State Codes and Statutes
Statutes > Vermont > Title-08 > Chapter-125 > 4584
§ 4584. Application for permit
(a) A corporation incorporated under this chapter shall immediately, after filing its articles of association, apply to the commissioner of banking, insurance, securities, and health care administration for a permit to operate. Such application shall be made to the commissioner upon forms to be prescribed by him. Such application shall include a statement of the territory in which such corporation proposed to operate, the services to be furnished and rendered by it, and the rates to be charged therefor. Such application shall be accompanied by two copies of any contract for medical services which the corporation proposes to make with its subscriber. Before issuing such permit, the commissioner may make such examination or investigation as he deems necessary. The commissioner may refuse such permit if he finds that the rates submitted are excessive, inadequate or unfairly discriminatory.
(b) A corporation organized under the provisions of this chapter shall not enter into a contract with a subscriber to furnish medical services until it has obtained from such commissioner a permit to do so.
(c) In connection with a rate decision, the commissioner may also make reasonable supplemental orders to the corporation and may attach reasonable conditions and limitations to such orders as he finds, on the basis of competent and substantial evidence, necessary to insure that benefits and services are provided at minimum cost under efficient and economical management of the corporation. The commissioner shall not set the rate of payment or reimbursement made by the corporation to any physician, hospital or other health care provider.
(d) The commissioner shall permit rates for a medical service corporation designed to enable the corporation to accumulate and maintain a reserve fund which shall from time to time during the calendar year be increased in an amount equal to at least two percent of the annual premium income of the corporation until the reserve fund is equal to at least eight percent of the annual premium income of the corporation. However, if the liabilities of the corporation exceed its assets, the commissioner shall permit the corporation to charge rates that enable the corporation to accumulate a reserve fund at the rate of at least five percent of annual premium income of the corporation until the corporation's assets equal its liabilities. Nothing herein shall require the commissioner to permit a corporation to accumulate a reserve fund until the law of the state of incorporation of that corporation is substantially similar to this subsection with respect to the reserve fund. (Amended 1975, No. 69, § 4, eff. April 18, 1975; 1989, No. 225 (Adj. Sess.), § 25(b); 1995, No. 180 (Adj. Sess.), § 38(a).)
