On April 1, Vermont became the first state in the nation to release proposed rates for the state’ s federally-mandated Health Benefits Exchange, Vermont Health Connect.
Vermont is the only state in the nation to consolidate purchasing of insurance products for small employers and individuals through Vermont Health Connect, which ensures there is an incentive for insurers to file competitive rate proposals.
The proposed rates were filed with the Department of Financial Regulation by Blue Cross Blue Shield of Vermont and MVP Healthcare. Following a public input period, the Green Mountain Care Board has final authority to approve, modify or reject the rates.
Cigna, an insurer which typically works with large institutional clients, has not submitted rates. The Vermont Health CO-OP still needs to receive a license to operate in Vermont. Once it does, as expected, its rates will be made public. The co-pays and deductibles also need to be established, which could affect the actual cost of each policy to the users.
The funding mechanism has not been established, but should be by this summer.
The rates filed by Blue Cross Blue Shield of Vermont and MVP Healthcare are comparable to current rates paid by small employers and their employees, but the plans filed generally include better health benefits.
Governor Shumlin heralded this milestone.
‘ While the rates must go through regulatory review, I am very pleased to see that they are roughly comparable to what people currently pay, but for better coverage,’ Shumlin said. ‘ I view the federally-mandated Exchange as a part of the path to health care reform in Vermont. We are driving toward better coverage for lower cost for all Vermonters. This is a step in the right direction.’
All health plans offered through Vermont Health Connect will meet strict benefit and quality standards to ensure all the essentials are covered, including visits to the doctor and emergency room, prescriptions, maternity care, and preventive care like cancer screenings and immunizations.
‘ Whether a parent in a family of four or a small business owner, Vermonters are eager to learn more about their future health coverage options,’ said Mark Larson, commissioner of the department of Vermont Health Access. ‘ In October, Vermonters will be able to compare plans and find the health coverage that’ s right for them. Financial help will be available to 40,000 Vermonters to cover the cost of premiums and deductibles and put the cost of health insurance within reach.’
Carriers interested in serving Vermonters through Vermont Health Connect were required to submit their rates, actuarial memo and several other documents required by Vermont law and the Affordable Care Act by March 25, 2013.
The plans are structured with design levels set by the federal health care law: Platinum, Gold, Silver, Bronze and Catastrophic. The levels vary in the amount of premium and out-of-pocket costs members pay. The average rates proposed for an individual at each of these levels are: $365.76 for Bronze, $441.09 for Silver, $527.95 for Gold and $609.47 for Platinum. These rates are similar to what is available on the current market today. For example, the average proposed rates for an individual purchasing a Silver level plan is $441.09 compared to $455.56 for Catamount Health.
Vermont Health Connect will also be the one place for income-eligible individuals ‘ those earning up to $94,000 for a family of four ‘ who don’ t have access to health coverage at work to access financial assistance for private health plans in the form of tax credits to help pay for premiums and cost-sharing, as well as public health programs including Medicaid and Dr. Dynasaur.
Beginning April 1, 2013, the public is invited to submit comments on the proposed rates to the Department of Financial Regulation’ s website or contact the department directly at 802-828-3301.
Recommendations will then be sent to the Green Mountain Care Board, which also invites the public to comment on the rate filings during public hearings, online, by calling 802-828-2177, or sending a letter to Green Mountain Care Board, 89 Main Street, Montpelier, Vt. 05620.
Final decisions on the rates are expected from the Green Mountain Care Board during the summer. Typically, rates are available in the late fall for Jan. 1.
For different scenarios of Vermonters moving from Catamount and traditional health insurance to the Exchange, click here.