NO. 18.  AN ACT RELATING TO MEDICARE SUPPLEMENTAL INSURANCE.

(H.427)

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1.  8 V.S.A. § 4062b(a), (b)(3) and (b)(4) are amended to read:

§ 4062b.  MEDICARE SUPPLEMENTAL HEALTH INSURANCE

(a)  Within five days of receiving a request for approval of any increased premiums composite average rate increase in excess of $500,000.00 three percent, or any other coverage changes which the commissioner determines will have a comparable impact on cost or availability of coverage for a Medicare supplemental insurance policy issued by any group or nongroup health insurance company, hospital or medical service organization, or health maintenance organization, with 5,000 or more total lives in the Vermont Medicare supplement market, the commissioner shall notify the department of aging and disabilities of the proposed premium increase.  A composite average rate is the enrollment-weighted average rate increase of all plans offered by a carrier.

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(3)  In reviewing any Medicare supplement rate increase for which an independent analysis has been performed pursuant to section 6706 of Title 33 and wherein the carrier’s requested composite average increase, the independent expert’s recommended composite average rate increase or the department actuary’s recommended composite average rate increase differ by two percentage points or more, the commissioner shall hold a public hearing where the insurer, the department actuary, the independent expert, any intervenor, and the public will have the opportunity to present written and oral testimony and will be available to answer questions of the commissioner and those present.  The hearing shall be noticed and held at a time and place so as to facilitate public participation, and shall be recorded and become part of the record before the commissioner.  In the commissioner's discretion, the hearing may be conducted through interactive television.  If the carrier’s requested composite average increase, the independent expert’s recommended composite average increase, or the department actuary’s recommended composite average increase differs by less than two percentage points, the department and the parties shall confer by conference call, or by any other available media, to review the rate requests and recommendations.  However, a public hearing may be held at the commissioner’s discretion for good cause shown.

(4)  In any review held in accordance with this subsection, the commissioner shall permit intervention by any person that the commissioner determines will materially advance the interests of the insured individuals.  The intervenor shall have access to, and may use the information of the independent expert appointed under section 6706 of Title 33.  The reasonable and necessary cost of intervention as determined by the commissioner shall be paid by the affected policyholders or certificate holders.  The maximum payment shall be $2,500.00 except when waived by the commissioner for good cause shown.  The $2,500.00 maximum amount may be adjusted to reflect, at the commissioner’s discretion, appropriate inflation factors.

Sec. 2.  33 V.S.A. § 6706 is amended to read:

§ 6706.  INDEPENDENT ANALYSIS

The commissioner of banking, insurance, securities, and health care administration shall adopt rules for the purposes of assuring an in-depth independent analysis by an expert, or experts, of proposed Medicare Supplement rate increases.  This analysis shall be performed only when the increased premiums composite average rate increase requested by insurers with 5,000 or more lives in the Vermont Medicare supplement market exceed $500,000.00 exceeds three percent, or when the commissioner finds that the proposed premium and policy changes will have a comparable adverse impact on availability or cost of coverage, or when it otherwise appears to be in the best interest of the insureds.  A composite average rate is the enrollment‑weighted average rate increase of all plans offered by a carrier.  The independent analyst shall be made available to the public during the analysis, and for the purpose of providing assistance with and testimony in connection with Medicare Supplement rate increase proposals.  The cost for the analysis shall be assessed to the affected policy or certificate holders.

Approved:  May 6, 2003