- Associated Press - Monday, June 1, 2015

WINOOSKI, Vt. (AP) - Gov. Peter Shumlin and other officials on Monday announced the successful completion of a crucial software upgrade for the troubled Vermont Health Connect insurance exchange.

But they cautioned that though the new software tools are in place, it may take some time before many consumers see the benefits, as staff work to clear a backlog of more than 10,000 people seeking coverage changes due to life changes like marriage or divorce, a new child or a new job.

And while the average time to process such a change in circumstance is expected to drop from two hours to 10 minutes, it’s likely to be fall before most consumers will be able to make account changes from Vermont Health Connect’s website, without staff assistance.

“We still have work to do to ensure the Vermont Health Connect system supports the level of customer service that Vermonters deserve, but today’s successful deployment is a major step in the right direction,” Shumlin said. He thanked the Vermont Health Connect team for working long days and weekends.

Shumlin again acknowledged the frustrations many people have encountered while trying to sign up for health insurance under the state system set up in keeping with the federal Affordable Care Act. Shumlin in March set a May 31 deadline for the state and its principal contractor, Optum, to get the change-in-circumstance software working, with a second deadline of having the backlog cleared and smooth functioning by Oct. 1.

Failing to meet those deadlines would force the state to consider joining the federal health exchange or a federal-state hybrid, creating a new round of multimillion-dollar expenses and disruptions, something officials made clear they wanted to avoid.

Shumlin and Lawrence Miller, the state’s director of health care reform, said getting the change-of-circumstance function to work properly has been the toughest hurdle for the system to date. Until now, staff have been required to manually enter data related to such changes in up to six different computer systems, including Vermont Health Connect, the private insurers who pay health claims, the state Medicaid system and a private company that handles claims processing. The process has been labor-intensive and prone to error, officials said.

The software installed during the weekend will enable the systems to communicate with one another, meaning data can be entered just once.

The milestone does not end all of Vermont Health Connect’s problems. It still is unable to enroll businesses, as originally envisioned and required by federal law. The state has received extensions of the deadline to meet that goal, and will push to have it dropped, because a work-around of having businesses deal directly with the private insurance carriers is working well, the governor said.

Because of what has been an often spotty information flow from Vermont Health Connect to private insurers, Blue Cross Blue Shield of Vermont still is owed more than $1 million for claims it paid for people whose Vermont Health Connect accounts had been discontinued and Blue Cross had not been informed, said the company’s president and CEO, Don George, who appeared at Monday’s news conference.

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