Code of Vermont Rules › Agency 21 - DEPARTMENT OF FINANCIAL REGULATION › Sub-Agency 020 - INSURANCE DIVISION › Chapter 001 - ACCIDENT AND SICKNESS MINIMUM STANDARDS › Section 21 020 001 - ACCIDENT AND SICKNESS MINIMUM STANDARDS

Current through June,
				2024
Section 1 Purpose
The purpose of this Regulation is to set forth certain
				  minimum standards concerning the policy provisions for accident and sickness
				  insurance and to outline those requirements governing solicitation of such
				  products so as to provide reasonable standardization and simplification of
				  terms and coverages of accident and sickness insurance policies and subscriber
				  contracts of hospital, medical and dental service corporations in order to
				  facilitate public understanding and comparison and to eliminate provisions
				  contained in accident and sickness insurance policies and subscriber contracts
				  of hospital, medical and dental service corporations which may be misleading or
				  confusing in connection either with the purchase of such coverages or with the
				  settlement of claims and to provide for full disclosure in the sale of such
				  coverages.
Section 2
				Authority
This Regulation is issued pursuant to the authority vested in
				  the Commissioner under 8 V.S.A., Chapter 3, Section 75.
Section 3 Applicability and Scope
This Regulation shall apply to all individual accident and
				  sickness insurance policies and subscriber contracts of hospital, medical and
				  dental service corporations except Medicare supplement policies or
				  certificates, delivered or issued for delivery in this state on and after the
				  effective date hereof, except is shall not apply to individual policies or
				  contracts issued pursuant to a conversion privilege under a policy or contract
				  of group or individual insurance when such group or individual policy or
				  contract includes provisions which are inconsistent with the requirements of
				  this Regulation. The requirements contained in this Regulation shall be in
				  addition to any other applicable regulations previously adopted.
Furthermore, with the exceptions hereinafter stated, this
				  Regulation shall apply to all accident and health policies including
				  certificates evidencing a contract of insurance issued and executed in any
				  state, and also contracts or polices that are delivered or issued for delivery
				  in this state pursuant to group plans; including group, blanket or franchise
				  plans. Any reference in this Regulation to individual accident and sickness
				  insurance policies shall include such group plans and the certificates issued
				  thereunder. This Regulation, however, does not apply to group policies issued
				  to one or more employers or labor organizations for the benefit of employees or
				  former employees or members or former members of the labor organizations, nor
				  shall it apply to group plans offered by professional, trade and occupational
				  associations to their respective members where the association:
(a) is composed of individuals all of whom
				are actively engaged in the same profession, trade or occupation;
(b) has been maintained in good faith for
				purposes other than the obtaining of insurance; and
(c) has been in existence for at least two
				years, prior to the date of its initial offering of such policy or plan to its
				members.