The rates for the 18 plans that will be offered on the state’s new health insurance exchange, called Vermont Health Connect, have been finalized.
The exchange, which is slated to open Oct. 1, will become the state’s sole health insurance marketplace for more than 100,000 Vermonters buying plans individually or through businesses with 50 or fewer employees. Vermont is one of 17 states creating its own exchange in accordance with the Affordable Care Act.
“I am very pleased that Vermont is the first state in the nation to finalize both its premiums and its choices for its health insurance marketplace,” Gov. Peter Shumlin said in a statement. “We are committed to bringing Vermonters a clear, affordable way to choose health insurance this fall.”
Blue Cross Blue Shield of Vermont and MVP are the only two licensed insurers that proposed premium rates for the exchange. The premiums are for the six standard plans the Green Mountain Care Board established last year and for non-standard plans, called choice plans. All plans must provide the 10 essential benefits set by the federal government and defined by the state. Such benefits include, but are not limited to, preventive care, pediatric, vision and oral care, and prescription drug and emergency services.
The standard plans fall under four main categories: platinum, gold, silver and bronze, with two high-deductible plans at the silver and bronze levels. The platinum plans have the highest premiums and provide the best benefits. The plans scale down to bronze, with lower premiums and lesser benefits.
Mark Larson, commissioner of the Department of Vermont Health Access, approved all six of each insurer’s standard plans, and three choice plans from each insurer at the bronze, silver and gold levels.
“Our goal was to select an array of plans that we thought provided an array of choices and meaningful options to Vermonters to meet the variety of needs and interests that individuals and small employers have,” Larson said.
The plans vary in terms of the services they provide and the provider networks accept them.
“For example, you might have three general practitioner visits co-pay free under one plan and five free under another,” said Emily Yahr, spokesperson for the exchange.
The Green Mountain Care Board recently ordered health insurers to take specific steps to reduce their premium rates for Vermont’s new health insurance market. Today’s unveiling shows that Blue Cross premiums were reduced by as much as $28.33 for a silver plan and by as little as $8.53 for a bronze plan. MVP premiums dropped by as much as $20.47 for a platinum plan and by as little as $10.94 for a bronze high-deductible plan.
Vermonters earning between 133 and 400 percent of the federal poverty line will be eligible for subsidies. To determine who is eligible for these subsidies and how much money Vermonters can receive, the state has created a subsidy calculator.