Vermont 2025-2026 Regular Session

Vermont Senate Bill S0043 Compare Versions

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11 BILL AS INTRODUCED S.43
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55 VT LEG #379227 v.1
66 S.43 1
77 Introduced by Senators White, Chittenden, Clarkson, Gulick, Vyhovsky and 2
88 Watson 3
99 Referred to Committee on 4
1010 Date: 5
1111 Subject: Health; health insurance; State employees’ health plan; school 6
1212 employees; reference-based pricing 7
1313 Statement of purpose of bill as introduced: This bill proposes to direct the 8
1414 Department of Human Resources to implement a reference-based pricing 9
1515 program in the State employees’ health plan for inpatient and outpatient 10
1616 hospital services at certain hospitals beginning in 2026. It would also limit the 11
1717 allowable growth rate of premiums in the State employees’ health plan to not 12
1818 more than medical inflation and would allow school employers to join the plan 13
1919 for coverage of their employees. 14
2020 An act relating to reference-based pricing and cost-containment in the State 15
2121 employees’ health plan 16 BILL AS INTRODUCED S.43
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2525 VT LEG #379227 v.1
2626 It is hereby enacted by the General Assembly of the State of Vermont: 1
2727 Sec. 1. 3 V.S.A. § 631 is amended to read: 2
2828 § 631. GROUP INSURANCE FOR STATE EMPLOYEES; SALARY 3
2929 DEDUCTIONS FOR INSURANCE, SAVINGS PLANS, AND 4
3030 CREDIT UNIONS 5
3131 (a)(1) The Secretary of Administration may contract on behalf of the State 6
3232 with any insurance company or nonprofit association doing business in this 7
3333 State to secure the benefits of franchise or group insurance. The terms of 8
3434 coverage under the policy shall be determined under section 904 of this title, 9
3535 but it may include: 10
3636 (A) life, disability, health, and accident insurance and benefits for 11
3737 any class or classes of State employees; and 12
3838 (B) hospital, surgical, and medical benefits for any class or classes of 13
3939 State employees or for those employees and any class or classes of their 14
4040 dependents. 15
4141 (2)(A)(i) As used in this section, the term “employees” includes any 16
4242 class or classes of elected or appointed officials, State’s Attorneys, sheriffs, 17
4343 employees of State’s Attorneys’ offices whose compensation is administered 18
4444 through the State of Vermont payroll system, except contractual and temporary 19
4545 employees, and deputy sheriffs paid by the State of Vermont pursuant to 24 20
4646 V.S.A. § 290(b). The term “employees” shall does not include members of the 21 BILL AS INTRODUCED S.43
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5151 General Assembly as such, any person rendering service on a retainer or fee 1
5252 basis, members of boards or commissions, or persons other than employees of 2
5353 the Vermont Historical Society, the Vermont Film Corporation, the Vermont 3
5454 State Employees’ Credit Union, Vermont State Employees’ Association, and 4
5555 the Vermont Council on the Arts, whose compensation for service is not paid 5
5656 from the State Treasury, or any elected or appointed official unless the official 6
5757 is actively engaged in and devoting substantially full-time to the conduct of the 7
5858 business of the official’s public office. 8
5959 * * * 9
6060 (iv) For purposes of group hospital-surgical-medical expense 10
6161 insurance only, the term “employees” may include school employees at the 11
6262 option of a school employer, as those terms are defined in 16 V.S.A. § 2101. 12
6363 * * * 13
6464 (b)(1) For group hospital-surgical-medical expense insurance, the Secretary 14
6565 of Administration shall: 15
6666 (A) ensure utilization of a reference-based pricing program for 16
6767 inpatient and outpatient hospital services at hospitals other than critical access 17
6868 hospitals; and 18
6969 (B) limit the annual rate of premium growth to not more than the 19
7070 percentage change from the previous year in the Consumer Price Index for 20
7171 medical care in the Northeast region. 21 BILL AS INTRODUCED S.43
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7676 (2) On or before March 15 annually, the Secretary shall report to the 1
7777 General Assembly on the effect of the reference-based pricing program on the 2
7878 cost of the group hospital-surgical-medical expense insurance for State 3
7979 employees. 4
8080 Sec. 2. EFFECTIVE DATE 5
8181 This act shall take effect on January 1, 2026, with the first required report 6
8282 under 3 V.S.A. § 631(b)(2) due on or before March 15, 2027. 7