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  3. Health Insurance — General
  4. Private Insurance
  5. Appeals (Private Insurance)

Health Insurance Regulation

The Vermont Department of Financial Regulation (DFR) makes sure that health insurers and health insurance plans follow Vermont law.

  • DFR writes regulations that protect consumers.
  • DFR reviews health insurance premium rates.
  • DFR plays a role in the insurance appeals process for external reviews.
  • DFR handles insurance complaints.

DFR doesn’t regulate all health insurance plans. Many large employers have “self-insured” plans. DFR doesn’t regulate self-insured plans. Self-insured plans do not have to follow the same rules.

To see if your insurance plan is regulated by DFR, talk to your human resources department or call DFR at 1-800-964-1784.

Two Important DFR Rules

Two DFR health care rules are particularly important:

  • Rule H-2009-03

This rule includes consumer protections: confidentiality, good networks, reasonable wait times, appeal rights and other quality requirements.
 

  • Rule H-2007-05

This rule gives you access to health care prices, health care quality and other information so you can make good decisions about medical costs.

  • Print

Contact Us

The Office of the Health Care Advocate is a free resource for Vermonters.

Call us for help at 1-800-917-7787 or fill out our Help Request Form.

Answer a few questions to find the health care information you need.
Use the Legal Help Tool and choose “Health.”

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