March 22, 2016

On March 15, 2016, Vermont submitted its application for a Section 1332 State Innovation Waiver. As discussed in the Jan. 12, 2016, edition of Compliance Corner, states may apply for a waiver from certain provisions of PPACA, including the health insurance marketplace for individuals, SHOP, premium tax credits, employer mandate and individual mandate. To be approved, the state must present an alternative strategy that will provide coverage that is at least as comprehensive as the existing federal provision, keep care at least as affordable and not increase the federal deficit.

Vermont has applied for a waiver from the SHOP. Their proposed alternative would be to maintain their current system of employers applying directly with insurers rather than through a portal. The insurers would process premiums and provide required notices. The state would review, select, and certify qualified health plans. The state would also provide a process for appeals and provide documentation for the small business health care tax credit. There would be no minimum participation requirement.

If approved, the waiver would be effective Jan. 1, 2017.

Waiver Application »