the person in this State; 8
112	112	(O) the total number of licensed insurance producers that are 9
113	113	associated with or assist the person in offering or enrolling participants in this 10
114	114	State in the plan or arrangement, the total number of participants enrolled in 11
115	115	the plan or arrangement through a licensed insurance producer, copies of any 12
116	116	training materials provided to a producer, and a detailed accounting of any 13
117	117	commissions or other fees or remuneration paid to a producer in the 14
118	118	immediately preceding calendar year for marketing, promoting, or enrolling 15
119	119	participants in a plan or arrangement offered by the person in this State; 16
120	120	(P) copies of any consumer-facing and marketing materials used in 17
121	121	this State in promoting the person’s plan or arrangement, including plan or 18
122	122	arrangement descriptions, benefit descriptions, and other materials that explain 19
123	123	the plan or arrangement; 20 BILL AS INTRODUCED H.102
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128	128	(Q) the name, mailing address, email address, and telephone number 1
129	129	of an individual serving as a contact for the person in this State; 2
130	130	(R) a list of any parent companies, subsidiaries, and other names that 3
131	131	the person has operated under at any time within the immediately preceding 4
132	132	five calendar years; and 5
133	133	(S) an organizational chart of the person and a list of the officers and 6
134	134	directors of the person; and 7
135	135	(2) a certification by an officer of the person that, to the best of the 8
136	136	person’s good-faith knowledge and belief, the information submitted is 9
137	137	accurate and satisfies the requirements of this subsection. 10
138	138	(b)(1) If a person subject to the requirements of subsection (a) of this 11
139	139	section fails to submit the information required by that subsection, the 12
140	140	submission is incomplete. The Commissioner shall make a determination of 13
141	141	completeness not later than 45 days after the submission is received. If the 14
142	142	Commissioner has not informed the person of any deficiencies in the 15
143	143	submission within 45 days after receiving the submission, the submission is 16
144	144	considered complete. 17
145	145	(2)(A) If the Commissioner determines that a person has failed to 18
146	146	comply with the requirements of subsection (a) of this section, the 19
147	147	Commissioner shall: 20 BILL AS INTRODUCED H.102
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152	152	(i) notify the person that the submission is incomplete and 1
153	153	enumerate in the notification each deficiency found in the person’s submission; 2
154	154	and 3
155	155	(ii) allow the person 30 days after notice of the incomplete 4
156	156	submission to remedy the deficiency found in the submission. 5
157	157	(B) If the person does not remedy the deficiency within the 30-day 6
158	158	period, the Commissioner may impose an administrative penalty not to exceed 7
159	159	$5,000.00 per day. 8
160	160	(C) If the person does not remedy the deficiency or deficiencies 9
161	161	within 30 days after the initial administrative penalty is imposed, the 10
162	162	Commissioner may issue cease and desist order pursuant to section 2110 of 11
163	163	this title. 12
164	164	(c) On or before April 1, 2026 and on or before each October 1 thereafter, 13
165	165	the Commissioner shall: 14
166	166	(1) prepare a written report summarizing the information submitted by 15
167	167	persons pursuant to subsection (a) of this section; and 16
168	168	(2) post the report on the Department’s website, along with accurate and 17
169	169	evidence-based information about the persons who submitted information 18
170	170	pursuant to subsection (a) of this section, including how consumers may file 19
171	171	complaints. 20 BILL AS INTRODUCED H.102
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176	176	(d) The Commissioner may adopt rules as necessary to implement this 1
177	177	section. 2
178	178	Sec. 2. EFFECTIVE DATE 3
179	179	This act shall take effect on passage. 4