Primer on Vermont Health Connect
As the commissioner of the Department of Vermont Health Access, the home of Vermont Health Connect, I hear a lot of confusion about what the new insurance marketplace means for Vermonters.
That’s why I’ve put together this overview of Vermont Health Connect. If after reading you still have questions, please visit our website vermonthealthconnect.gov, call our toll-free Vermont-based call center at 855-899-9600, meet with an in-person assister, or attend one of our informational events.
What is Vermont Health Connect?
It is a marketplace that offers both public and private health insurance plans. The marketplace will allow many Vermonters to find and compare their health insurance options. And like any other marketplace, Vermonters will be able to select the product, or plan, that best suits their unique needs and budget.
Through Vermont Health Connect, some will find they are eligible for a free public health plan — Medicaid or Dr. Dynasaur — and many will find that they are eligible for financial help to lower their medical costs. All of the private plans on Vermont Health Connect offer the same quality benefits, so for most Vermonters the choice will be how you want to pay for your health plan — less in monthly premiums and more when you see a doctor or more in premiums and less when you see a doctor.
Who can use it?
Vermont Health Connect is for individuals, families and small businesses in Vermont. You will use Vermont Health Connect if you don’t have insurance through your job or you buy insurance on your own, for any reason.
Also, if you work for or run a business with 50 or fewer full-time employees, Vermont Health Connect is the only place to find health insurance starting next year.
When does it open?
The insurance marketplace opens on Oct. 1, but that’s just the beginning of a six-month period when most Vermonters will be enrolling (called the open-enrollment period). The first open-enrollment period runs between Oct. 1, 2013, and March 31, 2014.
For small businesses:
How does it work?
If you are a small business owner who chooses to offer health insurance in 2014, you will take the following steps to enroll your employees:
1. Use the Small Employer Estimator on our website to determine if you have a small business for purposes of using Vermont Health Connect and compare costs of offering health insurance with not offering.
2. Connect with Vermont Health Connect online, by phone, or through an in-person assister such as a broker or a navigator.
3. Select a plan “menu.” You can either offer plans from one insurance provider (Blue Cross and Blue Shield of Vermont or MVP) or offer the full “menu,” all 18 plans available on Vermont Health Connect. You can also offer supplemental dental plans from Delta Dental through Vermont Health Connect.
4. Determine how much you want to contribute. You can offer single-only, couple, parent and child(ren) and family policies and contribute as much as you like to each type of policy. It’s important that you consider what you’re offering. If you do not offer insurance, your employees and/or their families may be eligible for financial help to lower their medical costs. If you do offer insurance, employees and their families (depending on the policy types you offer) are not eligible for financial help.
5. Upload a list of your employees. This can be done by uploading a file or you can enter the information — your choice.
6. Notify your employees. Use the Vermont Health Connect system to send employees a letter with enrollment instructions.
7. Give employees a choice. Through Vermont Health Connect, employees will select the plan from your “menu” that works best for their needs and budget. They will use your contribution to reduce the cost of the plan they choose.
8. Finalize enrollment. For plans that go into effect on Jan. 1, 2014, you should complete enrollment by Nov. 30.
9. Pay your bill. Invoices are generated on the first of the month and bills are due on the 21st. Vermont Health Connect consolidates employees’ choices into one bill for you, so there is no guesswork about what to deduct from payroll and how much you owe.
For individuals who do not have insurance through a job: How does it work?
To compare plans, find one that works for you, and enroll, visit Vermont Health Connect online, by phone, or through an in-person assister. If you would like your health plan to begin Jan. 1, 2014, you should enroll by mid-December and pay your first bill, if you have one, by the end of December.
Many Vermonters without insurance through a job — about 50,000, in fact — will be eligible for financial help that will lower the cost of their health plans. Many others will be eligible for Medicaid, a free, quality public health plan. If you are eligible for financial help, your help can be automatically applied to your plan, so you only pay your portion. Connect with Vermont Health Connect this fall and see what your options are.
Mark Larson is commissioner of the Department of Vermont Health Access.