About 80,000 Vermonters will have to get used to a new way of buying health care come 2014, and many groups are making public education a priority.
One such organization is BlueCross BlueShield of Vermont. On Thursday, BCBS President Don George and Vice President of Planning Catherine Hamilton spoke to approximately 60 small business owners at Mount Anthony County Club about the exchange, through which in 2014 will be how uninsured individuals have to purchase insurance. Businesses with 50 or fewer full-time equivalent employees that choose to offer insurance will also have to offer plans through the exchange.
The federal
Affordable Care Act requires each state have such an exchange in 2014. If a state does not develop its own, the federal government will implement one. Vermont, according to George, has opted to develop its own exchange, dubbed Vermont Health Connect, and is the only state making the use of the exchange mandatory for those who qualify to use it.
State officials have likened the exchange to Priceline.com, an online service which compares hotel and airfare from different companies. The exchange itself is not an insurance provider nor is it designed to control health care costs on its own, however it does hold providers in the exchange to certain standards — such as caps on out-of-pocket costs based on income.
George said BCBS and MVP Health Insurance have filed applications to be part of the exchange. He said his company is focused on educating as many people as it can about the transition in 2014. It’s estimated about 80,000 people will be impacted by the exchange requirement and those who need to use it must do so as there is no “default” option. He said a person required to use the exchange who is insured has to actively use the exchange — it will not take care of itself.
According to a survey done by the state in March 2012, only 27 percent of those surveyed had heard of the exchange.
“We have a real challenge ahead of us,” George said.
George said he has spoken at more than 30 seminars like the one held Thursday and plans on doing more. BCBS has identified 37 people who work for it that are qualified to teach others how the exchange works. Most of them have been re-tasked to staff a call center which will be available on April 22 while the rest plan to go into the field and work one-on-one with BCBS customers to make sure they know how the exchange works. BCBS also plans to upgrade its website by July so more information on how the exchange works will be available. The state and other groups are also working to get the information out there, he said.
There is a lot of information to be had, and not all of it is available said Hamilton, adding that she plans to run a future webinar that will endeavor to explain the tax implications of the exchange on small businesses. She said individuals who do not have insurance will be fined 1 percent of their income tax however they are eligible for graduated subsidies on their premiums, up to 400 percent of the federal poverty line. The subsidy only applies to people not covered through their employer.
Hamilton said the Internal Revenue Service will also be checking the information those who use the exchange provide, information that drew muttering from the audience. She said Oct. 1 is when open enrollment begins and people will use income information from the previous year. According to Hamilton, the IRS may recoup money from people who misrepresent their income information to the exchange.
Those using the exchange, either individuals or employers, can pick from four types of plans: Bronze, silver, gold, and platinum. Hamilton said an employee can opt for a plan different from the one the employer is offering and pay the difference. She said it’s expected bronze and silver will be the most widely used.
Starting in July the rates being offered will be available for viewing by the public. Open enrollment begins Oct. 1, with payments to the state due Dec. 15. The policies purchased take effect Jan. 1, 2014, and the open enrollment period ends March 31.
Hamilton said, in response to questions about the enrollment cutoff, that the federal law requires it to keep people from manipulating the system and encouraging people to enroll earlier. The goal is that by Jan. 1, 2015, a January enrollment cycle will be in gear.
George said that BCBS is focused on teaching people about the 2014 changes but also has its eye toward 2017 when Vermont could possibly develop a single-payer system. Currently the $1.6 billion figure associated with that endeavor has many wondering how it will be funded. George said so far no one knows how such a thing would be funded and providers and business owners alike have questions.
Source: Bennington Banner