BILL AS INTRODUCED S.132
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VT LEG #379182 v.1
S.132 1
Introduced by Senators White, Clarkson, Gulick, Major and Vyhovsky 2
Referred to Committee on 3
Date: 4
Subject: Health; health coverage; health care sharing plan or arrangement; 5
Department of Financial Regulation; reporting 6
Statement of purpose of bill as introduced: This bill proposes to require a 7
person who is not authorized to offer health insurance in Vermont and who 8
offers or intends to offer a health care sharing plan or arrangement to facilitate 9
payment or reimbursement of health care costs or services for Vermont 10
residents to report certain information annually to the Commissioner of 11
Financial Regulation and to certify the accuracy of the information. The bill 12
would direct the Commissioner of Financial Regulation to prepare an annual 13
report summarizing the information and post it on the Department of Financial 14
Regulation’s website. 15
An act relating to annual reporting on health care sharing plans and 16
arrangements 17 BILL AS INTRODUCED S.132
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VT LEG #379182 v.1
It is hereby enacted by the General Assembly of the State of Vermont: 1
Sec. 1. 8 V.S.A. § 4078 is added to read: 2
§ 4078. HEALTH CARE SHARING PLAN OR ARRANGEMENT; 3
REPORTING AND CERTIFICATION 4
(a) A person who is not authorized by the Commissioner under chapter 5
101, 123, 125, or 139 of this title to offer insurance in this State and who offers 6
or intends to offer a plan or arrangement to facilitate payment or 7
reimbursement of health care costs or services for residents of this State, 8
regardless of whether the person is domiciled in this State or another state, 9
shall submit to the Commissioner on or after October 1, 2025 and on or after 10
March 1 each year thereafter: 11
(1) the following information: 12
(A) the total number of individuals and households that participated 13
in the plan or arrangement in this State in the immediately preceding calendar 14
year; 15
(B) the total number of employer groups that participated in the plan 16
or arrangement in this State in the immediately preceding calendar year, 17
specifying the total number of participating individuals in each participating 18
employer group; 19
(C) if the person offers a plan or arrangement in other states, the total 20
number of participants in the plan or arrangement nationally; 21 BILL AS INTRODUCED S.132
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(D) any contracts the person has entered into with providers in this 1
State who provide health care services to plan or arrangement participants; 2
(E) the total amount of fees, dues, or other payments collected by the 3
person in the immediately preceding calendar year from individuals, employer 4
groups, or others who participated in the plan or arrangement, specifying the 5
percentage of fees, dues, or other payments retained by the person for 6
administrative expenses; 7
(F) the total dollar amount of requests for reimbursement of health 8
care costs or services that were submitted in this State in the immediately 9
preceding calendar year by plan or arrangement participants or providers who 10
provided health care services to plan or arrangement participants; 11
(G) the total dollar amount of requests for reimbursement of health 12
care costs or services that were submitted in this State and were determined to 13
qualify for reimbursement under the plan or arrangement in the immediately 14
preceding calendar year; 15
(H) the total dollar amount of payments made to providers in this 16
State in the immediately preceding calendar year for health care services that 17
were provided to or received by plan or arrangement participants; 18
(I) the total dollar amount of reimbursements made to plan or 19
arrangement participants in this State in the immediately preceding calendar 20 BILL AS INTRODUCED S.132
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VT LEG #379182 v.1
year for health care services provided to or received by a plan or arrangement 1
participant; 2
(J) the total number of requests for reimbursement of health care 3
costs or services submitted in this State in the immediately preceding calendar 4
year that were denied, expressed as a percentage of total reimbursement 5
requests submitted in that calendar year, and the total number of 6
reimbursement request denials that were appealed; 7
(K) the total dollar amount of health care expenses submitted in this 8
State by plan or arrangement participants or providers in the immediately 9
preceding calendar year that qualify for reimbursement pursuant to the plan or 10
arrangement criteria but that, as of the end of that calendar year, have not been 11
reimbursed, excluding any amounts that the plan or arrangement participants 12
incurring the health care costs must pay before receiving reimbursement under 13
the plan or arrangement; 14
(L) the estimated number of plan or arrangement participants the 15
person anticipates in this State in the next calendar year, specifying the number 16
of individuals, households, employer groups, and employees; 17
(M) a list of other states in which the person offers a plan or 18
arrangement; 19
(N) a list of any third parties, other than a licensed insurance 20
producer, that are associated with or assist the person in offering or enrolling 21 BILL AS INTRODUCED S.132
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VT LEG #379182 v.1
participants in this State in the plan or arrangement, copies of any training 1
materials provided to a third party, and a detailed accounting of any 2
commissions or other feeds or remuneration paid to a third party in the 3
immediately preceding calendar year for: 4
(i) marketing, promoting, or enrolling participants in a plan or 5
arrangement offered by the person in this State; or 6
(ii) operating, managing, or administering a plan or arrangement 7
offered by the person in this State; 8
(O) the total number of licensed insurance producers that are 9
associated with or assist the person in offering or enrolling participants in this 10
State in the plan or arrangement, the total number of participants enrolled in 11
the plan or arrangement through a licensed insurance producer, copies of any 12
training materials provided to a producer, and a detailed accounting of any 13
commissions or other fees or remuneration paid to a producer in the 14
immediately preceding calendar year for marketing, promoting, or enrolling 15
participants in a plan or arrangement offered by the person in this State; 16
(P) copies of any consumer-facing and marketing materials used in 17
this State in promoting the person’s plan or arrangement, including plan or 18
arrangement descriptions, benefit descriptions, and other materials that explain 19
the plan or arrangement; 20 BILL AS INTRODUCED S.132
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(Q) the name, mailing address, email address, and telephone number 1
of an individual serving as a contact for the person in this State; 2
(R) a list of any parent companies, subsidiaries, and other names that 3
the person has operated under at any time within the immediately preceding 4
five calendar years; and 5
(S) an organizational chart of the person and a list of the officers and 6
directors of the person; and 7
(2) a certification by an officer of the person that, to the best of the 8
person’s good-faith knowledge and belief, the information submitted is 9
accurate and satisfies the requirements of this subsection. 10
(b)(1) If a person subject to the requirements of subsection (a) of this 11
section fails to submit the information required by that subsection, the 12
submission is incomplete. The Commissioner shall make a determination of 13
completeness not later than 45 days after the submission is received. If the 14
Commissioner has not informed the person of any deficiencies in the 15
submission within 45 days after receiving the submission, the submission is 16
considered complete. 17
(2)(A) If the Commissioner determines that a person has failed to 18
comply with the requirements of subsection (a) of this section, the 19
Commissioner shall: 20 BILL AS INTRODUCED S.132
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(i) notify the person that the submission is incomplete and 1
enumerate in the notification each deficiency found in the person’s submission; 2
and 3
(ii) allow the person 30 days after notice of the incomplete 4
submission to remedy the deficiency found in the submission. 5
(B) If the person does not remedy the deficiency within the 30-day 6
period, the Commissioner may impose an administrative penalty not to exceed 7
$5,000.00 per day. 8
(C) If the person does not remedy the deficiency or deficiencies 9
within 30 days after the initial administrative penalty is imposed, the 10
Commissioner may issue cease and desist order pursuant to section 2110 of 11
this title. 12
(c) On or before April 1, 2026 and on or before each October 1 thereafter, 13
the Commissioner shall: 14
(1) prepare a written report summarizing the information submitted by 15
persons pursuant to subsection (a) of this section; and 16
(2) post the report on the Department’s website, along with accurate and 17
evidence-based information about the persons who submitted information 18
pursuant to subsection (a) of this section, including how consumers may file 19
complaints. 20 BILL AS INTRODUCED S.132
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(d) The Commissioner may adopt rules as necessary to implement this 1
section. 2
Sec. 2. EFFECTIVE DATE 3
This act shall take effect on passage. 4