Terms Used In Vermont Statutes Title 8 Sec. 8084a

  • Applicant: means :

  • Certificate: means , as used in this chapter, any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this State. See
  • Commissioner: means the Commissioner of Financial Regulation. See
  • following: when used by way of reference to a section of the law shall mean the next preceding or following section. See
  • Policy: means any policy, contract, subscriber agreement, rider, or endorsement delivered or issued for delivery in this State by an insurer; fraternal benefit society; nonprofit health, hospital, or medical service corporation; prepaid health plan; health maintenance organization; or any similar organization. See
  • State: when applied to the different parts of the United States may apply to the District of Columbia and any territory and the Commonwealth of Puerto Rico. See

§ 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 or enrollment, unless the method of application does not allow for delivery at that time. In such a case, an insurer shall provide all of the information listed in this subsection to the applicant not later than at the time of delivery of the policy or certificate:

(1) A statement that the policy may be subject to rate increases in the future.

(2) An explanation of potential future premium rate or rate schedule revisions and the policyholder’s or certificate holder’s option in the event of a revision.

(3) The premium rate or rate schedules applicable to the applicant that will be in effect until a request is made for an increase.

(4) A general explanation for applying premium rate or rate schedule adjustments that shall include:

(A) a description of when premium rate or rate schedule adjustments will be effective; and

(B) the right to a revised premium rate or rate schedule as provided in subdivision (2) of this subsection (a) if the premium rate or rate schedule is changed.

(5) Information regarding each premium rate or rate schedule increase on this policy form or similar policy forms over the past 10 years for this State or any other state that, at a minimum, identifies:

(A) The policy forms for which premium rates or rate schedules have been increased.

(B) The calendar years during which the form was available for purchase.

(C) The amount or percent of each increase. The percentage may be expressed as a percentage of the premium rate prior to the increase and may also be expressed as minimum and maximum percentages if the rate increase is variable by rating characteristics.

(b) In certain circumstances, the Commissioner may waive the disclosures required to be made by an insurer under subdivision (a)(5) of this section where such disclosures relate to blocks of business acquired by such an insurer from nonaffiliated insurers or the long-term care policies acquired from nonaffiliated insurers and when the increases that would otherwise be required to be disclosed occurred prior to the acquisition of such block or policies. Similarly, the Commissioner may waive the premium disclosures required by subdivision (a)(5) of this section, as relates to a rate increase on a long-term care policy form acquired from nonaffiliated insurers or a block of policy forms acquired from nonaffiliated insurers on or before the end of a 24-month period following the acquisition of the block of policies, and where disclosure of the rate increase had been made by the selling insurer prior to the acquisition. When making a decision to waive the disclosures required under subdivision (a)(5) of this section, the Commissioner shall consider such factors as whether making the disclosures would be unfair or punitive to the acquiring insurer and whether nondisclosure would harm Vermont consumers.

(c) The insurer shall, in a form and in a fair manner approved by the Commissioner, provide explanatory information related to premium rate and rate schedule increases covered by this section.

(d) An applicant shall, at the time of application, unless the method of application does not allow for acknowledgment at that time, in such a case, not later than at the time of delivery of the policy or certificate, sign an acknowledgment that the insurer made the disclosures required under subdivisions (a)(1) and (5) of this section.

(e) An insurer shall provide notice of an upcoming premium rate or rate schedule increase to all policyholders or certificate holders, if applicable, at least 90 days prior to the implementation of the premium rate or rate schedule increase by the insurer. The notice shall include the information required by subsection (a) of this section when the rate increase is implemented, as well as the explanatory information required by subsection (c) of this section that is specific to the upcoming premium rate or rate schedule increase. (Added 2005, No. 20, § 1, eff. May 11, 2005; amended 2021, No. 105 (Adj. Sess.), § 265, eff. July 1, 2022; 2023, No. 32, § 7, eff. July 1, 2023.)