Vermont Health Insurance (VT)

Vermont (VT)
Individual Health Insurance Regulations

Learn more about Vermont Individual Health Insurance

As an earning member of your family, it becomes your responsibility to safeguard your family against sickness or injuries. An appropriate health insurance can save you from huge medical bills and guarantee well-being of your family's health. It is prudent to evaluate your budget and family's health care needs, before purchasing health coverage. If you live in Vermont, you can choose from various options of health insurance. The Vermont Department of Banking, Insurance, and Securities & Health Care Administration (BISHCA) supervises the regulations under which the Vermont health insurers can sell private health insurance to individuals and families.

Vermont is one of the few states in the country that requires all Vermont individual health insurance companies to provide coverage on a guaranteed issue basis. Any person that is a resident of Vermont and does not have access to a group health plan must be offered coverage through any insurance company with whom they apply. Premiums are not based on the health status of the applicant and must be guaranteed for 12 months. On annual renewal, your premium may not increase by more than 20%, regardless of your claims history with the insurance company. Elimination riders are not permitted, but a 12 month exclusionary period can be imposed by the insurance carrier if the new member does not have adequate prior creditable coverage. The look-back period on pre-existing conditions is limited to 12 months, but is only applicable to persons that are subject to the 12 month exclusionary period. Civil unions must be recognized on family health plans by Vermont health insurance carriers.

Request Vermont Individual Health Insurance Quotes from any of our multiple providers.

Vermont (VT)

Small Group Health Insurance Regulations

In Vermont, and company with 1-50 employees may qualify for guaranteed issue small group health insurance. This means that no eligible group may be denied coverage based on the health status of any employee seeking coverage under the group health plan. Two employees must be present for half of the preceding calendar quarter and work 20 hrs/week for coverage. Insurance companies are permitted to demand 75% participation from all eligible employees working for the company that is establishing the group health plan. Employees that are already covered under a spouse's group plan do not count toward the 75% participation requirement. Premiums are community rated and may not be increased due to the health history of the group. No eligible employee may be denied coverage from the insurance company, regardless of their health status. Each insurance company offering small group medical insurance in Vermont must offer two standardized plans, called "common health plans." These plans are identical, regardless of which insurance company you choose, but the rates may vary from one insurance company to another. In Vermont, a self-employed person may qualify as a group of 1 and obtain the same level of health care benefits as other small groups with up to 50 employees.

Small business owners can request quotes for Vermont group health insurance from any of our listed providers.

Vermont COBRA and Continuation Coverage

Vermont has a law that is similar to the federal COBRA law that regulates employer groups of 20 or more employees. Employees of companies that fall under federal COBRA regulations may continue on the group health plan for up to 18 months. The Vermont version of COBRA only offers 6 months of continuation coverage, and to be eligible an employee must have been insured under the group plan for a minimum of 3 months. To accept coverage under the Vermont mini-COBRA regulations, you must notify your employer or health plan administrator within 30 days of the termination date of your group coverage. Conversion policies are available for persons that have exhausted their COBRA coverage. Since Vermont is a guaranteed issue state for individual health insurance, the state does not have a high-risk health pool.

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