Tag Archives: Blue Cross Blue Shield of Vermont

The Curious Case of the Single Intolerable Word

Gather ’round, children, and you shall hear… how Vermont’s biggest health insurer has gotten its knickers in a twist about one single word in a Green Mountain Care Board decision. The word was so objectionable that Blue Cross Blue Shield of Vermont appealed the decision solely because of that word. It did not object to any other part of the ruling.

When the appeal was denied BCBSVT took the case to the Vermont Supreme Court, where it awaits action. Seems like a whole lot of time, trouble and billable hours for a single word, but what do I know.

Let’s go back to the beginning. On May 7, Blue Cross Blue Shield of Vermont filed a request for 2022 insurance rates with the Green Mountain Care Board. The Blues asked for a 7.9% increase on individual policies, and smaller increases for group plans.

The request meandered through a lengthy series of briefs, filings, hearings and testimony. (All can be downloaded from this webpage.) On August 5, the GMCB issued its decision, knocking down the rate hike on individual policies to 4.7%. In its decision, the GMCB characterized the 7.9% request as “excessive.”

There. That’s the fatally toxic word. ‘Excessive.”

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Just what we needed: More bad news on Vermont Health Connect

The headline says it all, thanks to Erin Mansfield of VTDigger:

VERMONT HEALTH CONNECT IS GOING BACKWARD, STAKEHOLDERS SAY

The “stakeholders” are Blue Cross Blue Shield of Vermont and Vermont Legal Aid, an unlikely pairing to be sure. BCBS is calling for an independent review of the troubled health care exchange, and Legal Aid is fielding scores of complaints from “frustrated consumers.”

“We’re going backwards,” said Trinka Kerr, the chief health care advocate for Vermont Legal Aid. “Towards the end of last year, we were making progress. You could get things straightened out relatively quickly, and now things are more complicated than they used to be.”

Some of Governor Shumlin’s high-profile declarations of victory are now looking inoperative. The “change of circumstance” function, which was supposed to be a benchmark for VHC, had to be taken off line because it simply wasn’t ready to handle the workload. And as a result, the backlog is back!

Yes, VHC has a backlog of change orders numbering about 4,000. To put that number in perspective, VHC has a total of 33,000 customers who buy individual policies through the website.

Now, I stopped being good at math in about the seventh grade, but to me that looks like the backlog amounts to 12 percent of all customers served. Which is, in a word, dreadful.

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