The state’s largest private insurer will soon launch a website for small business customers that will allow members to renew their Vermont Health Connect coverage and change their information online.
Vermont was the only state to mandate that businesses with 50 or fewer employees purchase health insurance through the state exchange, and it originally hoped to have them do so through the Vermont Health Connect portal.
That didn’t happen in the exchange’s first year and won’t happen for the next enrollment period, either. State officials have given only a vague timeline for that functionality, suggesting that small businesses might be able to use the site by early 2015.
The state took the exchange offline last week until further notice, citing security concerns.
Vermont received federal approval to continue to rely on the insurers to serve small businesses required to use the exchange. Many other states have struggled to allow small businesses to use their exchange websites, and voluntary users in most states have relied on manual enrollment processes or the insurers.
The federal healthcare.gov exchange, used by 37 states, will attempt to roll out its small business option during the upcoming November enrollment period.
Blue Cross and Blue Shield of Vermont, the dominant insurer in the exchange, said Tuesday at a community meeting in Montpelier that it will launch an improved web portal for small businesses and their employees on Oct. 15 — the earliest it is legally allowed to do so.
Blue Cross has 3,500 small group clients purchasing exchange products for 32,441 employees. That’s 96 percent of the small group market on the exchange and 49 percent of the total exchange plans sold, according to the latest enrollment figures from the state.
The new web tool will offer full employee choice among the range of exchange plans offered by Blue Cross, if the employer decides to make that an option.
For employers that would like to stick with their current insurance plans, “We’ve mapped all your people to their products” for a simplified renewal process, said Catherine Hamilton, Blue Cross’ vice president of consumer services and planning.
The website will offer “one stop, one click for any changes that (customers) are making,” Hamilton said.
That’s in stark contrast to the Vermont Health Connect website individuals must use, which even before being taken down, did not have an automated process for changing customer information.
Employees of small businesses that use the exchange aren’t eligible for premium subsidies, which means the Blue Cross site does not need to connect to the federal data hub to verify income. Much of the complexity surrounding the state’s website concerns the interface with the federal system.
Plan design a problem for many
Jeff Schulz, Northfield’s town manager, said municipal employees insured through Blue Cross exchange products have significantly higher out-of-pocket costs now than they did prior to the Affordable Care Act.
Before the health care reform law passed, the Vermont League of Cities and Towns offered health coverage to municipal employees through a trust that used bulk purchasing to negotiate coverage with a private insurer.
Now town employees, and many other Vermonters formerly covered by state assistance programs that expired with the Affordable Care Act, with high medical costs could pay thousands of dollars for that care even while covered by insurance.
“It’s frightening,” Schulz said, of the realization that town workers could face $5,000 or even $10,000 in out-of-pocket medical costs even with their insurance.
“There are still ways to make it so there’s not as much impact on the employee, but it’s more difficult under the exchange,” said Steven Jeffrey, executive director of the league.
Hamilton, the Blue Cross VP, said the plan designs are relatively new and consumers are still learning about the exchange products. That’s a sentiment echoed by consumer advocates who say many people didn’t understand the cost-sharing impact of their new health plans.
Lowering the out-of-pocket costs included in the exchange products would require further premium increases, Hamilton said.
Blue Cross CEO Don George told the crowd Tuesday that government programs that underpay doctors and hospitals for health services continue to drive up costs for the privately insured.
Medicare, which has its rates set federally, increased reimbursements by just 1 percent, while Vermont cut a proposed increase in Medicaid rates.
Providers are forced to make up the difference in their negotiations with commercial insurers, George said, despite commercial insurance representing a smaller portion of providers’ total billing than the government health programs.
The state has required that exchange plans have no co-insurance for pediatric dental, but otherwise the coverage will remain largely unchanged in 2015.
