With just over a month left in open enrollment, it’s coming down to crunch time for Vermont Health Connect.
Despite ongoing problems with the state’s health insurance website, enrollment figures for individuals continue to rise and, as Gov. Peter Shumlin often points out, are higher per capita than those in any other state.
The latest figures from the Department of Vermont Health Access, presented to lawmakers Wednesday, show 33,291 individuals have selected a plan and 28,486 are fully enrolled.
That includes people who signed up for coverage through the exchange starting in January, February or March.
An additional roughly 40,000 Vermonters who receive coverage through a small business will also be enrolled directly through the insurance carriers by the end of open enrollment.
The state has not given a time frame for when small businesses will be able to use the website, and last week Shumlin indicated that they may continue to be directly enrolled by insurers through the rest of the year.
The state continues to give its enrollment figures in the number of policyholders rather than the number of lives covered by those policies, so the actual number of Vermonters covered by a plan purchased on the exchange is greater.
There are 635 Vermonters who signed up for coverage, paid for it and still aren’t enrolled – 287 of those signed up for January coverage and could have paid as early as October.
That’s largely due to people’s inability to make changes to their application or coverage through the website. It’s a component the state has said is its top priority, but officials have declined to say when it might come online — except to say it should be ready for the next round of open enrollment this fall.
“I’m still really concerned that the change of circumstance function is being done manually,” said Trinka Kerr, the state’s chief health care advocate. “It’s really amazing to me that it’s taken this long.”
Higher than expected numbers of people are qualifying for Medicaid thanks to that programs expansion under the Affordable Care Act.
However, close to 500 of the 15,000 people who applied for coverage on Vermont Health Connect and discovered they qualified for Medicaid are still being processed and don’t yet have that coverage – though it will be retroactive to the month in which they signed up.
Last year, there were 51,000 people on Vermont’s subsidized health coverage — such as VHAP and Catamount — and of those 62 percent are now enrolled in Medicaid or a Vermont Health Connect plan.
Wait times at the call center are down sharply, from a high that averaged 50 minutes in late December to just one minute in recent days.
In January and February, call volumes have remained steady, but increased staffing, an overflow call center in Chicago and better training have allowed the state’s contractor to keep wait times brief.
The public should expect those call times to bump up in the coming weeks as direct enrollment goes down to the wire, said Lindsey Tucker, a deputy commissioner with the Department of Vermont Health Access.
It currently takes three to five days to process premiums, meaning the time from when the state receives a check to when the information is transmitted to the insurance carrier.
That’s when things move smoothly, but Tucker acknowledged that in some cases it takes longer.
One example of a hiccup is when people print the form on colored paper to send in with their check, the state’s Nebraska-based premium processor can’t scan it into their system.
“That’s an example where even though a Vermonter is following the process and doing the right thing, because of the way it happened it took a little longer and needed a manual process,” Tucker said.
Those and other instances in which things don’t go smoothly with premium processing trigger an investigation by the state.
“We’re collecting data on the percentage of checks that fall into this category,” she said.
Eventually, though the state has declined to say when, Vermonters should be able to make payments online with a credit card.
Tucker said the vast majority of delays are still due to people’s inability to make changes online, which must be resolved manually.
The state still does not send out eligibility notices to Vermonters who enroll in coverage through the health connect, which Kerr said she finds concerning.
“Some people applied in October and haven’t received these legally required notices,” she said.
Most people who applied early in the process know their status, either because they’ve received an invoice, a call from the state or called the state themselves because they were worried that they hadn’t received those notices, Kerr said.
If the state were to send them out now, she worries it would cause confusion, because many Vermonters are trying to beat the clock on open enrollment.
The nine- to 10-page notices are poorly worded and contain mostly information on privacy and people’s rights, with the actual eligibility information confined to just one or two of those pages, she said.
Despite her concern and the ongoing problems, Kerr said the state has demonstrated commendable flexibility trying to make sure its unfinished website doesn’t result in coverage gaps.
“People who have urgent situations and their coverage is messed up, they bent over backward ways to get them coverage quickly,” she said.
