Bill H.95, introduced by Representative Black of Essex, seeks to update and reorganize 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 introduces consistent language and terminology, defining key terms such as "covered individual," "health care services," and "health insurance plan." It establishes compliance requirements with federal laws, outlines regulations against unfair discrimination by health insurers, and sets forth guidelines for the termination of coverage, age limits, and the prohibition of rebates for non-group and small group policies offered through the Vermont Health Benefit Exchange. The bill also enhances transparency and accountability in the health insurance market by detailing the filing and approval process for health insurance policy forms and premiums, including public comment opportunities and requirements for plain language summaries.

Additionally, the bill introduces several amendments to existing health insurance regulations, focusing on consumer protections and access to essential health services. It mandates comprehensive coverage for various medical services, including reproductive health, mental health, and cancer treatment, while prohibiting cost-sharing for certain services like sexual assault examinations. The bill also emphasizes the importance of telemedicine and ensures that health insurance plans cover these services equivalently to in-person consultations. Furthermore, it clarifies the rights of individuals in civil unions regarding dependent coverage and establishes a framework for independent external reviews of health care service decisions. Overall, Bill H.95 aims to enhance clarity, compliance, and consumer protections within Vermont's health insurance framework, with an effective date set for January 1, 2026.

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)