For immediate release: August 17, 2012
Contact: Leigh Tofferi (802) 223-6131

State Recommends BCBSVT as the Benchmark Plan for Exchange

BERLIN, VT – The state’s Department of Vermont Health Access (DVHA) has recommended a Blue Cross and Blue Shield of Vermont (BCBSVT) benefit plan as the basis for health benefits that must be used by all insurers offering benefit plans on the state’s health insurance exchange beginning in 2014.

The decision follows months of work between BCBSVT and the various state agencies and consultants engaged by the state to assist them in defining the Essential Health Benefits or allowable coverage that will be offered on the Vermont Health Benefits Exchange.

The federal Affordable Care Act requires each state to create or enable an “exchange” where citizens can shop for, compare, and purchase individual and small group health insurance plans in 2014 and 2015. The federal law required states to look at four types of current plans offered in the state and select one as the “benchmark” plan whose benefits will serve as the basis for all plans available to Vermonters in the exchange in 2014 and 2015.

If accepted by the Green Mountain Care Board, the recommendation means that the most of the benefits in plans authorized for sale on the Exchange will be based on those products BCBSVT currently has in the market.

“Choosing BCBSVT as the benchmark plan would mean the least amount of change for Vermonters,” DVHA said in announcing its recommendation. “Seventy-seven percent of Vermonters in markets that are expected to enter the Exchange currently have a BCBSVT product and would continue to receive those same benefits in addition to any new benefits outlined by the ACA. “

The Green Mountain Care Board will accept public comments on the recommendation, and then make a final decision on September 20. Advocacy groups generally have applauded the recommendation. DVHA has recommended that the State Children’s Health Insurance Plan (SCHIP) be used as the benchmark plan for pediatric oral health care benefits; Exchange products must include dental benefits for children.

DVHA’s recommendation to use the BCBSVT product platform as the benchmark for Exchange product design does not represent an endorsement of BCBSVT as a preferred Qualified Health Plan on the Exchange, according to the agency.

Blue Cross and Blue Shield of Vermont is the state’s oldest and largest health insurer, providing coverage for about 180,000 Vermonters. It employs about 340 Vermonters at its headquarters in Berlin and branch office in South Burlington, and offers group and individual health plans. More information about Blue Cross and Blue Shield of Vermont is available on the Internet at www.bcbsvt.com. Blue Cross and Blue Shield of Vermont is an independent corporation operating under a license with the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.