The Vermont Insurance Exchange (Marketplace) is called Vermont Health Connection (Vermont Health Benefit Exchange). Vermont Health Connection is administered by the State of Vermont.
General information about the Vermont Health Connection can be found at: https://portal.healthconnect.vermont.gov/VTHBELand/welcome.action.
PATIENTS
The Vermont Health Connection is essentially a marketplace for individuals and small businesses with up to 100 employees to shop for health insurance if they do not already have insurance coverage from another source. If they have insurance from another source (such as employment, retirement benefits, or spousal benefits), they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the Federally-facilitated Marketplace.
This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.
As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Department of Financial Regulation
89 Main Street
Montpelier, VT 05620 – 3101
802-828-3301
www.dfr.vermont.gov/
Complaints: http://www.dfr.vermont.gov/insurance/insurance-consumer/file-insurance-complaint
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Federally-facilitated Marketplace.
Wyoming has established Blue Cross Blue Shield of WY as the “benchmark” plan.
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.
Blue Cross Blue Shield of Vermont
Plan Website: http://www.bcbsvt.com/individual-insurance
Provider Enrollment: http://www.bcbsvt.com/provider
Plan types offered: Individual, SHOP
MVP Health Care
Plan Website: https://swp.mvphealthcare.com/wps/portal/mvp/home/!ut/p/b1/04_Sj9CPykssy0xPLMnMz0vMAfGjzOJDTQ2CnZwMHQ0s3N3NDDz9XDy9vTwMjPyNzIEKIoEKDHAARwNC-v088nNT9QtyI8oBGot8Og!!/dl4/d5/L2dBISEvZ0FBIS9nQSEh/
Provider Enrollment: http://www.mvphealthcare.com/provider/credentialing.html
Plan types offered: Individual, SHOP