Title 08, Banking and Insurance

§ 5040. Separability of provisions If any provision of this chapter, or the application of such provision to any person or circumstances, shall be held invalid, the remainder of the chapter and the application of such provision to persons or circumstances other than those as to w…

§ 5101. Definitions As used in this chapter: (1) “Commissioner” means the Commissioner of Financial Regulation. (2) “Health maintenance organization” means any person who furnishes, either directly or through arrangements with others, comprehensive health care services to an enro…

§ 5102. Application; certification, filing, and license fees (a) No person may operate a health maintenance organization without obtaining a certificate of authority from the Commissioner. (b) Application for a certificate of authority shall be made to the Commissioner and includ…

§ 5102a. Grievance procedures A health maintenance organization shall establish and maintain a grievance or complaint handling procedure that has been approved by the Commissioner to provide for the resolution of grievances and complaints initiated by members. The organization sh…

§ 5102b. Solvency protections (a) Before issuing any certificate of authority, the Commissioner shall require that the health maintenance organization have an initial net worth of $1,500,000.00 and shall thereafter maintain the minimum net worth required under subsection (b) of t…

§ 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…

§ 6001. Definitions As used in this chapter, unless the context requires otherwise: (1) “Affiliated company” means any company in the same corporate system as a parent, an industrial insured, or a member organization by virtue of common ownership, control, operation, or managemen…

§ 6002. Licensing; authority (a) Any captive insurance company, when permitted by its articles of association, charter, or other organizational document, may apply to the Commissioner for a license to conduct insurance business comprised in section 3301 of this title and may gran…

§ 6003. Names of companies No captive insurance company shall adopt a name that is the same, deceptively similar, or likely to be confused with or mistaken for any other existing business name registered in the State of Vermont. (Added 1981, No. 28.)

§ 6004. Minimum capital and surplus; letter of credit (a) Prior to issuing any policies of insurance or entering into any contracts of reinsurance, each captive insurance company shall possess and thereafter maintain unimpaired paid-in capital and surplus of: (1) in the case of a…

§ 6005. Dividends No captive insurance company may pay a dividend out of, or other distribution with respect to, capital or surplus without the prior approval of the Commissioner. Approval of an ongoing plan for the payment of dividends or other distributions shall be conditioned…

§ 6006. Formation of captive insurance companies in this State (a) Subject to the approval of the Commissioner, a captive insurance company may be formed as any type of entity permissible under Vermont law. (b)-(c) [Repealed.] (d) A captive insurance company incorporated or organ…

§ 6006a. Mergers (a) Any captive insurance company meeting the qualifications set forth in subdivision 6006(j)(1) of this title may merge with any other insurer, whether licensed in this State or elsewhere, in the following manner: (1) The board of directors of each insurer shall…

§ 6006b. Redomestication (a) Any foreign or alien insurer that qualifies for licensure as a captive insurance company in this State may redomesticate to this State by complying with all of the requirements of law relative to the organization and licensing of a captive insurance c…

§ 6007. Reports and statements (a) Captive insurance companies shall not be required to make any annual report except as provided in this chapter. (b) Prior to March 1 of each year, and prior to March 15 of each year in the case of pure captive insurance companies, association ca…

§ 6008. Examinations and investigations (a) Whenever the Commissioner determines it to be prudent, but not less frequently than once every five years, the Commissioner shall personally, or by some competent person appointed by the Commissioner, inspect and examine each captive in…

§ 6009. Grounds and procedures for suspension or revocation of license (a) The license of a captive insurance company may be suspended or revoked by the Commissioner for any of the following reasons: (1) insolvency or impairment of capital or surplus; (2) failure to meet the requ…

§ 6010. Legal investments (a)(1) Except as may be otherwise authorized by the Commissioner, agency captive insurance companies, association captive insurance companies, sponsored captive insurance companies, protected cells in sponsored captive insurance companies, and risk reten…

§ 6011. Reinsurance (a) Any captive insurance company may provide reinsurance of policies approved by the Commissioner comprised in section 3301 of this title, on risks of its parent, affiliated companies, and controlled unaffiliated business ceded by any other insurer, and may p…

§ 6012. Rating organizations; memberships No captive insurance company shall be required to join a rating organization. (Added 1981, No. 28.)

§ 6013. Exemption from compulsory associations No captive insurance company shall be permitted to join or contribute financially to any plan, pool, association, or guaranty or insolvency fund in this State, nor shall any such captive insurance company, or any insured or affiliate…

§ 6014. Tax on premiums collected (a) Each captive insurance company shall pay to the Commissioner of Taxes on or before March 15 of each year a tax at the rate of 38-hundredths of one percent on the first 20 million dollars and 285-thousandths of one percent on the next 20 milli…

§ 6015. Rules and regulations The Commissioner may adopt and from time to time amend such rules relating to captive insurance companies as are necessary to enable the Commissioner to carry out the provisions of this chapter. (Added 1981, No. 28; amended 2003, No. 55, § 7.)

§ 6016. Laws applicable No provisions of this title, other than those contained in this chapter or contained in specific references contained in this chapter, shall apply to captive insurance companies. Risk retention groups shall have the privileges and be subject to the provisi…

§ 6017. Captive Insurance Regulatory and Supervision Fund (a)(1) There is hereby created a fund to be known as the Captive Insurance Regulatory and Supervision Fund for the purpose of providing the financial means for the Commissioner of Financial Regulation to administer this ch…

§ 6018. Delinquency Except as otherwise provided in this chapter, the terms and conditions set forth in chapter 145 of this title shall apply in full to captive insurance companies formed or licensed under this chapter; however, the assets of a separate account established under …

§ 6019. Rules for controlled unaffiliated business The Commissioner may adopt rules establishing standards to ensure that a parent or its affiliated company, or an industrial insured or its affiliated company, is able to exercise control of the risk management function of any con…

§ 6020. Conversion to or merger with reciprocal insurer (a) An association captive insurance company, risk retention group, industrial insured captive insurance company formed as a stock or mutual corporation, or other insurer approved by the Commissioner may be converted to or m…

§ 6024. Dormant captive insurance companies (a) As used in this section, unless the context requires otherwise, “dormant captive insurance company” means a captive insurance company that has: (1) ceased transacting the business of insurance, including the issuance of insurance po…

§ 6031. Formation (a) One or more sponsors may form a sponsored captive insurance company under this chapter. In addition to the general provisions of this chapter, the provisions of this subchapter shall apply to sponsored captive insurance companies. (b) Subject to the approval…

§ 6032. Definitions As used in this subchapter: (1) “General account” means all assets and liabilities of the sponsored captive insurance company not attributable to a protected cell. (2) “Incorporated protected cell” means a protected cell that, subject to the approval of the Co…

§ 6033. Supplemental application materials In addition to the information required by subdivisions 6002(c)(1) and (2) of this title, and subject to the confidentiality provisions of subdivision 6002(c)(3) of this title, each applicant-sponsored captive insurance company shall fil…

§ 6034. Protected cells A sponsored captive insurance company formed or licensed under the provisions of this chapter may establish and maintain one or more protected cells to insure risks of one or more participants or, subject to Commissioner approval, other parties unaffiliate…