Title 08, Title 08: Banking and Insurance

§ 7156. Sales practices for wellness programs (a) A pet insurer or producer shall not market a wellness program as pet insurance. (b) If a wellness program is sold by a pet insurer or producer it shall be subject to the following requirements: (1) The purchase of the wellness pro…

§ 7157. Insurance producer training (a) An insurance producer shall not sell, solicit, or negotiate a pet insurance product until after the producer is appropriately licensed and has completed the required training identified in subsection (c) of this section. (b) An insurer shal…

§ 7158. Rules The Commissioner may adopt rules to administer this chapter and to effectuate its policies and purposes. (Added 2023, No. 110 (Adj. Sess.), § 28, eff. July 1, 2025.)

§ 7159. Violations A violation of this chapter shall be subject to the penalties and enforcement provisions specified in section 3661 of this title. (Added 2023, No. 110 (Adj. Sess.), § 28, eff. July 1, 2025.)

§ 8001. Definitions As used in this chapter: (1) “Commissioner” means the Commissioner of Financial Regulation. (2) “Continuing care” means the furnishing in a facility, pursuant to a continuing care contract, of board and a variety of living arrangements together with nursing, m…

§ 8002. Certificate of authority; authority of the Department (a) A provider shall not receive any entrance fee, or portion thereof, or enter into a continuing care contract unless the provider has obtained a certificate of authority from the Commissioner. However, a refundable p…

§ 8003. Sale or transfer of ownership Any provider desiring to sell or transfer ownership of a continuing care facility shall notify the department 30 days in advance of completion of such sale or transfer. The Commissioner may revoke, after notice and hearing, and upon written f…

§ 8004. Lien on behalf of residents; rehabilitation or liquidation (a) Prior to the issuance of a certificate of authority under this chapter, or at such other time as the Commissioner may determine it is in the best interests of residents of a facility, the Commissioner may file…

§ 8005. Continuing care contracts (a) A continuing care contract shall be in writing and shall contain at a minimum the provisions required in subsection (d) of this section. (b) All contract forms and the form of any attachments, addenda, or attachments by reference shall be fil…

§ 8006. Termination of contract; notice (a) A person who enters into a continuing care contract with a provider may voluntarily terminate the contract within 30 days of executing such contract and shall receive a refund of all money paid according to the provisions of subdivision…

§ 8007. Refunds (a) Unless otherwise provided in this section, all refunds of entrance fees shall be made within 60 days of the day notice of termination is given. Refunds shall be made less any additional costs specifically incurred by the provider at the request of the resident…

§ 8008. Escrow of entrance fees (a) In the event the facility is not in operation at the time entrance fees are paid, the entrance fees or portions thereof shall be deposited in an escrow account. Such escrowed fees shall not be released to the provider until the following condit…

§ 8009. Reserve requirements A provider shall maintain a reserve fund equal to annual principal and interest payments on all debt or 15 percent of annual operating expenses, whichever is greater. The Department may require that these funds be placed in an escrow account, or other…

§ 8010. Disclosure (a) A provider shall maintain financial records for the facility, including independently audited financial statements, and copies of all inspection reports pertaining to that facility that have been issued by any governmental agency and filed with the provider…

§ 8011. Resident associations; annual resident meeting (a) Residents of a facility have the right to self-organization and the right to engage in activities for the purpose of keeping informed on the operation of the facility or for the purpose of other mutual aid. (b) Annually, …

§ 8012. Enforcement (a) The Commissioner may, after notice and an opportunity for hearing, impose an administrative penalty of not more than $15,000.00 against any person who violates a provision of this chapter. The hearing before the Commissioner shall be a contested case subje…

§ 8013. Hearing on denial of certificate or rate application An adverse decision by the Commissioner under section 8002 of this title shall state the grounds and particulars on which the decision was based in such detail as to reasonably inform the affected party. Any party aggri…

§ 8014. Rules The Commissioner may adopt rules under 3 V.S.A. chapter 25 necessary to carry out the provisions of this chapter. (Added 1987, No. 247 (Adj. Sess.), § 1.)

§ 8015. Nondiscrimination The provisions of 9 V.S.A. § 4503 as they relate to age shall not apply to providers offering continuing care under the provisions of this chapter. (Added 1987, No. 247 (Adj. Sess.), § 1.)

§ 8016. Fees for administration of this chapter (a) An application for a certificate of authority shall be accompanied by a fee of $1,500.00. (b) The Department shall be reimbursed for any expenses it reasonably incurs itself or by its agents in pursuing the following statutory d…

§ 8017. Consumers guide The Commissioner shall publish and distribute a consumers’ guide to continuing care retirement communities and a directory of such facilities. (Added 1987, No. 247 (Adj. Sess.), § 1.)

§ 8018. Resident Assistance Fund (a) A provider shall establish a Resident Assistance Fund for the purpose of assisting residents who are unable to meet a portion of periodic or other charges of the provider. (b) The Fund shall be established by an initial contribution of at leas…

§ 8081. Purpose The purpose of this chapter is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to establish standards for l…

§ 8082. Definitions As used in this chapter: (1) “Applicant” means: (A) In the case of an individual long-term care insurance policy, the individual who seeks to contract for benefits. (B) In the case of a group long-term care insurance policy, the proposed certificate holder. (2…

§ 8083. Extraterritorial jurisdiction No group long-term care insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in subdivision 8082(4)(D) of this title, unless this State or another state having statuto…

§ 8084. Disclosure standards (a) The Commissioner shall adopt rules establishing standards for full and fair disclosure of the terms of a long-term care insurance policy. (b) The disclosure standards established under subsection (a) of this section shall include provisions settin…

§ 8084a. Required disclosure of rating practices to consumers (a) Other than policies for which no applicable premium rate or rate schedule increases can be made, insurers shall provide all of the information listed in this subsection to the applicant at the time of application o…

§ 8084b. Suitability (a) This section shall not apply to life insurance policies that accelerate benefits for long-term care. (b) The “issuer,” meaning every insurer, health care service plan, or other entity marketing long-term care insurance, shall: (1) develop and use suitabil…

§ 8085. Minimum benefits and coverage; general (a) The Commissioner shall adopt rules establishing standards for minimum benefits and coverage that must be provided by a long-term care insurance policy to carry out the purposes of subsection (b) of this section. Nothing in this s…

§ 8086. Preexisting conditions (a) No long-term care insurance policy or certificate shall use a definition of “preexisting condition” that is more restrictive than the following: “preexisting condition” means a condition for which medical advice or treatment was recommended by o…

§ 8087. Prior institutionalization No long-term care insurance policy shall condition benefits upon a period of prior hospitalization or upon admission to a facility for the same or related condition that led to hospitalization or admission to the facility. (Added 2003, No. 124 (…

§ 8088. Loss ratio standards The Commissioner may adopt rules establishing loss ratio standards for long-term care insurance policies, provided that a specific reference to long-term care insurance policies is contained in the rule. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Ja…

§ 8089. Right to return; free look (a) Individual long-term care insurance policyholders shall have the right to return the policy within 30 days of its delivery and to have the premium refunded if, after examination of the policy, the policyholder is not satisfied for any reason…

§ 8090. Outline of coverage for applicant; certificate (a) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document an…

§ 8091. Policy summary for life insurance policy providing long-term care benefits (a) If an individual life insurance policy provides long-term care benefits within the policy or by rider, a policy summary shall be delivered at the time of policy delivery. In the case of direct …

§ 8092. Acceleration of life insurance death benefit; monthly report Anytime a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report shall be provided to the policyholder. The repor…

§ 8093. Denial of claims; written explanation (a) If a claim under a long-term care insurance contract is denied, the issuer shall, within 60 days of the date of a written request by the policyholder or certificate holder, or a representative thereof: (1) provide a written explan…

§ 8094. Incontestability period (a) For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation t…

§ 8095. Nonforfeiture benefits (a) Except as provided in subsection (b) of this section, a long-term care insurance policy may not be delivered or issued for delivery in this State unless the policyholder or certificate holder has been offered the option of purchasing a policy or…

§ 8096. Secondary notice of cancellation The Commissioner shall adopt the National Association of Insurance Commissioners’ model rule regarding secondary notice of cancellation of long-term care policies. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)

§ 8097. Authority to adopt rules The Commissioner shall adopt reasonable rules to promote premium adequacy and to protect the policyholder in the event of substantial rate increases, and to establish minimum standards for marketing practices, agent compensation, field issuance, a…

§ 8098. Buyer’s guide The Commissioner shall require that a person offering long-term care insurance distribute to applicants a buyer’s guide in a form prescribed by the Commissioner. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)

§ 8099. Enforcement (a) No policy may be advertised, marketed, or offered as long-term care insurance unless it complies with the provisions of this chapter and rules adopted under this chapter. (b) In addition to any other remedy or sanction provided by law, after notice and opp…

§ 8101. Report of material transactions required (a) Every insurer domiciled in this State shall file a report with the Commissioner disclosing material acquisitions and dispositions of assets or material nonrenewals, cancellations, or revisions of ceded reinsurance agreements un…

§ 8102. Acquisitions and dispositions of assets (a)(1) For the purposes of this chapter, asset acquisition shall include every purchase, lease, exchange, merger, consolidation, succession, or other acquisition other than the construction or development of real property by or for …

§ 8103. Nonrenewals, cancellations, or revisions of ceded reinsurance agreements (a) Scope. Except as provided in subsection (c) of this section, a report as prescribed by section 8101 of this title is required to be filed without regard to which party has initiated the nonrenewa…