Vermont Health Benefit Exchange

Vermont Health Benefit Exchange
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In May 2011, Governor Shumlin signed HB 202, a law that started the establishment of the Vermont Health Benefit Exchange. Eventually the state plans to apply for a federal waiver to transition to Green Mountain Care, the single-payer system that will insure all residents of Vermont. Vermont’s Exchange was established by HB202 as a state-operated […]Continue reading «Vermont Health Benefit Exchange »

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In May 2011, Governor Shumlin signed HB 202, a law that started the establishment of the Vermont Health Benefit Exchange. Eventually the state plans to apply for a federal waiver to transition to Green Mountain Care, the single-payer system that will insure all residents of Vermont. Vermont’s Exchange was established by HB202 as a state-operated program within the Department of Vermont Health Access. The Exchange has an Advisory Committee consisting of Commissioner of Vermont Health Access, health insurance representatives, representatives of Medicare and Medicaid funded programs, and healthcare professionals. The Green Mountain Care Board will be overseeing Vermont’s Exchange. The Board consists of five members. 
Many major tasks necessary to set up the Exchange have already been completed. With the help of subcontractors, issues such as the number of uninsured and underinsured, finance-related functions, and technology needs have already been analyzed. An Advisory Group led Health Care Forums in Vermont to inform and update about the Exchange. Plans offered will include at least two from private insurers and two multi-state plans. Vermont is working to get as much carrier participation as possible and carriers are required to offer plans at the silver and gold levels. Small Business Health Options Program (SHOP) Exchange will be set up by 2014 and allow small businesses with a group of 50 or fewer to buy insurance. Currently SHOP Exchange is still under planning and some details are being finalized. The Board recommended that individual and small group exchange should be in one market and sold through the Exchange. 
A single process will be used to determine eligibility for the Exchange, Medicaid and other programs. In order to successfully design an Exchange interface, Vermont is participating in Enroll UX 2014, a New-England states consortium creating design standards for exchanges. In addition, Vermont is trying to use the same Oracle-based architecture Oregon has employed. The Exchange is funded by a $1 million Exchange planning grant, a $36 million Early Innovator Grant shared with other New England States and an $18 million Level One Establishment grant. Next steps for the Board include designing a navigator program, qualified health plan certification, and an outreach plan. 
Information from http://healthreform.kff.org

 

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