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 such as age and gender, but 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 premiums do not deviate from the community rate by more than 20 percent after applying age and tobacco ratings.

Furthermore, the bill allows carriers to implement incentives such as rewards, premium discounts, and modifications to cost-sharing amounts for members who participate in health promotion and disease prevention programs. These incentives are capped at 15 percent of the premium cost for the applicable coverage tier. 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