Current health insurance plans extended for small businesses

Gov. Peter Shumlin was asked about the state's online health insurance website at a news conference on federal food assistance program cuts at the Central Vermont Community Action Council in Barre on Monday. Photo by John Herrick/VTDigger

Gov. Peter Shumlin was asked about the state’s online health insurance website at a news conference on federal food assistance program cuts at the Central Vermont Community Action Council in Barre on Monday. Photo by John Herrick/VTDigger

Once written off as a “nothing burger” by Gov. Peter Shumlin, problems with the payment portion of Vermont Health Connect have forced another delay in the state’s implementation of the Affordable Care Act (ACA).

The Shumlin administration is extending 2013 health insurance plans into 2014 for up to 1,400 small businesses because the state’s online health insurance exchange still can’t process payments for the new plans.

For just about everything you wanted to know about the state’s health care exchange, but were afraid to ask, go to VTDigger’s user’s guide to Vermont Health Connect.

The guide includes an interactive chart that helps you find your estimated subsidy level instantly.

Officials said they have made progress developing the payment system for individuals and families. A batch of overnight upgrades to the Vermont Health Connect website should allow those participants to start paying for their plans in time for them to take effect in January.

Mark Larson, commissioner of the Department of Vermont Health Access

Mark Larson, commissioner of the Department of Vermont Health Access

There’s a caveat, however — they’ll have to do so by mailing in a check, rather than simply entering their credit card information online. That’s because the Department of Vermont Health Access can’t ensure that security protections are up to snuff, DVHA Commissioner Mark Larson said Monday.

The administration continues to decline to provide a date by which both payment systems will be fully up and running. Testing is ongoing, according to Larson.

Larson said the fact that the system is on the verge of being able to send out invoices to individuals represents major progress.

“I think that is clearly a milestone and a significant step forward,” Larson told reporters during a conference call Monday morning. “We are excited to be able to announce today the ability for individuals and families to be able to be invoiced.”

Shumlin described the development as “a big moment for us,” when asked about it at an unrelated news conference in Barre.

“From Commissioner Larson’s perspective and mine, this is a huge accomplishment because it means the systems are working, that you can actually go in, complete the process and get the bill out,” Shumlin said.

The Vermont Health Connect website will be taken offline for the upgrade, beginning 5 p.m. Monday. By Tuesday afternoon, DVHA officials say Vermont Health Connect will produce accurate invoices, and process payments for individuals and families.

The hitch is that people can’t actually pay online yet. DVHA will start sending out bills later this week to the roughly 7,000 families and individuals who have selected plans. People entering the individual market need to select a plan by Dec. 23 and pay for it by Jan. 7.

This is the second time DVHA has turned to paper options — the department distributed paper applications in October, allowing people to pick up plans without dealing with the glitch-ridden website.

Robin Lunge, Shumlin’s director of health care reform, said significant improvements will take place “behind the scenes” Monday night, but she acknowledged that they won’t streamline the process for the consumer.

“It’s important to realize there is a lot of data that will be passed between us and the carriers in order to get people enrolled, so that’s also part of the launch,” she said. “So, while from the consumer experience, they are getting a paper bill and a paper check, there’s a lot more going on behind the scenes that’s not obvious to the consumer.”

The extension for businesses with 50 or fewer employees, which will last through March 31, only applies to the employers who signed up through Vermont Health Connect. It doesn’t impact employers who decided to bypass the exchange by signing up directly through an insurance carrier, nor does it affect businesses that had already opted to extend their coverage until March 31.

Small businesses that have already elected to extend their current coverage through March 31 are not affected by Monday’s decision, an administration news release said.

Shumlin unveiled those additional options Oct. 31 in response to website glitches that had stymied employers’ attempts to enroll in the exchange. Larson said DVHA doesn’t yet know how many businesses chose those routes.

The commissioner emphasized that the extension for small businesses is keeping with the administration’s top priority: making sure Vermonters don’t experience an interruption in their health coverage.

“We will ensure that all small groups have a pathway to coverage that does not create a gap in their coverage, and that is significant progress,” Larson said.

But the stopgap could create complications for businesses planning to switch insurance carriers in 2014. Unless they stay with the same carrier, deductibles and out-of-pocket costs will reset when businesses transition from the extended plan to the new plan.

“That’s why the long-term solution remains the same, “ Larson said. “We want to be able to have employers process their applications through Vermont Health Connect so they can offer employees a choice of plans and carriers without having this issue created by the extension.”

Larson is directing businesses to contact their insurance carriers with questions about how the extension will affect coverage.

Darcie Johnston, director of Vermonters for Health Care Freedom, said the extension creates more uncertainty for small businesses. Johnston, who opposes the mandate that small businesses and individuals enroll in the exchange, maintains that a year-long delay of that requirement makes more sense than a solution that has businesses switching plans mid-year.

“Businesses need certainty. Vermonters need certainty, and this is anything but a certain process. It’s been a constant drip, drip, drip water torture,” Johnston said.

Johnston described Monday’s announcement as “purely political,” and she criticized Larson for putting a rosy spin on a system that continues to malfunction.

The Department of Vermont Health Access issued a news release with the headline, “Premium Processing and Payment Functions to be Deployed for Individuals and Families.” In a release of her own, Johnston wrote, “The commissioner wants to show forward progress — reality be damned.”

Follow Alicia on Twitter @aefreese

Comments

  1. David Black :

    “Johnston described Monday’s announcement as “purely political,” and she criticized Larson for putting a rosy spin on a system that continues to malfunction.”

  2. David Black :

    “The Shumlin administration is extending 2013 health insurance plans into 2014 for up to 1,400 small businesses because the state’s online health insurance exchange still can’t process payments for the new plans.”

  3. Keith Stern :

    This is the future for all of us as the governments continue to run more of our lives.

  4. Walter Carpenter :

    “This is the future for all of us as the governments continue to run more of our lives.”

    But it is a private company which has made such a hash out of this.

    • Carol Frenier :

      It is a private company hired by, and supposedly managed by, the government. If they were serving a private client, they would be out of business by now.

      • And if we had a universal health care system like every other developed country has had for the last 50 years we wouldn’t be dealing with the current convoluted, fragmented, and overly expensive health insurance system mess. Thank the insurance lobby and congressional friends for not allowing that.

        • ” We have enjoyed the best healthcare system in the world.” Maybe after WWll we had the best… that isn’t true today,(except for the super wealthy) as statistics confirm.
          As far as freedom goes, the folks in Western Europe, Canada, Japan, Australia, etc. might disagree.

        • Eric Mills :

          “We have enjoyed the best healthcare system in the world.”

          Yeah, as long as you don’t go by cost, coverage, outcome or actual satisfaction of the citizenry.

          But why bother bringing in metrics that actually matter when your views are clearly driven by nothing more than ideology?

          • Keith Stern :

            That is a laugh coming from you.

        • Eric Mills :

          Thanks Keith, everyone needs a good laugh.

          Every time I remember you claiming Social Security ran a deficit time frame where the records clearly showed it ran a surplus, I chuckle a bit.

          Every time I remember you insisting the numbers were wrong because they failed to confirm your ideology, I manage a laugh.

          • Keith Stern :

            They say ignorance is bliss and in your case apparently true. Have a good laugh and continue to deny the truth.

        • Eric Mills :

          Keith,

          Name one single statement I have made that is untrue, then back it up with data.

          Otherwise, you don’t have a leg to stand on.

          • Keith Stern :

            From Salon.com: Social Security started running a deficit in 2010

          • Keith Stern :

            From the SS administration:
            The current payout of Social Security benefits in excess of taxes will not have any impact on Social Security benefit payments for many years.

            Current trust fund reserves, along with future taxes, are expected to be sufficient for the full and timely payment of benefits until 2033.

  5. Dave Dempsey :

    In January the next wave of problems will begin. There are thousands of people who currently buy their own insurance that have no idea that they were mandated to buy insurance through the healthcare exchange. Many of them don’t even know what the healthcare exchange is. Many of the individuals who do know what the healthcare exchange is and about the mandate are so confused that they don’t know what to do. What happens when they find out that the government has signed them up for a new plan similar to the one they have now and they get a bill with a different premium amount. What about the health care providers who will have to change the records for all of the people with new plans before they can send out their bills to the right place. The administrators of the healthcare exchange have assumed that everyone in Vermont knows what the healthcare exchange is and how it affects them. That is simply not the case.

  6. Mark P Moye :

    Where is Al Gobeille – I thought he was the board member with the business acumen to help avoid these pitfalls for small businesses

  7. Keith Stern :

    Factcheck.org 2011:
    Some senior Democrats are claiming that Social Security does not contribute “one penny” to the federal deficit. That’s not true. The fact is, the federal government had to borrow $37 billion last year to finance Social Security, and will need to borrow more this year. The red ink is projected to total well over half a trillion dollars in the coming decade.
    Do you need more proof?

  8. Keith Stern :

    Not defending anything about that. I haven’t seen the law regarding legislators having insurance under Obamacare but I am sure as with everything they do it is a sham. I assume they have no max payout and any of them can go to any doctor and hospital they want.
    Got info showing I’m wrong?

    • Eric Mills :

      Keith,

      You made a claim about SS being in deficit during a specific time period, someone showed you the numbers clearly proved you wrong. Rather than just admit it, you declared the numbers had to be wrong. That clear things up?

      “I am sure as with everything they do it is a sham.”

      And I’m sure you have no credible evidence to back up your beliefs.

      When making an assertion, the burden is on you to provide the evidence. Preferably with actual links.

      • Keith Stern :

        Last try Eric and then I’m done with you. I showed you three examples where 2 news sources and the Social Security agency said the program is running a deficit and you still go back to some obscure chart that showed otherwise. Stick with that by all means.
        I don’t need to show any proof about my belief about congress and the ACA because it won’t change a thing and you won’t believe it anyway.

        • Eric Mills :

          Keith,

          What you did is called moving the goal post, or more specifically, changing the argument and providing sources to prove a point you did not originally make.

          You have no credible proof about Congress and the ACA because I have already shown you were wrong.

          I believe the facts, the problem is they do not support your statements.

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