[T]he third-party biller for Vermont Health Connect was sold to a publicly traded company three months ago and no longer goes by the name Benaissance.
Several lawmakers in the House of Representatives and the lobbyist for Blue Cross Blue Shield of Vermont say they didn’t learn of the transaction until Wednesday during testimony that questioned the company’s refund policies.
The biller has been the intermediary in what health exchange customers repeatedly complain is a dysfunctional system, in which they get billed incorrect amounts for their commercial insurance plans and are threatened with termination even if they pay their bill in full.
The revelation came at the third weekly hearing the House Health Care Committee has been holding to determine the future of the state’s embattled health insurance exchange. The committee said it had invited a representative from Benaissance to testify at the hearing and did not list the company’s new name on the agenda.
The multinational company is called WEX, known for handling health insurance debit cards and gas credit cards for the trucking industry. It bought Benaissance, the Nebraska-based company that has served as a third-party biller for insurance companies and a coordinator of health care savings accounts since 2006.
The two companies announced the acquisition in October and finalized the deal in November. WEX created a subsidiary called Evolution1, which replaces Benaissance. State officials have continued to call the company Benaissance, even though the business no longer uses the name.
Reps. Chris Pearson, P-Burlington, Anne Donahue, R-Northfield, and Doug Gage, R-Rutland, all said in interviews Wednesday that the hearing was the first time they had heard the company was sold.
Trinka Kerr, the chief health care advocate for Vermont Legal Aid, was the first witness to reveal the sale. She told lawmakers about it in the context of two Vermont Health Connect customers who she said are still waiting for account refunds.
Kerr said the two customers are seeking refunds on their health insurance policies. She said Vermont Health Connect told them the only way to get those refunds is to terminate their existing policies and re-enroll. Neither wanted to re-enroll because enrollment was so difficult in the first place, she said.
“What we’ve been told is that Benaissance has been bought out by another company and that this new company has relooked at the contract with the state,” Kerr said, “and that under that contract there’s some provision that won’t allow the payment of refunds while coverage is active.”
“I’m hoping the administration can respond to that because we haven’t been able to get these refunds moving, and in both cases, these particular folks really need those refunds,” she said.
“When we try to resolve cases, we talk to people at Vermont Health Connect … and they’re the ones saying the refund problem in part is arising from the purchase of Benaissance,” Kerr said.
Lawrence Miller, the chief of health care reform for Gov. Peter Shumlin, started shaking his head while Kerr was testifying.
The chair of the House Health Care Committee, Rep. Bill Lippert, D-Hinesburg, then asked the company representative for Evolution1 and the Shumlin administration to respond directly to Kerr’s comments.
Mark Waterstraat, the senior vice president of health care exchange sales for Evolution1, said he personally executed the original Benaissance contract with the state of Vermont. He said it is renewed every July and that nothing has changed in the contract since the company essentially changed its name.
Waterstraat told Lippert the company has a process for expediting refunds to people who are in dire need of them. He said he didn’t know if those people Kerr mentioned had reached out to Vermont Health Connect.
Kerr interrupted: “They definitely have, and they were told they couldn’t get refunds without canceling their insurance.”
Miller spoke up: “Well, then they were told wrong.”
Lippert, the committee chair, responded, “Well, then that’s a problem too.”
Miller said, “Yes, I would agree. But that was bad information.”
A few minutes later, Miller interrupted Waterstraat’s testimony and asked Kerr, “Do you want the refund language from the contract, which is available on the DVHA website?”
The Department of Vermont Health Access lists its contracts here. However, the contracts listed on the website are still under the name Benaissance, not Evolution1.
At the end of the hearing, Lippert told Waterstraat to ask people who work underneath him whether they have changed the way they execute the terms of the contract because they work for a new company.
Lippert said he would take Waterstraat at his word that there were no changes to the contract. But Lippert said many senior managers at large companies do not know what their front-line workers do.
