Title 08, Title 08: Banking and Insurance

§ 5103. Precertificate activities The Commissioner, in his or her discretion, may permit an applicant to contact potential members prior to the issuance of a certificate of authority, to discuss the health care services the applicant proposes to offer and the proposed evidences o…

§ 5104. Filing and approval of rates and forms; supplemental orders (a)(1) A health maintenance organization that has received a certificate of authority under section 5102 of this title shall file and obtain approval of all policy forms and rates as provided in sections 4026 and…

§ 5105. Examinations (a) The Commissioner shall make an examination of the affairs of any health maintenance organization organized or holding a certificate of authority as a health maintenance organization in this State as often as the Commissioner deems it necessary, but not le…

§ 5106. Annual report to the Commissioner (a) Every organization subject to this chapter, annually, within 90 days of the close of its fiscal year, shall file a report with the Commissioner, said report verified by an appropriate official of the organization, showing its financia…

§ 5107. Powers of health maintenance organizations (a) Health maintenance organizations may: (1) Buy, sell, lease, encumber, construct, renovate, operate, or maintain hospitals, health care clinics, other health care facilities, and other real and personal property that is incide…

§ 5107a. Application for continuing authority upon merger, consolidation, transfer of control, or sale of contracts (a) If a health maintenance organization that annually writes more than $10 million of premium in this State intends to merge into or with or consolidate with, tran…

§ 5108. Prohibited practices Section 4724 of this title relating to unfair trade practices shall be construed to apply to health maintenance organizations, except to the extent that the Commissioner determines that the nature of health maintenance organizations renders such secti…

§ 5109. Sanctions Upon satisfactory evidence that any health maintenance organization has violated any law or regulation or in any way has failed in meeting its financial and contractual obligations to its members, including quality assurance as provided by 18 V.S.A. § 9414, the …

§ 5110. Name of health maintenance organization No health maintenance organization, unless licensed as an insurer, may use in its name, evidences of coverage, contracts, or literature, any of the words “insurance,” “casualty,” “surety,” “mutual,” or any other words descriptive of…

§ 5111. Rules The Commissioner may, after notice and hearing, adopt reasonable rules under 3 V.S.A. chapter 25 as are necessary or proper to carry out the provisions of this chapter. (Added 1979, No. 117 (Adj. Sess.); amended 2015, No. 23, § 86.)

§ 5112. Statutory construction and relationship to other laws Except as provided in this chapter, and except as provided in section 3315 and chapter 112, subchapter 2 of this title, provisions of the insurance laws and specifically provisions of chapters 123 and 125 of this title…

§ 5113. Severability If any section, term, or provision of this chapter shall be adjudged invalid for any reason, such judgment shall not affect, impair, or invalidate any other section, term, or provision of this chapter, but the remaining section, terms, and provisions shall be…

§ 5114. Part-time employees A health maintenance organization shall not exclude part-time employees or refuse to offer the same benefits to part-time employees as it offers to the employee groups of which the part-time employees would be members if they were full-time employees. …

§ 5115. Duty of nonprofit health maintenance organizations Any nonprofit health maintenance organization subject to this chapter shall offer nongroup plans to individuals in accordance with 33 V.S.A. § 1811 without discrimination based on age, gender, industry, and medical histor…