Bill H.95, introduced by Representative Black of Essex, seeks to overhaul Vermont's health insurance statutes by repealing the existing chapter and enacting a new, restructured chapter within 8 V.S.A. chapter 107. The bill establishes key definitions such as "covered individual," "health care services," and "health insurance plan," while mandating compliance with federal laws like the Health Insurance Portability and Accountability Act and the Patient Protection and Affordable Care Act. It also outlines the enforcement responsibilities of the Commissioner and includes provisions to prohibit unfair discrimination in premium rates, regulate advertising practices, and establish penalties for violations. Additionally, the bill addresses coverage termination processes, requiring advance notice of premium payments and grace periods, while ensuring transparency in health insurance practices by prohibiting rebates and commissions for certain policies.

The bill further introduces amendments to existing regulations concerning the rights and protections of insured individuals, including the prohibition of discretionary clauses in health insurance policies and the requirement for clear policy documentation. It mandates comprehensive coverage for various medical services, including reproductive health, mental health, and cancer-related services, while ensuring that health insurers cannot impose greater cost-sharing for these services compared to other health conditions. The legislation also emphasizes the importance of timely access to care and outlines the responsibilities of health insurers in notifying policyholders about premium payments and coverage changes. Overall, H.95 aims to create a more coherent, equitable, and transparent health insurance framework in Vermont, enhancing consumer protections and access to essential health services.

Statutes affected:
As Introduced: 8-107, 1-317(c), 1-317, 8-4512(b), 8-4512, 8-4515a, 8-4516, 8-4587, 8-4588, 8-4724(7)(E), 8-4724, 8-4724(7), 8-5104(a), 8-5104, 8-5115, 8-8083, 8-8094(e), 8-8094, 18-701, 18-706, 18-4750, 18-9361(a), 18-9361, 18-9362(a), 18-9362, 18-9375(b), 18-9375, 18-9377(g)(1), 18-9377, 18-9377(g), 18-9381(d), 18-9381, 18-9404(d), 18-9404, 18-9414a(a), 18-9414a, 18-9462, 18-9573(a), 18-9573, 32-1407(b), 32-1407, 32-10401, 33-1813(a)(2), 33-1813, 33-1813(a), 33-1814, 33-4110(a)(6), 33-4110, 33-4110(a)