Vermont Business Magazine The Green Mountain Care Board (GMCB) today issued its decision on BlueCross and BlueShield of Vermont’s (BCBSVT) large group insurance filing, which establishes the formula, manual rate, and associated factors the insurer will use to set premiums for large group renewals.
BCBSVT provides health insurance coverage to individuals, small and large employer groups, and Medicare enrollees in Vermont. GMCB’s decision applies to the BCBSVT’s large group products, which are used to determine premium rates for employer groups with over 100 employees. GMCB is expected to rule on the small group rate requests for BCBSVT and MVP later this summer.
BCBSVT asked GMCB to approve a rate increase of 17.3%. GMCB denied this request, identifying appropriate adjustments to reduce the rate of increase experienced by large group employers in Vermont. Specifically, GMCB ordered BCBSVT to make three key adjustments to lower its rate increase:
- Hospital Budget Guidance: BCBSVT must reduce the manual rate to reflect the impact of the Board’s finalized Fiscal Year 2026 Hospital Budget Guidance, a reduction of approximately 0.2 percentage points.
- Hospital Budget Enforcement: BCBSVT must reduce the manual rate to accurately account for the impact of the Fiscal Year 2023 hospital budget enforcement decisions for the University of Vermont Medical Center and Rutland Regional Medical Center, a reduction of approximately 0.7 percentage points.
- Legislative Impact (H.266): BCBSVT must also reduce the manual rate to reflect the estimated financial impact of Vermont’s recently enacted legislation, H.266, a reduction of approximately 2.8 percentage points.
Together, these adjustments are projected to lower the proposed rate increase from 17.3% to approximately 13.7%. The actual premium increase experienced by any particular group will depend on its claims experience, as large group products are experience rated.
“We are committed to ensuring that health insurance rates are as affordable and fair for Vermonters as possible while balancing the need for insurer solvency and access to care,” said Owen Foster, Chair of the Green Mountain Care Board. “As identified in the Oliver Wyman report, Vermont’s health system requires significant transformation to address gaps in care, ensure provider sustainability, and to protect Vermonters from excessive healthcare costs.”
GMCB’s decision reflects its statutory responsibility to balance access to quality care, insurance affordability, and the financial stability of Vermont’s healthcare system.
For more information about this filing or other GMCB decisions, please visit: https://gmcboard.vermont.gov
About: The Green Mountain Care Board (GMCB) is a 5-member, independent Board created in 2011 with an ambitious mission to drive system-wide improvements in access, affordability, and quality of healthcare to improve the health of Vermonters. Through public meetings, GMCB ensures a transparent approach to healthcare regulation and a voice for stakeholders, including healthcare organizations, clinicians, and members of the public. With a holistic, data driven approach, GMCB carries out its regulatory duties, supports innovation in healthcare delivery and payment reform, and serves as an important resource for independent, transparent analyses of Vermont’s healthcare system performance.
Green Mountain Care Board. Montpelier. 6.19.2025.
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