WINOOSKI — The Vermont Health Connect website will go back online Nov. 15, the first day of the open enrollment period. State officials made that announcement Wednesday, and expressed cautious optimism that they will soon be able to put past failures behind them.
Agency of Human Services Secretary Harry Chen and Lawrence Miller, chief of Health Care Reform, said they have the systems and processes in place to get it right.
Vermont Health Connect has resolved the security issues that forced it offline in September, and has been reconnected to the federal hub for several weeks, Miller said.
But he cautioned: “No matter how good testing goes, and how good everything else goes, there will be the unexpected.”
The rebooted exchange will remain heavily reliant on manual processes, and the effects of past issues still linger. Both have the potential to create unexpected problems.
The price tag for the exchange also continues to grow, and much of the work contractors are doing now is being billed retroactively, so it’s hard to pin down its actual cost, which, as of September, was more than $100 million.
Most of that money came from federal grants, and while Vermont will still have access to those funds next year, it will be expected to pay for operations starting in January.
Miller sounded less confident that operational costs won’t add to the state’s budget deficit, which is already expected to be at least $90 million. The budget includes only $11 million for operating the exchange in fiscal year 2015.
“We don’t know that the budgeted amount is sufficient or not sufficient at this point. We haven’t completed that analysis,” he said.
In a worst case scenario, the expense could top out at close to $20 million, but such a large adjustment is unlikely, he said. Overages will need to be covered in the Budget Adjustment Act, he added.
The exchange won’t be able to automate changes to personal information or coverage, something the state hopes to be able to do by mid-2015.
Miller also intends to ask the feds for permission to allow insurance carriers to continue to work directly with small business in 2016, he said.
Those items are considered development work, and will likely be covered by the feds.
What customers can expect to see
When the exchange’s web portal comes back online Saturday, customers can expect a faster and less confusing user experience, according to state officials.
The site will have a login button so users can easily access their account, links will take people where they’re supposed to, the application questions are less confusing and page load times should be faster, Miller said.
However, only the 3,000 to 8,000 anticipated new customers will actually be able to purchase insurance on the revamped website.
The 32,000 existing customers can browse 2015 plans to see if they want to switch. They can also check their subsidy eligibility, but they won’t be able to renew coverage online.
Instead, they must download a form to change their coverage or update personal information, a copy of which they should have also received in the mail, according to state officials. Those changes can also be made by calling the customer service call center.
Changes include anything that could impact coverage, such as adding or subtracting a person to the policy, a marriage, new income, or the loss of income. There are also changes to personal information, such as updating one’s address or contact information.
Existing users who don’t need to make any changes will be automatically enrolled in the same plan. That work is expected to be complete by mid-December. Open enrollment ends Feb. 15.
Premiums have increased for plans offered through the exchange, but people receiving subsidies will be shielded from the increases.
Newcomers who don’t want to use the website can seek the help of navigators as well as the call center if they need assistance — as can existing users who have questions or need help.
The open enrollment process
There is still no automated process for changing people’s personal information or coverage, so while new users can purchase their insurance online, changes will have to be manually entered by contractors or state workers.
There are still 5,300 requested changes from 2014 that Vermont Health Connect and its contractors have yet to resolve. Many of the unresolved requests are “duplicative” or in some cases redundant because the change has already been made, Miller said.
There are others that may already be resolved, but state workers have been unable to contact the customer. Some have yet to be processed.
State employees and contract workers at a call center will focus on closing out the remaining change requests from 2014, and processing any new change requests for 2015 coverage.
Nationally, only 15 percent of exchange customers are expected to switch plans or report changes during open enrollment, Miller said, but the state is prepared for that number to be as high as 60 percent.
To help mitigate any backlogs or bottlenecks — and to avoid the mandatory overtime that many state employees and temporary workers had to endure over the holidays last year — the state has signed up 288 workers to put in voluntary overtime as needed.
Optum, the state’s primary contractor, will handle the auto-mapping of existing users who don’t need to make changes into their same coverage, and monitoring the enrollment of new customers.
Optum loaded the 2015 plan data into the exchange Monday night, and state and contract workers received training for open enrollment Wednesday.
Vermont Health Connect workers will familiarize themselves with the back end of the live system on Thursday and Friday, and the exchange will open for business Saturday morning.
The system can handle roughly 400 to 600 users at a time, and Miller does not expect an overload of the site.
