Health Insurers Annual Reports
Health Insurers Annual Reports as mandated by the Legislature are now available here. These reports include statistics regarding claims, appeals, marketing and advertising expenses, lobbying and legal expenses and political contibutions as well as other financial data.
Annual Reports, Act 152
Quality Assurance Report
The provisions of Title 18 V.S.A. § 9414(a)(5) requires that the Commissioner, commencing with calendar year 2016, prepare an annual report on or before July 1 of each year providing the number of complaints received during the previous calendar year regarding violations or suspected violations of the standards set forth in this section or adopted by rule pursuant to this section. The report is to specify the aggregate number of complaints related to each standard, and such reports may be found here.
H-2009-03, Consumer Protection and Quality Requirements for Managed Care Organizations, helps to ensure consumer protection and quality requirements that managed care organizations (MCO). MCOs are required to submit their reports to the department on or before July 15 annually. Below are the most recent reports from 2020.
Filing and Reporting Instructions
Please send Baseline Review Filings and Network Adequacy Reporting via USPS to:
Department of Financial Regulation
Attn: Sebastian Arduengo
89 Main Street
Montpelier, VT 05620
If you would like confirmation that the material has been received you must provide the following:
A copy of the submission
A self-addressed envelope
Act 140 of 2021 added an attestation requirement for prior authorization review in 18 V.S.A. § 9418b(h). Companies may comply with the statute by submitting a letter signed by a corporate officer attesting to the requirements of the statute to the Commissioner of Financial Regulation and Chair of the Green Mountain Care Board. The statute requires health plans to attest that it has reviewed “the list of medical procedures and medical tests for which it requires prior authorization at least annually and [eliminated] the prior authorization requirements for those procedures and tests for which such a requirement is no longer justified or for which requests are routinely approved with such frequency as to demonstrate that the prior authorization requirement does not promote health care quality or reduce health care spending to a degree sufficient to justify the administrative costs to the plan.” In addition to the signed attestation, the Green Mountain Care Board may ask health insurers to present on prior authorization review at future Board meetings.