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deductibles were more expensive than made a mistake while signing up online. they had been, too. But she paid her pre- “The jargon was too technical for me to mium — only to learn, when she filled understand,” she says, and she missed a $188 prescription, that the pharmacy the chance to sign up for the tax credits couldn’t find a record of a valid insur- for which she and her husband qualified. “It was so easy to just click, and ance plan. She started calling around — first to then it was like, ‘Oops, you’re screwed for three months.’” Vermont Health When she called Connect, then to Vermont Health Connect to Blue Cross and Blue get the situation sorted out, Shield of Vermont. she landed in the infamous She got different queue of thousands seeking answers from both a “change of circumstance.” systems. “It’s like Meanwhile, Desjardins still watching people try KERRy COMOLL O needed to see her doctor to hang wallpaper for weekly visits, but she without arms,” says Comollo; the two systems just didn’t didn’t have any insurance information seem to communicate. “It just takes 10 to provide. Her provider let her keep her appointments, but offered Desjardins this gazillion phone calls.” Her premiums had seemingly been advice: “You’re your own advocate. You applied twice to the months of March can get lost in the shuffle. Make it one of and April, but not for May and June. In your jobs to really make it happen.” [and, yup, still free.] It took three months, and countless trying to get to the bottom of the problem, she wound up with three different phone calls, but Desjardins’ situation insurance cards with three different is finally sorted out. Even so, she spent policy numbers. A few days ago, she an hour on the phone recently trying to M-Sa 10-8, Su 11-6 got an email threatening cancellation change her online password and to pay 4 0 because of “nonpayment,” though she’s her premium — only to be told, in the 802 862 5051 end, to mail a check. still paying her premium every month. S W E E T L A D YJ A N E . B I Z “Something isn’t connecting,” she “I have no idea if I have insurance right now,” she says. “I have no clue.” She says. said the employees at Vermont Health 8v-sweetladyjane082014.indd 1 8/18/14 8v-free-colors.indd 11:03 AM 1 6/5/12 Connect have been polite and friendly, Looking Ahead but ultimately Comollo has little faith Roughly 7,000 Vermonters are in situLOCAL FINANCING! in the system. She’s been routinely told ations similar to the one described by that if a provider or pharmacist can’t Desjardins. They’re waiting in a long Whether you’re a first-time home-buyer, someone looking pull up her insurance plan, she should “change of circumstance” queue of for a vacation home, or purchasing an investment property pay out of pocket and submit her claims people who can’t automatically update the Heather Torre Team is here for you! later “after this gets all cleared up,” she their health insurance plans online. says. “Well, I don’t have a whole lot of That’s down from more than 14,000 We Offer: Jumbo, Conventional, New Construction, faith about it getting all cleared up.” earlier this summer, but according to a
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Kim Desjardins, 35, lives in Essex. Because neither Desjardin’s job as a part-time art teacher nor her husband’s work in retail offered benefits, the couple previously relied on the state’s Catamount Health plan for insurance. Desjardins knew going in that her plan on the exchange would cost more money. Her premiums went up, and some of her Catamount benefits — including waived copays and medication costs under a chronic care management plan — disappeared. Desjardins waited until almost the end of the open enrollment period to switch to the exchange, but she never considered going without insurance. She has a chronic mental health condition that requires a monthly prescription and weekly visits to her provider. Her trouble started when Desjardins
report from the state’s new contractor, IT company OptumInsight, an additional 4,000 Vermonters are also experiencing billing problems. Earlier this month, the state decided 3 to part ways with the Canadian contractor CGI, which did all of the initial work on the health exchange. The transition to OptumInsight will take place through September, by which point the state is estimating it will have paid nearly $70 million to CGI for a website that still isn’t fully functional. Meanwhile, there’s a new deadline looming: Open enrollment for next year’s health insurance plans begins on November 15. Optum’s latest report to the state warns that Vermont Health Connect should have contingency plans in place to manually process renewals — in case the website is not yet fully functional. m
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