June 26, 2019

Health insurance open enrollment upcoming

Open enrollment for health insurance plans in Vermont begins Nov. 1, and Vermont Health Connect plans to launch the 2019 version of its Plan Comparison Tool on Oct. 16.

Open enrollment will last through Dec. 15, a period of six weeks when people with existing insurance can change plans and new applicants can sign up through the state-run marketplace at vermonthealthconnect.gov.

What’s new this year?

— Increased financial aid: People receiving subsidies will be eligible for about $1,200 more in premium assistance in 2019 than they received in 2018 because the premiums on Silver-level plans are increasing significantly. Premiums for Silver plans drive federal subsidies; when the premiums for Silver plans increase, subsidies also increase. Premium subsidies can be used on any level plan, Bronze through Platinum.

— Lower cost Bronze, Gold and Platinum plans: Non-Silver premiums are not increasing as much, so subsidized members will find that these plans cost much less than they did in 2018. With the increased subsidies, low-income Vermonters may find that they qualify for at least one zero premium plan.

— More plans in the marketplace: Most Vermonters will find 26 options for qualified health plans, including two new Silver plans. Vermonters who are under 30 years old still have the option of choosing a catastrophic plan.

— Lower cost silver plans outside the marketplace: Those with incomes too high to qualify for subsidies are not protected from Silver premium increases. They can change to a non-Silver plan or call an insurance carrier and enroll directly in a new lower cost Silver plan known as “Reflective Silver.” Reflective Silver plans cannot be sold through Vermont Health Connect, only direct from a carrier.

In past years, most Vermonters chose Silver plans. That will likely change this year as Gold plans will offer lower out-of-pocket costs and now have a similar or lower monthly premium. However, lower-income Vermonters can enroll in an Enhanced Silver 87 or 94 plan that has lower out-of-pocket costs than Gold plans.

What’s the same?

— Same schedule: Open Enrollment runs from Nov. 1 to Dec. 15, just like last year. Vermonters who sign up or request a new plan will have a start date of Jan. 1.

— Same channels: Vermonters can enroll or change plans online, by phone or with one of 200 in-person assisters located across the state.

— Financial help: Most applicants qualify for subsidies that lower their monthly premium and/or out-of-pocket costs. Income limits depend on household size, ranging from nearly $50,000 for an individual to $100,000 for a family of four.

 Direct enrollment: Vermonters who don’t qualify for subsidies can call Blue Cross Blue Shield of Vermont or MVP to enroll directly.

The Plan Comparison Tool launching Oct. 16 at vermonthealthconnect.gov (under “Decision Tools”) will be the quickest way for Vermonters to estimate subsidies and compare expected total costs based on age, income and health status.

“The tools and timelines are the same as last year, but the potential savings and the importance of taking action is much greater,” an announcement last week from the Vermont Department of Health Access stated. “Vermonters who take a few minutes to evaluate their plan options can generally expect to pay hundreds of dollars less in 2019 than those who automatically renew into the 2019 version of their 2018 plan.”

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