In the state of Vermont, employer groups with 50 or under full-time permanent employees qualify for community-rated and association health plans in which premiums are approved and published by the state's Department of Banking, Insurance, Securities and Health Care Administration (BISHCA for short). Under Vermont's community-rated regulations for small group employers, premiums cannot deviate from the published rates regardless of the group's demographics, the participants' claims utilization or the nature of the business. Once a group is enrolled and the plan is implemented, premiums are ordinarily set for one year. Association plans are an exception to this rule (visit the Association Medical Plans page).

For an employer that has a workforce with chronic medical issues and/or members experiencing non-work-related accidents or illnesses requiring expensive medical treatment, the community-rated system is a distinct advantage. Furthermore, state law requires all carriers serving the small-group arena to accept all enrollees without regard to an individual's state of health, referred to as "guaranteed issue". This creates a more even playing field for smaller Vermont employers as insurers cannot refuse to offer coverage to a less healthy group. Conversely, an employer with a young and healthy staff might find the universal rates to be higher than those it could obtain in Vermont were the state to have an unregulated marketplace.

A small employer in Vermont should begin reviewing its medical insurance at least a month and a half, and preferably two months, prior to its anniversary date. Benefit Design & Strategies LLC works closely with a number of small-group Vermont employers not only with their health insurance but also their other employer-sponsored benefits. Call BDS to see what we can do for your company or non-profit organization.