Technological snafus with the online state exchange Vermont Health Connect have resulted in millions of dollars of premiums being left on the books of insurance companies for which insurers have not received payment.
According to a report in Times Argus, Governor Peter Shumlin and Lawrence Miller, chief of healthcare reform, have been working to reconcile these billing discrepancies for roughly three weeks.
Now, Blue Cross Blue Shield and MVP Healthcare are waiting for state employees to process the paperwork manually to determine if they really are owed money for the unpaid premiums. Due to the glitches on the site, the two carriers were told they should stop billing customers.
No one has reported how much money is at stake, but Miller did suggest Blue Cross Blue Shield thought it may be as high as $4 million.
“I hesitate to quantify it until they’ve actually gone through the work,” he told the news outlet. “It represents maximum exposure because if there are claims in there where people are covered and they do actually owe money, then we’ll go ahead and work with them to collect that.”
Also at issue is payments received by healthcare benefits administration firm Benaissance, which the state has contracted with to process premium payments. Miller says “a few hundred checks” have been sent in by customers, though without enough information to credit the payments to a specific account.
Vermont says at least 70% of the disputed premium losses have already been resolved and were discovered to have been the result of customers’ terminating their policies without the state exchange notifying carriers. If that percentage holds true, the two carriers still stand to be owed a large amount of money.
Blue Cross Blue Shield, which sells more plans in Vermont, stands to gain more from the snafu than MVP. MVP is said to have canceled policies freely on its own books to avoid risk, while BCBS has a policy of keeping plans on their books rather than run the risk of canceling them by mistake.
Vermont Health Connect has been experiencing automation issues since its launch in October 2013. Miller says the focus instead has been on enrolling people in plans and helping them retain coverage.
“They were not necessarily processing terminations or cancellations as a very high priority,” said Miller.
