MONTPELIER — State officials have a “high level” of confidence that an improved Vermont Health Connect website will re-launch for the public Saturday in time for the open enrollment process.
Chief of Health Care Reform Lawrence Miller said security upgrades were completed about three weeks ago and the state is reconnected to the federal data hub. The state chose to disconnect from the hub in mid-September before the Centers for Medicaid and Medicare, the federal entity that oversees state exchanges, forced them to disconnect because of security concerns.
Miller said the state now meets all of CMS’s security requirements.
Online health insurance marketplaces, known as exchanges, are required by the federal Affordable Care Act. The state chose to build its own rather than join an exchange created by the federal government. Since launching in October 2013, however, Vermont’s site has lacked core functions and experienced technological problems.
Miller said Tuesday that the state’s contractor, Optum, which replaced original contractor CGI earlier this year, has made a series of improvements to the Vermont Health Connect site’s design and performance. Obsolete content has been removed. The state will “meet every expectation” it had when open enrollment begins on Nov. 15.
Gov. Peter Shumlin, speaking at an unrelated news conference Monday, said he is “cautiously optimistic” the site will perform as expected on Saturday.
“My team believes that when we light up the website it’s going to be able to do two things that we weren’t secure about before,” Shumlin said. “The first is obviously the security concerns have been worked out, and that’s a big deal. The second is that we believe the functionality is going to be much better.”
State officials, including Miller, chief of health care reform for Gov. Peter Shumlin, Harry Chen, acting secretary of the Agency of Human Services and Stephanie Beck, director of health care operations at AHS, are expected to brief reporters today on developments with VHC.
Those looking to renew their policies for 2015 will be able to see plan options online an download renewal forms. Those forms will be entered manually by staff, however, and not processed online. State officials announced that process over the summer.
Existing customers were given the option of authorizing the state to check subsidy eligibility for a five year period when they first signed up for an exchange plan. Because there were no material changes to health connect insurance plans, aside from pricing, those who granted the state that authority will be “auto-mapped” into the 2015 version of their health plan and receive updated billing information.
Those that did not provide that authorization have been sent letters asking them to fill out a form and send it back allowing the state to check for subsidy qualification.
A portion of the website went live on Oct. 15 that outlines the 2015 health plans, rules and a subsidy calculator. The site also provides renewal forms that can be downloaded, filled out and returned by mail. Those seeking to renew plans can also contact the call center or visit a trained navigator.
The state is expecting between 3,000 and 8,000 people to enroll in exchange plans, offered either by Blue Cross Blue Shield of Vermont or MVP, for the first time. Those first-time applicants will be able to apply online.
The questions and options for new enrollees have been revised to reduce the occurrence of errors, Miller said, and are now more in line with how a navigator or call center staff would help fill out the forms.
“Those question sets have be updated, including reordered in some cases, and reworded so that it’s much more clear,” Miller said. “I think we will have a much lower error rate with those things.”
Other core functions, including the so-called change of circumstance, will remain offline until after the close of open enrollment on Feb. 15. Users who need to change personal information, such as their address or marital status, will continue to undergo a manual process rather than the faster, automated system the website was initially expected to offer.
Additionally, small business employees will still not be allowed to enroll through the website and must obtain insurance directly from carriers.
“It needs to be tested out, and that includes the carriers. I don’t see that testing being able to start, from a capacity standpoint, until Feb. 15,” the official said.
The transition from CGI to Optum required a stoppage of all development work, meaning further upgrades to the system, including automated change of circumstance and small business enrollment, will not be added until after the open enrollment period.
The state expects about 15 percent of those already enrolled in exchange plans to consider a new plan or some change to their benefits, which is the industry average each year. But because about 60 percent of those enrolled receive a subsidy, the state has prepared for up to 60 percent of enrollees seeking a change.
“It would be foolish for us not to provide for that,” Miller said.
About 220 Optum employees who are currently working on manual change of circumstance requests will shift Saturday to entering no-change renewals into the system, according to the Miller.
Employees from Maximus, the contractor operating the VHC call center, will also be available. And the state reached out to AHS and Department of Information and Innovation staff for voluntary overtime. The volunteer effort is different from the forced overtime the state implemented last year for some employees.
“Last year, you’ll recall, we did impose mandatory overtime,” Miller said. “That went over really, really badly. Canceling Christmas pisses people off, and it’s just not enough people,” Miller said.
Those that volunteer are being screened for their skill sets and directed accordingly. Some will work a few extra hours during the week, while others will work on weekends.
Optum’s current contract, known as a time and materials contract, is worth $29 million. It includes completing some work left behind by CGI when the firm and the state parted ways. It also includes the manual entry of data and some of the development work to get the site ready for open enrollment.
The contract will likely be amended and expanded after the open enrollment period to complete development work on the missing functions. Miller said it is unclear what the full amount of the contract will be.
CMS will provide an extension on developments for Vermont, as it has for Massachusetts and Maryland, Miller said.
Despite the “pretty high” level of confidence in the site, some risk remains, Miller said. The development and test environment for the site cannot completely mimic a live environment. And there could still be some “downstream risks associated with connectively with the federal data hub,” according to Miller.
The site was deployed internally, with public access still blocked, on Monday night. It is currently undergoing “a heavy security scan” and performance evaluation. Testing will continue Wednesday before the site is opened to customer service representatives on Thursday. On Saturday the public will have access.