Vermont has had almost no functioning individual or small-group 2014 health insurance market for the past week.
Unlike other states, Vermont now requires all sales to go through its Patient Protection and Affordable Care Act exchange system.
The Green Mountains State is running its own state-based exchange, Vermont Health Connect. Managers hope to get about 100,000 through the site by the Dec. 15 deadline for individuals and small employers to get 2014 coverage in place by Jan. 1.
Individuals and small employers can still use agents or brokers, but the state requires any buyers who use a producer to pay a fee of just $20 per person insured per month. A benefit plan administrator is supposed to pay the broker commissions. Vermont brokers had to lobby to get the monthly fee increased to $20 per month. Originally, the state was going to set the fee at $.
The exchange has been completely down much of time since it opened Oct. 1.
Saul Skrocki, director of group benefits at Fleischer Jacobs Group, a Vermont firm that sells insurance and employee benefits, said that one employee at the firm has sometimes managed to log on to the broker portal and tried to enter customer applications, but it isn’t reliably open.
The system always crashes, without storing any of the data entered, and the employee trying to feed applications into the system has to start over when the system comes back up, Skrocki said.
“It’s a complete mess,” Skrocki said.
One Vermont daily, The Burlington Free Press, has reported that the Vermont Chamber of Commerce has resorted to helping member firms by submitting 25 paper applications.
Skrocki – who said he supports the goals of PPACA – said he wishes it were being implemented differently.
Skrocki said one problem is that exchange plan designers held rates down by increasing enrollee exposure to deductibles, co-payment amounts and other out-of-pocket costs two or three times higher than what most Vermont consumers with private coverage faced in the past.
Another challenge has been many Vermont policymakers’ preference for a single-payer system, Skrocki said.
In other states, exchange builders have tried to lower costs by increasing the level of competition between carriers.
In Vermont, exchange officials seem to have discouraged competition, Skrocki said.
The Vermont exchange will start with two carriers, but one has lower rates and a bigger network, and will likely hold an insurmountable advantage over its competitor, Skrocki said.