Eileen Elliott’s op-ed, Navigating the health exchange for small businesses, appeared in The Burlington Free Press Creative Corner on May 2, 2013.
There is reason for small businesses to be optimistic about the upcoming health exchange, called Vermont Health Connect. Beginning in October, businesses with 50 or fewer full-time employees will begin using the Exchange to enroll in health insurance. Earlier this month, Blue Cross/Blue Shield of Vermont and MVP Health Care submitted their proposed rates for premiums to the state for review, and these proposed premiums are in line with amounts being paid today.
In many ways, the fact that the proposed rates did not skyrocket as predicted is not surprising. Over the last two decades, Vermont created Dr. Dynasaur for children, banned health insurance companies from imposing higher rates on the sick and elderly than they would on the young and healthy, expanded Medicaid, created and subsidized the Vermont Health Access Plan (VHAP) and Catamount for uninsured low-income adults, devised pharmacy programs to ease the cost of medications, and introduced the Blue Print for Health, which targets chronic conditions.
All these changes had the effect of insuring more Vermonters and providing increased access to health care. In Vermont, unlike the rest of the country, more than 94 percent of the population is insured. Our health insurance companies have already had to adapt to Vermont’s requirements, which made it easier for them to propose rates that are consistent with the national insurance reforms that are new to other insurers and states.
Besides having cost information about premiums, businesses also know what is in the standard benefit package that these insurance companies will offer on Vermont Health Connect. The price of insurance will vary based on the insured’s cost sharing (how much an employee will pay out-of-pocket for deductibles, co-pays and co-insurance), but the benefits are the same for all health insurance products.
These benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, and preventive and wellness services. Also included are chronic disease management and pediatric services, like oral and vision care.
Fortunately, every day there is more information about what to expect and how to prepare for buying insurance on Vermont Health Connect. Vermont Health Connect has its own website, http://healthconnect.vermont.gov, which increasingly has more information for the small businesses, individuals and families who will be using it in a few short months. Besides containing important basics about the state reforms, the website now has a tax credit calculator for small businesses with fewer than 25 employees who currently offer insurance and may qualify, even retroactively, for federal credits.
Soon, there will also be navigators and a call-in line to help. And, of course, brokers will still be available for those businesses that have successfully relied on them for information and assistance.
One of the goals of Vermont Health Connect is to make buying health insurance easy. Standardized benefits and predictable cost sharing levels bring comparison shopping to this formerly confusing world. Still, the availability of people, cost information, and resources to help with the change ahead, particularly in the first round, is invaluable.
photo by ernstl
