Vermont Health Connect, the state insurance exchange, has released a draft version of administrative rules for small group coverage, the first of several frameworks that will govern what's envisioned as a stepping stone to a publicly-financed, single-payer health system.
Overseen by the Department of Vermont Health Access, Vermont Health Connect previously merged the individual and small group markets.
Under the draft rules, small group employers will be defined as having 50 or fewer full-time employees, and will increase to employers with up to 100 full-time employees In January 2016, and after 2017 -- when the state plans to apply for a federal waiver to pursue a single-payer system -- the exchange will include all employers in the same merged market, regardless of size.
Employees working 30 hours or more will be considered full-time, following the Affordable Care Act's definition. Seasonal employees -- who by some estimates comprise 30 percent of the state's workforce -- will be defined by Vermont Health Connect as working a scheduled job for no more than 20 weeks per year.
[See also: Vermont board outlines 2012 work towards single-payer system]
At the least, Vermont Health Connect plans to include health plans from the state's two main commercial insurers -- Blue Cross Blue Shield of Vermont and MVP Health -- and two multi-state plans that will be run by the Office of Personnel Management.
Under the proposed small group rules, qualified employers in Vermont will be able to choose between offering employees the option to select any plan from the exchange and choosing from plans from certain issuers. Employers will also be able to offer stand-alone dental and vision plans.
Current small group health plans in Vermont can renew their plans in 2013 for another year, according to the proposed rules; grandfathering beyond 2014 isn't clear. Beginning in January 2015, qualified employer plans have to align with the calendar year.
The proposed rules also outline Vermont Health Connect's payment and administrative obligations. Vermont Health Connect will provide employers with a monthly bill showing employer and employee contributions, in addition to the amount due the health plan, which the exchange will collect.
Vermont Health Connect is taking public comment on the draft currently and it will eventually be integrated into the exchange's health benefits program administrative rule.