When will the rates and plan designs be final?

The rates and plan designs are final and now posted on the Vermont Health Connect website.  Click HERE for details.

Can an employee choose to opt-out of the employer-offered plan and go into the Exchange as an Individual and get government subsidies and tax credits?

Employees may choose to opt-out of their employer plan and enter the Exchange as an Individual but the only way they will get government subsidies and tax credits is if their employer plan is determined unaffordable.

If an employer has employees in other states (NJ, MD, etc.), can the employee of a Vermont employer can get their insurance in Vermont or their home state? Would the employer pay a bill from the other state’s Exchange?

Vermont employers will be able to offer their out-of-state employees plans through Vermont Health Connect. It’s up to employers to make sure the plan options they pick for their employees covers the network out-of-state employees will utilize. Employers can also offer plans on out-of-state Exchanges (where the employee resides), if the plans on Vermont Health Connect lack necessary networks.

Can a business that decides not to offer coverage still get help paying for a broker who comes into to help employees sign up individually?

Yes.  At the very least, individuals could be invoiced and bring in their broker invoices to their employer for them to pay, if an employer agrees.  We will work with the selected TPA to find a more simplified and direct way to bill the employer who makes this choice.  

Must a small employer continue to offer employer-sponsored health coverage through Vermont Health Connect?

No, a small employer does not have to continue offering coverage.  A small employer could choose to stop offering employer-sponsored coverage and their employees may be eligible for coverage as Individuals in Vermont Health Connect. If interested in continuing employer-sponsored coverage, small employers may only purchase coverage through Vermont Health Connect in 2014. 

Will sole proprietors use Vermont Health Connect as individuals or as employers? What about their family members who may also be employees?

Sole proprietors are considered individuals and will access health coverage through Vermont Health Connect accordingly. Family members who are employees will also access coverage as individuals.  If a sole proprietor has one or more employees who are not family members, he/she may sponsor employer coverage for the non-family member employees. If the sole proprietor offers coverage to all of his/her full time employees, the sole proprietor and his/her family may participate in the employer plan (assuming the employer meets all other eligibility criteria). 

Can an employer differentiate their contributions to a single versus family plan?

Yes.