Health Insurers
The Health Care Administration Division provides guidance and regulatory information for health insurers, managed care organizations, and mental health review agents.
- The Accident & Health Insurers section provides the requirements and information needed for all health insurance filings.
- The Annual Statement Supplement Report (ASSR) is a web-based, annual report required to be filed by insurance carriers with the Division. The requirements and forms needed are provided in this section.
- The Managed Care Organizations page provides information about consumer protection and quality assurance for managed care organizations.
- Mental Health Review Agent Licensing page provides the requirements for licensing and reporting.
- Vermont's Health Insurance Coverage for Mental Health and Substance Abuse Treatment page provides information and links regarding "Mental Health Parity" - a law that requires insurers to provide insurance coverage for mental health and substance abuse treatment equally to other health conditions.
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The Health Plan Report Card provides comparative data on how Vermont health plans performed during the most recent reporting period and over time against the national and New England average in the areas of experience of care and service, preventive care, acute illness care and chronic illness care.
- The Vermont Healthcare Claims Uniform Reporting and Evaluation System (VHCURES) section provides information regarding the collection of health insurance claims.
- The Third Party Administrators (TPA) page addresses registration requirements and forms.
- The Pharmacy Benefit Manager (PBM) page addresses registration requirements and forms.
- The Rental Network Contracts page addresses registration requirements and forms.
- The Uniform Provider Credentialing process determines whether the provider is eligible to provide health care services to an insured, or to a hospital patient, or whether the provider is eligible to receive reimbursement for health care services.