The announcement from the Shumlin administration is a tacit acknowledgement that the state's health care exchange website won't be ready in time to sign up small businesses that need to obtain coverage for workers in 2014.
The Shumlin administration says the decision was spurred by ongoing uncertainty about when Vermont Health Connect will be fully operational. It is the second time state officials have allowed businesses with 50 or fewer employees to sign up with insurers directly rather than requiring that employers and their workers enroll through Vermont Health Connect.
The decision gives insurers adequate time to reach out to their small business clients, according Don George, president and CEO of Blue Cross and Blue Shield of Vermont. Representatives from Blue Cross and the other insurer on the exchange, MVP Health Care, told lawmakers last week they needed to know within a month if the website's small business sign-up option would be functional, or if they would be called on to do another round of direct enrollment.
Mark Larson, commissioner of the Department of Vermont Health Access, said he was disappointed that the online enrollment for businesses still isn't functional. But offering direct signups with insurers, he said, is a "proven pathway" to sign-up businesses, and gives both insurers and employers the certainty they need going forward.
Larson did not have a figure for how many businesses, or the total number of employees, would be affected by the latest contingency plan.
In November, the state announced small businesses could enroll directly with insurers for coverage starting Jan. 1 or keep their 2013 coverage through March 31. Before the end of 2013, about 29,000 workers were enrolled directly through insurers. Businesses that used the extension and businesses with coverage that expires in the first quarter of 2014 will enroll directly with Blue Cross or MVP, Larson said.
There has to be a default option for businesses that don't pick a plan with either insurance carrier, acknowledged Bill Little, vice president for MVP's Vermont operation. That contingency will be ironed out in the next few weeks, but he expects it will only apply to a handful of businesses, Little said.
One of the advantages of the Vermont Health Connect's online marketplace is that an employer could offer all 18 VHC plans to employees and still receive one aggregated bill. Having businesses enroll through the insurers makes it difficult to offer employees that same range of coverage options, Larson acknowledged.
His team continues to test and make improvements to the small business capacity on the exchange website, Larson said.
"When we're ready to roll out the full functionality, we want it to be in a planned and thoughtful manner instead of rushing to a date certain," Larson said at a press conference at his Winooski offices.
Signing up businesses through the exchange requires ushering a huge amount of data through numerous transactions, and it's going to take more work to ensure that information flows smoothly from Vermont Health Connect to its premium processor and on to the insurance companies, Larson said.
Allowing small business to continue direct enrollment will give Vermont Health Connect the chance to focus on enrolling individuals through the exchange website, Larson said, many of whom have yet to sign up and others are still waiting for their applications and payments to be processed.
Larson drew a line between the technical work that has to happen to get the small business option running, and the delay in processing credit and debit card payments, noting that capacity is already in place.
The capability is awaiting a payment industry certification, applied for by CGI, the tech firm that Gov. Peter Shumlin recently noted "underperformed at every turn."
Lawrence Miller, secretary of Commerce and Community Development, joined Larson and representatives from the two insurance companies to make Tuesday's announcement. The governor recently asked him to work with Larson's people to see them through the final steps of the exchange rollout.
Miller will serve in an advisory role, but that role is fulltime, he said. That means his commerce deputies will have to take on larger responsibilities in his absence, Miller said.