The State Flexibility to Stabilize the Market Cycle II Grant Program - The State of Vermont and the Department of Financial Regulation (the Department) seek participation in the State Flexibility to Stabilize the Market Grant Program. The Department has the primary responsibility over the regulation of the private health insurance market. The Department oversees the implementation of the identified market reforms in Part A of Title XXVII of the PHS Act. Through its health insurance form review as well as market conduct activities, the Department is in the best position to assess the needs of consumers and develop innovative measures to ensure consumers have continued access to affordable, comprehensive health insurance coverage in the individual and small group markets. In accordance with the letter of intent drafted in November of 2020, the Department of Financial Regulation plans to use the grant funds to carry out four main tasks: 1) Analyze the current Essential Health Benefit Package to ensure the coverage is meeting the needs of the small group and individual markets 2) Analyze whether current networks are adequate for consumers and providing accessible coverage 3) Enhance the existing policy filing review processes and formularies to ensure health insurance issuers do not include and utilize discriminatory benefit designs 4) Perform market scan of the uninsured population to ensure coverage is accessible to all of Vermont’s population and develop action plan if necessary. The Department anticipates utilizing grant funds to support a form review process for existing staff and to engage technical experts, where needed and appropriate, to conduct actuarial, economic, and market scans to better understand if coverage being offered is adequate, non-discriminatory, and meeting the needs of insureds in Vermont. All funds requested are for grant activities only. The Department will not use grant funds to supplant current staff salaries.
