NEWFANE — Town employees have a potential variety of new options for health insurance under a new federal law that aims to see all Americans covered in a health care program by Jan. 1.
According to Larry Smith, manager of risk management services of the Vermont League of Cities and Towns, town employee coverage could be available through Blue Cross Blue Shield of Vermont, MVP Healthcare, or the open market, depending on what Selectmen opt for this October.
Smith spoke at the scheduled public comment period of the Aug. 1 Selectboard meeting to deliver an overview of insurance options Newfane will get to offer through Vermont Health Connect, a new state clearinghouse for privately offered insurance benefits.
“One thing that will change in 2014 is that the employer really choses the funding level: how much you're going to contribute. Employees, starting 2014, have a choice of plans” within the two carriers, Smith said.
Newfane is under no obligation to offer either or both of the carriers, Smith said. He described Blue Cross Blue Shield as a national carrier, and MVP as a regional HMO network.
In neither case will care be reimbursed if the expense occurs out of network, he said.
Smith added that town employees would have the option of “buying up or down” from within tiered options relative to what Selectmen contribute, to make sure they get the plan that best suits them.
Skimming one of Smith's handouts, Selectboard Chairman Jon Mack asked, “What does it mean, 'The only game in town'?”
“That means ... for groups like yourself, in 2014, starting in January, Vermont Health Connect will be the only place to purchase your insurance,” Smith said.
The handouts Smith provided to Selectboard members were for groups of fewer than 15 employees, all of whom would be affected in one way or another. Mack noted the town payroll includes full-time employees, who would be eligible to participate, “and maybe one person at 10 hours a week” who apparently would not.
Newfane can set up its new accounts starting Oct. 1. Town employees will be able to choose a plan Dec. 1, and are advised to file their choice by the 15th to get their insurance card by the start of coverage, Jan. 1, 2014.
Currently the town arranges for 80 percent coverage through MVP Healthcare at a total contribution of $78,000, Mack said. He added the same amount was budgeted for next year, and that Selectmen would therefore aim to level-fund the town's contribution.
At mention of the Town's current expenditures on healthcare, Smith volunteered, “You can limit carriers, would be one of your choices, but they [employees] would have choices of any plan in that carrier or they can just have the whole market available.
“Or consider whether it's worth keeping or dropping coverage. If you don't offer anything, employes can go to the exchange as individuals, and, based on their income, can be eligible for federal tax credits [or] federal tax subsidies,” he said.
Smith also advised that, in a change from the status quo, any plan chosen by an employee aged 65 or order would be secondary to Medicare, which that person would have to buy into “outside the exchange.”
“VLCT doesn't touch Medicare. It has nothing to do with Medicare,” Smith said.
Starting in 2014, many Vermonters will be eligible for tax credits and other forms of financial assistance to help pay for the cost of health care.
Also starting in 2014, small businesses with 50 or fewer employees will be able to use Vermont Health Connect to find coverage for their employees. In 2016, small businesses will include businesses with 100 or fewer employees.
In 2017, the idea is to open coverage to “all groups, all towns, going to single payer,” Smith said.
The VLCT website advises, “Health reform is taking shape, and for small and medium-size employers right now, maintaining the status quo is not an option. By October, your municipality might have to do any number of things, such as revisit a collective bargaining agreement, begin counting employees in a new way, or decide whether to offer a health insurance benefit.”
With a full agenda on the table, Mack kept Smith to a half hour of his planned two-hour presentation, promising to invite him back after Selectmen had had time to digest the handout material and schedule a public meeting for town employees to review their options.
“That's a great start. We're going to have to dig very deeply to understand this. But this is pretty nice, pretty solid,” Mack said.