The bill H.430 proposes amendments to Vermont's health insurance regulations, specifically allowing health insurers to adjust premiums for individual and small group health insurance plans based on the age of beneficiaries and their tobacco usage. The current law prohibits demographic rating factors, including age and gender, from being used in determining premiums. However, the new provisions will enable registered carriers to vary premium rates based on age, with a maximum rate differential of 3 to 1, and based on tobacco usage, with a maximum rate differential of 1.5 to 1. Additionally, the Commissioner of Financial Regulation will establish standards for these classifications while ensuring that the premium charged does not deviate significantly from the community rate filed by the carrier.

Furthermore, the bill allows for the implementation of health promotion and disease prevention programs, enabling carriers to offer rewards or discounts for adherence to such programs. The total value of these incentives is capped at 15 percent of the premium cost, ensuring that the overall rate deviations remain within specified limits. The act is set to take effect on January 1, 2026, marking a significant shift in how health insurance premiums can be structured in Vermont.

Statutes affected:
As Introduced: 33-1811