State resorts to paper forms for health Exchange, but they're incomplete

by Andrew Stein vtdigger.org When Vermonters had trouble accessing the state’s new online health insurance market last week, the Department of Vermont Health Access sent insurance brokers and in-person helpers ‘ called navigators ‘ paper applications.
The problem for brokers, navigators, employers and employees is that the forms are incomplete. The applications do not contain essential information fields for enrolling employees and for employers who want to contribute to their workers’ health insurance.
‘There is some information that will be left out if someone does a paper app,’ said Tom Rugg, a Hickok and Boardman account executive, who is overseeing a team of brokers. ‘I don’t know that the paper app is going to be a correct substitute for the online enrollment. I worry they won’t capture all of the information.’
The chief information field that is missing from the employer application form is a place to put the dollar amount that an employer would contribute toward an employee’s premium. Also, there is no place on the application form for employers to indicate a particular insurance carrier or plan they would contribute to, if they desire to choose one.
Conversely, the employee application does not provide an opportunity for a worker to choose a plan or see what his or her employer is offering.
Betsy Bishop, president of the Vermont Chamber of Commerce, has a team of navigators on staff that is geared toward helping employers and employees make decisions in the new health insurance environment.
‘It seems like if you were going to have a backup process because your system isn’t working well, that you’d put that information on the paper,’ she said.
Meanwhile, time is ticking down to Jan. 1, when it will be mandatory for Vermonters choosing health coverage independently or through businesses with 50 or fewer employees to buy it on the market, called Vermont Health Connect.
Mark Larson, commissioner of Vermont Health Access, which oversees the new market, said that Monday or Tuesday the state would send out an addendum to the employer application that would allow employers and employees to complete the application. He said that brokers and navigators could help employers and employees enter that information electronically or mail in the two-part paper application.
‘I know that a lot of brokers have appointments made. The paper application allows them to have those meetings so that when they finish that meeting, they have the information they need to complete the application,’ Larson said. ‘We’re hoping more and more brokers are able to log in on their own and be able to put that information in electronically. Either strategy is fine with us, we just want to make sure in January people have coverage.’
But many brokers and navigators say they still can’t get into the Web-based marketplace electronically.
‘We haven’t been able to walk through what the actual online application looks like,’ Rugg said. ‘We’re having a really hard time getting in there and seeing what we need to lead people through. Therein lies one of our issues as a broker community. Our job is to help employers and individuals through the site, and we haven’t received that training yet. We’re seeing screenshots here and there, and that’s about it.’
Larson says he has two teams working with brokers and navigators individually to get logged into the market’s back end, and Bishop said Monday afternoon that two of her five navigators were able to finally gain access to the market.
Tom Torti is the president of the Lake Champlain Chamber of Commerce. He has been a strong supporter of Gov. Peter Shumlin’s approach to implementing the Affordable Care Act. Vermont is one of 16 states creating its own state-run market, and it’s the only state that is requiring both individuals and small businesses to buy their insurance in the market.
Torti applauded Larson and his team for improving the speed of the site from its sluggish start on day one. While he said he wasn’t privy to the paper application situation, he was concerned that all of the necessary information fields were not included in one form.
‘This is supposed to be easier and simpler, and if you have to do two or three steps, where in the past you did zero or one, that’s not good,’ he said. ‘That goes to undermining the credibility of the system that is of critical importance to businesses and their employees.’
As of 4 p.m. Monday the state reported that 42,500 individuals had visited the website,
healthconnect.vt.gov, since it opened. Of that number, 3,180 had created usernames and passwords.
Bishop says she and her team aren’t aware of anyone who has actually signed up for a plan yet. Although the payment function for the site was delayed until Nov. 1, Vermonters are supposed to be able to choose plans now and pay for them later.
‘My concern is that we haven’t seen a successful registration through the process,’ she said. ‘If the system was just slow, you would see some of the people getting through all of the screens, being able to pick the insurer, having the employer upload the employee census, having the employee go in and select a plan â ¦ but no one has gone through that process yet.’
Larson says there are some Vermonters who have indeed made it through the process. While he did not provide specific numbers, his staff said that they would provide that data Tuesday.
Links
Paper Application for Small Business Employers
Paper Application for Small Business Employees