The state is ramping up outreach efforts as the opening of the new health care exchange draws near.
The new health insurance market, Vermont Health Connect, is scheduled to open Oct. 1 for roughly 100,000 Vermonters buying health coverage individually or through businesses with 50 or fewer employees. Mark Larson, commissioner of the Department of Vermont Health Access, is overseeing the creation of the web-based insurance exchange, and he says it will be ready on time.
“We sit here today on track so that Vermonters who are in the individual and small group market will be able to compare plans starting October 1 and pick a plan that fits best for themselves and their budget,” Larson told legislators during a phone briefing Wednesday. “We sit here with work left to do, fully acknowledging that, but on track.”
The legislative briefing came one day after the state opened two toll-free hotlines to field questions about the new market. Individuals can call 855-899-9600, and employers and their employees can call the small business line at 855-499-9800.
Larson says that on Oct. 1 Vermonters will be able to use these hotlines to buy coverage and apply for Medicaid benefits that will be extended in 2014 to cover individuals earning up to 133 percent of the federal poverty line. Currently, Medicaid covers individuals earning up to the poverty line, which amounts to $11,490 for an individual.
Earlier this year, the state signed a 12-month extension with Maximus Inc. worth $12,578,162 to run the state’s call center from Burlington. It has run the state’s Medicaid call center up until this point.
Vermonters are also supposed to be able to use the state’s online marketplace to choose from the 18 plans offered by Blue Cross Blue Shield of Vermont and MVP Health Care. Larson said the web-based portals should be ready to go on Oct. 1 at healthconnect.vermont.gov.
The opening of the toll-free call centers parallels a broadcast advertising blitz the state is pushing in early September to raise awareness about the exchange.
The state last week signed an amended contract with Washington, D.C.-based GMMB to create the state’s advertisements and help the state brand the exchange. GMMB has consulted the state since the beginning of 2012, and the contract of $2.9 million runs out July 31, 2014.
While GMMB is creating the ads, the state is paying Richmond-based HMC Advertising $2.3 million through Oct. 18, 2014, to place its ads.
These two contracts account for about half of the roughly $9 million in federal dollars the state plans to spend on outreach. Of that amount, $2 million has been awarded to so-called “navigators” to provide one-on-one assistance for Vermonters trying to choose plans on the exchange. For information on a navigator organization near you, click here.
This $9 million in federal dollars for outreach is a small fraction of the roughly $170 million the state has received to get the technology-heavy exchange up and running. Thus far, the state has spent almost $600,000 on ads related to the exchange.
While Vermonters are supposed to be able to purchase new insurance coverage in October, their coverage will not kick in until Jan. 1, 2014. At that time, individuals will be required under federal law to buy health insurance on the exchange.
If they don’t, they will be penalized.
“Starting in 2015 on your tax return, you will now be required to attach proof of insurance, so that the IRS knows that you will not be subject to the penalty,” Robin Lunge, director of Health Care Reform, told legislators on Wednesday. “The penalty in the first year is 1 percent of your income or $95, whichever is greater.”
While there is no federal penalty for small businesses that don’t offer insurance, the state of Vermont will apply an assessment to any business that does not pay for a portion of their employees’ insurance. Employers will be assessed about $120 a quarter, or $480 a year, for each full-time employee they do not cover.
The federal government will provide premium subsidies for individuals earning up to 400 percent of the federal poverty level, and the state will provide premium assistance and cost-sharing subsidies to aid Vermonters earning between 133 percent and 300 percent of the poverty level. For individuals, that income level ranges from $15,282 to $34,470.
The state has created this subsidy calculator for Vermonters to calculate whether they are eligible for subsidies and at what level they should be subsidized.
Correction: The employer assessment for health insurance coverage charges employers about $120 a quarter per uncovered employee, not $120 a year as was first reported.
