Vermont § 1803 - Vermont Health Benefit Exchange

§ 1803. Vermont Health Benefit Exchange

• (a)(1) The Department of Vermont Health Access shall establish the Vermont Health Benefit
  Exchange, which shall be administered by the Department in consultation with the Advisory
  Committee established in section 402 of this title. (2) The Vermont Health Benefit Exchange shall be considered a division within the Department
  of Vermont Health Access and shall be headed by a Deputy Commissioner as provided
  in 3 V.S.A. chapter 53. (b)(1)(A) The Vermont Health Benefit Exchange shall provide qualified individuals and qualified
  employers with qualified health benefit plans, including the multistate plans required
  by the Affordable Care Act, with effective dates beginning on or before January 1,
  2014. The Vermont Health Benefit Exchange may contract with qualified entities or
  enter into intergovernmental agreements to facilitate the functions provided by the
  Vermont Health Benefit Exchange. (B) Prior to contracting with any health insurer, the Vermont Health Benefit Exchange
  shall consider the insurer’s historic rate increase information required under section 1806 of this title, along with the information and the recommendations provided to the Vermont Health
  Benefit Exchange by the Commissioner of Financial Regulation under Section 2794(b)(1)(B)
  of the federal Public Health Service Act. (2) To the extent allowable under federal law, the Vermont Health Benefit Exchange may
  offer health benefits to populations in addition to those eligible under Subtitle
  D of Title I of the Affordable Care Act, including: (A) to individuals and employers who are not qualified individuals or qualified employers
  as defined by this subchapter and by the Affordable Care Act; (B) Medicaid benefits to individuals who are eligible, upon approval by the Centers for
  Medicare and Medicaid Services and provided that including these individuals in the
  Health Benefit Exchange would not reduce their Medicaid benefits; (C) Medicare benefits to individuals who are eligible, upon approval by the Centers for
  Medicare and Medicaid Services and provided that including these individuals in the
  Health Benefit Exchange would not reduce their Medicare benefits; and (D) State employees and municipal employees, including teachers. (3) To the extent allowable under federal law, the Vermont Health Benefit Exchange may
  offer health benefits to employees for injuries arising out of or in the course of
  employment in lieu of medical benefits provided pursuant to 21 V.S.A. chapter 9 (workers’ compensation). (4) To the extent permitted by the U.S. Department of Health and Human Services, the Vermont
  Health Benefit Exchange shall permit qualified individuals and qualified employers
  to purchase qualified health benefit plans through the Exchange website, through navigators,
  by telephone, or directly from a health insurer under contract with the Vermont Health
  Benefit Exchange. (c)(1) The Vermont Health Benefit Exchange may determine an appropriate method to provide
  a unified, simplified administration system for health insurers offering qualified
  health benefit plans. The Exchange may include claims administration, benefit management,
  billing, or other components in the unified system and may achieve simplification
  by contracting with a single entity for administration and management of all qualified
  health benefit plans, by licensing or requiring the use of particular software, by
  requiring health insurers to conform to a standard set of systems and rules, or by
  another method determined by the Commissioner. (2) The Vermont Health Benefit Exchange may offer certain services, such as wellness programs
  and services designed to simplify administrative processes, to health insurers offering
  plans outside the Exchange, to workers’ compensation insurers, to employers, and to
  other entities.