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NO. 13. AN ACT RELATING TO MEDICARE SUPPLEMENTAL HEALTH INSURANCE.

(H.172)

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

Sec. 1. 8 V.S.A. § 4062b is added to read:

§ 4062b. MEDICARE SUPPLEMENTAL HEALTH INSURANCE

(a) Within five days of receiving a request for approval of any increased premium for a Medicare supplemental insurance policy issued by any group or nongroup health insurance company, hospital or medical service organization, or health maintenance organization, the commissioner shall notify the department of aging and disabilities of the proposed premium increase.

(b) Within five days after receiving notification pursuant to subsection (a) of this section, the department of aging and disabilities shall inform the members of the advisory board established pursuant to 33 V.S.A. § 505 of the proposed premium increase.

(c) The commissioner shall hold a public informational hearing regarding the proposed premium increase, if within ten days after the advisory board receives notice of the increase pursuant to subsection (b) of this section, 25 or more policy or certificate holders affected by the proposed increase or any organization that represents at least 25 affected policy or certificate holders requests such a hearing. The commissioner shall not approve any premium increase until after any informational hearing is held pursuant to this subsection.

Sec. 2. 8 V.S.A. § 4080e is added to read:

§ 4080e. COMMUNITY RATING; SUPPLEMENTAL POLICIES

(a) A health insurance company, hospital or medical service corporation or health maintenance organization shall use a community rating method acceptable to the commissioner for determining premiums for Medicare supplemental insurance policy.

(b) The commissioner shall adopt rules for standards and procedure for permitting health insurance companies, hospital or medical service organizations, or health maintenance organizations that issue Medicare supplemental insurance policies to use one or more risk classifications in their community rating method. The premium charged shallnot deviate above or below the community rate filed by more than 40 percent for the period January 1, 1998, through December 31, 1998. The premium charged shall not deviate above or below the community rate filed by more than 20 percent for the period January 1, 1999, through December 31, 1999. Beginning January 1, 2000, the premium charged shall not deviate from the community rate and the rules shall not permit medical underwriting and screening.

Sec. 3. EFFECTIVE DATE

This act shall take effect on July 1, 1997, and shall apply to all policies, contracts and benefit plans offered, issued or renewed on and after September 1, 1997.

Approved: May 5, 1997