The Vermont Statutes Online
The Statutes below include the actions of the 2025 session of the General Assembly.
NOTE: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.
(Cite as: 8 V.S.A. § 5109)
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§ 5109. Sanctions
Upon satisfactory evidence that any health maintenance organization has violated any
law or regulation or in any way has failed in meeting its financial and contractual
obligations to its members, including quality assurance as provided by 18 V.S.A. § 9414, the Commissioner may, in the Commissioner’s discretion, pursue any one or more of
the following courses of action:
(1) Suspend the certificate of authority to operate as a health maintenance organization
under this chapter. During the period of suspension, the organization shall not enroll
any additional members except new employees of any employer whose employees are enrolled
in the health maintenance organization by virtue of their employment, newborn children,
or other newly acquired dependents of existing members and shall not engage in any
advertising or solicitation whatever.
(2) Revoke the certificate of authority to operate as a health maintenance organization
under this chapter. When the certificate of authority is revoked, the organization
shall proceed under the supervision of the Commissioner, immediately following the
effective date of the order of revocation, to wind up its affairs, and shall conduct
no further business except as may be essential to the orderly conclusion of the affairs
of the organization. It shall engage in no further advertising or solicitation whatsoever.
The Commissioner may, by written order, permit such further operation of the organization
as the Commissioner may find to be in the best interests of members to the end that
members will be afforded the greatest practical opportunity to obtain continuing health
care coverage.
(3) Impose an administrative penalty of not more than $5,000.00 for each and every unlawful
act committed; each violation shall constitute a separate fineable offense.
(4) Issue an administrative order requiring the health maintenance organization: to cease
or modify inappropriate conduct or practices by it or any of the personnel employed
or associated with it; to fulfill its contractual and financial obligations to its
members.
(5) When the Commissioner has cause to believe that grounds for the denial of an application
for a certificate of authority exist or that grounds for the suspension or revocation
of a certificate of authority exist, the Commissioner shall notify the health maintenance
organization in writing specifically stating the grounds for denial, suspension, or
revocation and fixing a time of at least 30 days thereafter for a hearing on the matter. (Added 1979, No. 117 (Adj. Sess.); amended 1993, No. 30, § 12, eff. May 21, 1993; 1995, No. 167 (Adj. Sess.), § 23; 2021, No. 105 (Adj. Sess.), § 242, eff. July 1, 2022.)