VHC Open Enrollment 2018

Cassandra Madison

Director, Health Access Eligibility and Enrollment

MEAB

September 25, 2017

Open Enrollment: Nov.1 – Dec.15

� Current members will automatically be renewed into the 2018 version of their 2017 plan. To keep their coverage, all they have to do is keep paying their bills.

� If they want to request a change, they have until December 15 to do so.

� If a new member wants to sign up for 2018 coverage, they have until December 15 to apply and confirm a health plan.

Open Enrollment Readiness

� Operational schedule similar to last year’s successful plan

� Notable difference: Notices of Decision mailing in early November rather than December to help members meet new December 15 deadline

� Biweekly planning meetings held since July to align DVHA, carriers, and VLA on testing, technical plans, notice schedule, outreach, and more

� Open Enrollment Readiness Review held with CCIIO September 13

2018 Health Plans

� All 2017 plans from all metal levels will be sold in 2018, plus four new bronze plans

� Two new bronze plans from each carrier

� New plans do not have separate prescription (Rx) max out-of-pocket (MOOP), just the integrated MOOP that covers both medical & Rx

� Standard Bronze Without Rx MOOP (BCBSVT & MVP)

� Developed in response to legislative directive

� Deductible waived for specialist, primary care and behavioral health office visits (with co-pay). Also waived for generic prescriptions

� Relative to other bronze plans, could appeal to Vermonters who are more likely to have office visits and only use generic prescriptions

� New Non-Standard Bronze Without Rx MOOP (BCBSVT & MVP)

� Deductible waived for first three PCP/MH office visits

� Wellness rewards

� With slightly lower premiums than standard plans, could appeal to Vermonters who are aiming to minimize premiums

2018 Health Plans

� In addition, BCBSVT is removing the Rx MOOP for existing Bronze Blue Reward (non-standard) plan.

� Members who had this plan in 2017 AND who met or exceeded their Rx MOOP in 2016 must be mapped to a plan with Rx MOOP (according to the VT law). This will be one exception to the rule that households should be automatically enrolled into the plan they had the previous year. Approximately 30 households will be impacted.

� Customers may self-select an alternate health plan during Open Enrollment, if they choose.

Affordability

� Despite rate increases, most VHC members will be able to find a 2018 health plan at the same metal level they had in 2017 for about the same, or less, premium that they paid in 2017.

� BCBSVT rates increased 9.2% on average, some plans less and some more.

� MVP rates increased 3.5% on average, some plans less and some more.

� Federal tax credits for qualifying Vermonters (up to ~$48,000 for an individual and ~$65,000 for a two-person household) also increased.

� An individual earning $30,000 will receive ~$13 more per month in premium tax credits than they received in 2017

� Depending on size of rate increase for the member’s particular plan, they could either pay more or less in 2018 than they paid for the same plan in 2017.

� Before changing plans, member should visit online Plan Comparison Tool at VermontHealthConnect.gov to view expected total costs (premium and out-of-pocket).

� All Silver plans are available with Cost-Sharing Reductions for qualifying members.

Help with Plan Selection

� 2018 Plan Comparison Tool – Launching around October 16 to help members determine premiums of 2018 plans after subsidies as well as the likely total costs (premium plus out-of-pocket) of all plans options

� Webinars – Events on November 9 will feature representatives from all three carriers as well as DVHA

� Assisters – With more than 160 Certified Application Counselors (CACs) and Navigators throughout the state, there are 50% more professionals providing free in-person assistance than two years ago

Late Payments and Grace Periods

Key Educational Materials

Health Insurance 101

Getting Started with Vermont Health

Connect

Health Insurance: Why It’s Important & What

You Need to Know

How MEAB Members Can Help DVHA Deliver a Successful Open Enrollment

� Review draft Bronze flyer and give Molly feedback

� Look for Stakeholder Kit from Molly (approx. October 1) with sample article and announcements to use in newsletters, listservs, Front Porch Forum posts, etc.

� Link to 2018 Plan Comparison Tool (approx. October 16)

� Promote webinars scheduled for November 9

� Link to educational materials (links on previous slide)

� Help distribute posters and print materials (by mail and/or at October MEAB)

� Your ideas?