Vermont: Important information about the 2019 ACA Open Enrollment Period

The timeline is the same but recent changes mean that Vermonters who take a few minutes to compare plans will find more choices and more financial help than ever before

Open Enrollment is the annual period when new applicants can use the marketplace to sign up for health and dental plans for the coming year. It is also the time that existing members have the option to change plans – an option that many more members than usual will want to consider.

What’s new?

• Much more financial help - Subsidized members will receive over $1,200 more in premium subsidies in 2019 than they received in 2018. This is because the premiums for Blue Cross Blue Shield of Vermont (BCBSVT) and MVP Health Care (MVP) on-exchange silver plans are increasing significantly. Premiums for silver plans drive federal subsidies—so when the premiums for silver plans increase, subsidies also increase. Premium subsidies can be used on any metal level plan, bronze through platinum (see illustration of what the typical member pays in 2018 vs. 2019).

In other words, Vermont has finally jumped onboard the #SilverSwitcharoo Express!

• Lower cost bronze, gold, and platinum plans – Non-silver premiums are not increasing as much, so subsidized members will find that these plans cost much less than they did in 2018 (and often lower than they cost from 2014 to 2017). Vermonters who don’t have insurance because they thought it was unaffordable in past years are strongly encouraged to check again. With the increased subsidies, many will find that they qualify for at least one zero premium plan.

Again, that's due specifically to #SilverSwitching.

• More plans in the marketplace - Most Vermonters will find 26 options for qualified health plans – including two new silver plans. Vermonters who are under 30 years old still have the option of choosing a catastrophic plan from either carrier in addition to the 26 other options. Subsidies cannot be applied to catastrophic plans, however, so subsidized members will often find that they can buy richer plans for less.

• Lower cost silver plans outside the marketplace – Unsubsidized members (those with incomes too high to qualify for subsidies) are not protected from silver premium increases, unless they change plans or leave the marketplace. Their best options will be to change to a non-silver plan or to call an insurance carrier and enroll directly in a new lower cost silver plan, known as “reflective silver.” Reflective silver plans cannot be sold through VHC, only direct from a carrier.

Once again: That's all due to the #SilverSwitcharoo.

Remembering that not all silver plans are created equal - In past years, most Vermonters chose silver plans. That will likely change in 2019 as gold plans usually offer lower out-of-pocket costs and now have a similar (and often lower) monthly premium. However, Vermonters with qualifying incomes can enroll in an Enhanced Silver 87 or 94 plan that has lower out-of-pocket costs than gold plans. For these Vermonters, a silver plan is likely to still be the best value. The Plan Comparison Tool is the quickest way for Vermonters to see if they might qualify for Enhanced Silver 87 or 94. Current members will also receive an eligibility notice in November.

What’s the same?

• Same schedule - Open Enrollment runs from November 1 to December 15, just like last year. Vermonters who sign up or request a new plan will have a start date of January 1. Those who miss the deadline could have to wait until January 2020 to start health coverage.

• Same channels – Vermonters can enroll or change plans online, by phone, or with one of 200 in-person assisters located across the state.

• Financial help - Most applicants qualify for subsidies that lower their monthly premium and/or out-of-pocket costs. Income limits depend on household size, ranging from nearly $50,000 for an individual to $100,000 for a family of four.

• Direct enrollment - Vermonters who don’t qualify for subsidies can call BCBSVT or MVP to enroll directly and establish a single point of contact. As noted above, this option is particularly important for unsubsidized members who want to stay in a silver plan.

• Plan Comparison Tool – Clicking on ‘Decision Tools’ at VermontHealthConnect.gov. is the best way to estimate subsidies and compare expected total costs (monthly premium plus out-of-pocket costs) based on someone’s age, income, and health status.

In short, the tools and timelines are the same as last year, but the potential savings and the importance of taking action is much greater. The options can seem confusing, but the Plan Comparison Tool can make it easier. Vermonters who take a few minutes to evaluate their plan options can generally expect to pay hundreds of dollars less in 2019 than those who automatically renew into the 2019 version of their 2018 plan.

Plan Comparison Tool Helps Vermonters Compare 2019 Health Plans and Save Money
Recent changes mean that Vermonters who take a few minutes to compare plans will find more choices and more financial help than ever before

WATERBURY – In preparation for open enrollment, state officials have launched the 2019 version of an online tool that helps Vermonters weigh insurance options and choose the health plan that best fits their needs and budget. The 2019 Plan Comparison Tool is accessible from VermontHealthConnect.gov and allows individuals and small business employees to easily screen at least 26 health plan options.

As in past years, the tool allows members to compare total costs in an average year or bad year, view doctor directories and drug lists, and much more. New this year, the tool also provides members with the ability to see their total costs in a low-use year (or “good year”) and the likelihood of someone with their age and health status having a good year.

With big changes on the horizon, the tool is an essential five-minute step for all current and prospective members of Vermont’s health insurance marketplace.

Three big changes in marketplace

First, it’s important to note that most Vermonters who purchase health insurance on their own qualify for financial help to lower the cost of coverage. Due to a complex set of events initiated by recent federal changes, that financial help will go way up in 2019. Subsidized single members will receive over $1,200 more in 2019 than they did in 2018, while couples and families will generally receive over $2,500 more. This means that most members will see significant savings if they explore all options (see what the typical member pays in 2018 vs. 2019).

A second change is that premiums for silver-level qualified health plans (QHPs) are increasing much more than other metal level plans. This is especially notable because three out of five (60%) individuals are currently enrolled in silver plans. It is especially important for these members to actively explore their alternatives.

Finally, to help small business employees and higher income individuals whose incomes are too high to qualify for financial help, Vermont developed “reflective silver” plans. These plans – available only by calling Blue Cross Blue Shield of Vermont (BCBSVT) or MVP Health Care (MVP) directly – give unsubsidized members the opportunity to buy silver plans for closer to the price they paid for similar plans in 2018. Reflective silver plans aredisplayed on the 2019 Plan Comparison Tool, but only if the tool determines that the user does not qualify for subsidies.

“We want Vermonters to know that there were policy changes at the federal level that could impact the cost of their current plans,” said Governor Phil Scott. “I want to thank the members of my Administration, legislature, and stakeholders across the state who came together to respond to these changes with a focus on affordability for Vermonters. The key remaining step is for Vermonters to pick the right plans and, fortunately, the Plan Comparison Tool is here as a resource to help them do just that,” Governor Scott added.

Time to take action

Current Vermont Health Connect members aren’t required to compare health plans or to take any action at all. As long as they continue to pay their bills, members are automatically renewed into the 2019 version of their 2018 plan. In past years, most members have gone this route. Due to this year’s changes, however, officials are strongly encouraging members to invest the time needed to be sure they’re in the best plan for them.

“This is not the year to auto-renew,” said Cory Gustafson, Commissioner of the Department of Vermont Health Access. “Comparison shopping is how Americans try to get the best deal possible for all kinds of consumer choices. That is true for every purchase, every year, but it’s especially true for health insurance in 2019. The difference between the ‘right plan’ and ‘wrong plan’ could easily be thousands of dollars. Fortunately, the Plan Comparison Tool will help Vermonters identify the right plan.”

About the Plan Comparison Tool

The Plan Comparison Tool was developed by the non-profit Consumers' Checkbook and has won the Robert Wood Johnson Foundation's award for best plan choice tool. This is the fourth year that Vermont is using the tool. It has been used in nearly 60,000 sessions over the last twelve months.

After taking a couple minutes to enter age, income, health status, and expected use of medical services, the anonymous tool tells the user if they qualify for financial help to lower the cost of coverage. It also presents the estimated total annual costs (premium minus subsidies plus estimated out-of-pocket) of each of the 26+ qualified health plans. The user then has several options for sorting and screening results, or they can dive into plan details and link to more information on the BCBSVT and MVP websites.

“This kind of resource is very important because a consumer just can't figure out: is a plan with the $200 deductible and a $10,000 out-of-pocket limit better for me than a plan with a $2,000 deductible and $4,000 out-of-pocket limit—and how about differences in co-pays, co-insurance, etc.?” said Robert Krughoff, president of Consumers’ Checkbook. “People don't know how much various health services cost or their likelihood of needing different services – and even health insurance experts can be hard-pressed to figure out which plan is best without a helpful tool. Vermont Health Connect is a leader in making this help available.”