The HCA begins by gathering information on the rate filing. We carefully examine the information to identify errors or problems. If the filing is very complicated, we often hire an actuary (an expert in mathematics and statistics) to review the rate filing.
We look at whether the rate filing meets Vermont’s legal criteria.
- Is it affordable?
- Does it promote quality care?
- Does it promote access to health care?
- Does it protect the insurer’s ability to pay claims?
- Is it unjust, unfair, inequitable, misleading or contrary to law?
- Is it excessive, inadequate or unfairly discriminatory?
If the rate filing fails any of these legal factors we explain why it fails to the Green Mountain Care Board.
In many cases, we submit questions to the board that we would like the insurance company to answer. The board decides whether or not to send our questions to the insurer.
Finally, if our team finds that the price change is not affordable or otherwise fails to meet Vermont’s legal standards, we participate in the rate review hearing and/or submit written arguments to the board. In many cases, we argue that the proposed rate should be lowered and ask the Green Mountain Care Board to either reduce or reject the price increase. If the board rules against us, we can choose to appeal the decision to the Vermont Supreme Court.