1 | 1 | | BILL AS INTRODUCED S.43 |
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2 | 2 | | 2025 Page 1 of 4 |
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4 | 4 | | |
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5 | 5 | | VT LEG #379227 v.1 |
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6 | 6 | | S.43 1 |
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7 | 7 | | Introduced by Senators White, Chittenden, Clarkson, Gulick, Vyhovsky and 2 |
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8 | 8 | | Watson 3 |
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9 | 9 | | Referred to Committee on 4 |
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10 | 10 | | Date: 5 |
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11 | 11 | | Subject: Health; health insurance; State employees’ health plan; school 6 |
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12 | 12 | | employees; reference-based pricing 7 |
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13 | 13 | | Statement of purpose of bill as introduced: This bill proposes to direct the 8 |
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14 | 14 | | Department of Human Resources to implement a reference-based pricing 9 |
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15 | 15 | | program in the State employees’ health plan for inpatient and outpatient 10 |
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16 | 16 | | hospital services at certain hospitals beginning in 2026. It would also limit the 11 |
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17 | 17 | | allowable growth rate of premiums in the State employees’ health plan to not 12 |
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18 | 18 | | more than medical inflation and would allow school employers to join the plan 13 |
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19 | 19 | | for coverage of their employees. 14 |
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20 | 20 | | An act relating to reference-based pricing and cost-containment in the State 15 |
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21 | 21 | | employees’ health plan 16 BILL AS INTRODUCED S.43 |
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22 | 22 | | 2025 Page 2 of 4 |
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25 | 25 | | VT LEG #379227 v.1 |
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26 | 26 | | It is hereby enacted by the General Assembly of the State of Vermont: 1 |
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27 | 27 | | Sec. 1. 3 V.S.A. § 631 is amended to read: 2 |
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28 | 28 | | § 631. GROUP INSURANCE FOR STATE EMPLOYEES; SALARY 3 |
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29 | 29 | | DEDUCTIONS FOR INSURANCE, SAVINGS PLANS, AND 4 |
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30 | 30 | | CREDIT UNIONS 5 |
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31 | 31 | | (a)(1) The Secretary of Administration may contract on behalf of the State 6 |
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32 | 32 | | with any insurance company or nonprofit association doing business in this 7 |
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33 | 33 | | State to secure the benefits of franchise or group insurance. The terms of 8 |
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34 | 34 | | coverage under the policy shall be determined under section 904 of this title, 9 |
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35 | 35 | | but it may include: 10 |
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36 | 36 | | (A) life, disability, health, and accident insurance and benefits for 11 |
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37 | 37 | | any class or classes of State employees; and 12 |
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38 | 38 | | (B) hospital, surgical, and medical benefits for any class or classes of 13 |
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39 | 39 | | State employees or for those employees and any class or classes of their 14 |
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40 | 40 | | dependents. 15 |
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41 | 41 | | (2)(A)(i) As used in this section, the term “employees” includes any 16 |
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42 | 42 | | class or classes of elected or appointed officials, State’s Attorneys, sheriffs, 17 |
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43 | 43 | | employees of State’s Attorneys’ offices whose compensation is administered 18 |
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44 | 44 | | through the State of Vermont payroll system, except contractual and temporary 19 |
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45 | 45 | | employees, and deputy sheriffs paid by the State of Vermont pursuant to 24 20 |
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46 | 46 | | 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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47 | 47 | | 2025 Page 3 of 4 |
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49 | 49 | | |
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50 | 50 | | VT LEG #379227 v.1 |
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51 | 51 | | General Assembly as such, any person rendering service on a retainer or fee 1 |
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52 | 52 | | basis, members of boards or commissions, or persons other than employees of 2 |
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53 | 53 | | the Vermont Historical Society, the Vermont Film Corporation, the Vermont 3 |
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54 | 54 | | State Employees’ Credit Union, Vermont State Employees’ Association, and 4 |
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55 | 55 | | the Vermont Council on the Arts, whose compensation for service is not paid 5 |
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56 | 56 | | from the State Treasury, or any elected or appointed official unless the official 6 |
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57 | 57 | | is actively engaged in and devoting substantially full-time to the conduct of the 7 |
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58 | 58 | | business of the official’s public office. 8 |
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59 | 59 | | * * * 9 |
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60 | 60 | | (iv) For purposes of group hospital-surgical-medical expense 10 |
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61 | 61 | | insurance only, the term “employees” may include school employees at the 11 |
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62 | 62 | | option of a school employer, as those terms are defined in 16 V.S.A. § 2101. 12 |
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63 | 63 | | * * * 13 |
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64 | 64 | | (b)(1) For group hospital-surgical-medical expense insurance, the Secretary 14 |
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65 | 65 | | of Administration shall: 15 |
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66 | 66 | | (A) ensure utilization of a reference-based pricing program for 16 |
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67 | 67 | | inpatient and outpatient hospital services at hospitals other than critical access 17 |
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68 | 68 | | hospitals; and 18 |
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69 | 69 | | (B) limit the annual rate of premium growth to not more than the 19 |
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70 | 70 | | percentage change from the previous year in the Consumer Price Index for 20 |
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71 | 71 | | medical care in the Northeast region. 21 BILL AS INTRODUCED S.43 |
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72 | 72 | | 2025 Page 4 of 4 |
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74 | 74 | | |
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75 | 75 | | VT LEG #379227 v.1 |
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76 | 76 | | (2) On or before March 15 annually, the Secretary shall report to the 1 |
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77 | 77 | | General Assembly on the effect of the reference-based pricing program on the 2 |
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78 | 78 | | cost of the group hospital-surgical-medical expense insurance for State 3 |
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79 | 79 | | employees. 4 |
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80 | 80 | | Sec. 2. EFFECTIVE DATE 5 |
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81 | 81 | | This act shall take effect on January 1, 2026, with the first required report 6 |
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82 | 82 | | under 3 V.S.A. § 631(b)(2) due on or before March 15, 2027. 7 |
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