Blue Cross Blue Shield of Vermont

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GMCB cuts Blue Cross rate request by one-third

MONTPELIER — The Green Mountain Care Board has rejected Blue Cross Blue Shield of Vermont’s 12.7 percent requested rate increase, imposing a smaller increase of 9.2 percent. The board, the state’s health care regulatory body that oversees insurance rates and hospital budgets, announced the rate approval Thursday. BCBSVT requested the 12.7 percent increase, citing rising medical and pharmaceutical costs, increased utilization of medical services, an aging population and mandated changes to federal law as, the reasons behind the rate hike. After an analysis of the review, however, the board unanimously approved a lower rate increase for 2018 plans sold by BCBSVT on the state’s health insurance exchange. “As we issue our decision today, we are mindful of the uncertainties surrounding provisions of the Affordable Care Act, and the difficulties that many Vermonters —particularly those who do not qualify for premium assistance or cost-sharing reductions — face as health insurance premiums continue to rise faster than other economic indicators,” the board wrote in its order. Continue Reading →

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Blue Cross Blue Shield of Vermont seeks $10.3 million from state

MONTPELIER — Blue Cross Blue Shield of Vermont is seeking $10.3 million from the state for premiums and services it did not receive payment for as the insurer works to close out its 2016 book of business on the state’s health insurance exchange. It is the third year in a row since Vermont Health Connect launched that Blue Cross Blue Shield of Vermont and the state are undergoing a process known as reconciliation. The state paid $1.6 million to BCBS for the 2014 plan year and $3.5 million for the 2015 plan year. The reconciliation process is necessary because the state’s online insurance marketplace was not fully implemented when it launched and some technological elements did not function correctly, resulting in discrepancies within the billing and enrollment system of Vermont Health Connect. In some cases, consumers terminated their insurance plans but the change took months to take effect within the system. Continue Reading →

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Health insurers seek rate increases

MONTPELIER — Vermont’s largest health insurer is asking regulators to approve a double-digit increase in premiums as it deals with myriad cost pressures. Blue Cross Blue Shield of Vermont has filed its requested 2018 health insurance rates for plans sold on the state’s exchange with the Green Mountain Care Board, the state’s health regulatory body that reviews and approves health insurance rates as well as hospital budgets. The insurer, which covers about 70,000 Vermonters, is seeking an average rate increase of 12.7 percent. BCBS President and CEO Don George said the requested increase is based on the cost of health care services as well as policy decisions unrelated to care that the company does not control. Those outside pressures account for about 6 percent of the 12.7 percent increase, he said. Continue Reading →

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State to pay Blue Cross $3.5 million to settle billing discrepancies

MONTPELIER — State officials have agreed to pay Blue Cross Blue Shield of Vermont $3.5 million to close out the insurer’s line of business through the state’s online insurance marketplace in 2015. The additional payment to Blue Cross comes after a months-long reconciliation process that was required to help settle discrepancies within the billing and enrollment system of Vermont Health Connect, the state’s online health insurance exchange set up through the federal Affordable Care Act. The agreement between the state and Blue Cross was finalized late last year by the administration of former Democratic Gov. Peter Shumlin, who left office last week as Republican Gov. Phil Scott was sworn in. Cory Gustafson, Scott’s Department of Vermont Health Access commissioner, confirmed the $3.5 million settlement Thursday. Gustafson worked as the director of government and public relations for Blue Cross at the time of the settlement before being tapped to served in Scott’s administration. Continue Reading →

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Blue Cross Blue Shield: Vermont Health Connect owes $6.2 million

MONTPELIER — Blue Cross Blue Shield of Vermont is seeking $6.2 million from the state for premiums the insurer did not receive and claims it paid out after the state had terminated individual insurance plans, according to the company and state officials. BCBS and the state are engaged in a reconciliation process to settle the books for health insurance plans sold on Vermont Health Connect, the state’s online health insurance exchange, during 2015. It is the second year that reconciliation is taking place. The state paid $1.6 million to settle the book of business in 2014. A public records request made by the Vermont Press Bureau seeking documents related to the 2015 reconciliation process was returned by the Department of Vermont Health Access, but all 125 pages had all relevant information related to the request redacted. Continue Reading →

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Blue Cross seeks millions from Vermont Health Connect

MONTPELIER — Blue Cross Blue Shield of Vermont believes it is owed more than $5 million from Vermont Health Connect for unpaid insurance premiums and claims paid on plans that were terminated by the state in 2015. The insurance carrier is going through a reconciliation process with the state for the second straight year to settle its books for plans it sold through the state’s online health insurance marketplace. For plans sold in 2014, the state paid BCBS $1.6 million after the reconciliation process was complete. BCBS told state officials last month that it believes as much as $3.8 million is owed for unpaid premiums in 2015. Additionally, another $2.3 million is owed on claims it paid out for plans that were terminated by the state but not communicated to the company, according to Cory Gustafson, director of government and public relations at BCBS. Continue Reading →

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Rate increases sought by BCBS and MVP

MONTPELIER — The state’s two health insurance providers offering individual and business plans on Vermont Health Connect have submitted requested rate increases to the state for next year. Blue Cross Blue Shield of Vermont and has requested an 8.4 percent increase in rates, while MVP Health Care is asking for a 3 percent average rate increase, according to the Green Mountain Health Care Board, the state’s regulatory body for health care issues. In its filing with the GMCB, BCBS said state and federal mandates are a significant reason for the rate increases for its federally qualified health plans, as well as rising medical and pharmaceutical costs. “In the absence of mandated changes associated with the Affordable Care Act, a 5.3 percent increase would have been requested,” BCBS wrote in its filing. Actual rate increases, depending on health plans, range between 4.7 percent and 14.3 percent for BCBS. Continue Reading →

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