QHP INDIVIDUAL COVERAGE BY METAL LEVELINDIVIDUALS ENROLLED IN QUALIFIED HEALTH PLANS (QHP) OR MEDICAID FOR CHILDREN AND ADULTS (MCA)

DECEMBER 2014

250,000

200,000

150,000

100,000

50,000

0

ENRO

LLM

ENT

MCA - AdultQHP - IndividualQHP - Small Business

Note: E� ectuated enrollments for QHP as reported by insurers to VHC. Medicaid for Children and Adults (MCA) as reported by Vermont Health Connect and Vermont’s legacy ACCESS system. MCA includes Dr. Dynasaur and CHIP but does not include Medicaid for the Aged, Blind, and Disabled (MABD).

COVERED VERMONTERS

VERMONT HEALTH CONNECT DECEMBER 2015 DASHBOARD

DEMOGRAPHICS

45-54

35-44

55-64

> 64

26-34

18-25

< 18

AGE

WHO IS COVERED BY QUALIFIED HEALTH PLANS?

Individual QHP Population by County30%

25%

20%

15%

10%

5%

0%

Addison

Bennington

Caledonia

Chittenden

Essex

Franklin

Grand Isle

Lamoille

Orange

OrleansRutlan

d

Washington

WindhamWindsor

7%7%

24%

1%1%4%4%4%4% 5%

9%9%9% 10%

9%6%

37%

22%

11%

13%

WEBSITE AVAILABILITY* IN DECEMBER 2015:

99.99%

ONLINE BY PHONE

57% of calls answered in under 30 seconds, compared to 55%

in November.

CALLS ANSWERED

(Up from28,605 in

November.)

CUSTOMER SUPPORT

< 1818-25

26-34

35-44

45-54

55-64

(was 99.17% in October)

87% OF CALLS

ADDRESSED BY INITIAL

REPRESENTATION(NO TRANSFER).

29,928

37,749

61,522

69,052

MCA - Child

*Percentage of time web portal was up and running outside of scheduled maintenance period.

56%

12%

11%20%

1% Catastrophic

Platinum

Gold

Bronze

SilverDECEMBER 2015

(Down from 89%in November.)

29,847

81,268

64,276

38,198

Published 2/1/2016

1% > 64

IN PERSON

DECEMBER 2015NAVIGATOR

CONSULTATIONS*

2,293 *Unique interactions with individuals lasting at least 10 minutes, including those that result in an application

and follow-ups for health coverage.

33,416

FINANCIAL HELP

WHO’S RECEIVING FINANCIAL HELP TO PURCHASE A QHP AND WHAT ARE THEY PAYING FOR HEALTH CARE?

*The BCBSVT Standard Silver Plan is the most common plan. **Note: There are four tiers of cost-sharing reductions. Depending on income, an individual in a Standard Silver CSR plan could have a deductible

between $100 and $1,900 and a maximum out-of-pocket between $500 and $4,000. The median CSR customer is in a Silver 87 plan detailed above.

POSSIBLE TOTAL COSTS (PREMIUM & OUT-OF-POCKET)

Typical (median) individual receiving Cost-Sharing Reductions**

Income: $21,500 Plan Type: BCBSVT Standard Silver 87 Plan

ELIGIBLE FOR:• Advanced Premium Tax Credits• Vermont Premium Assistance• Cost-Sharing Reductions

37%

NOT ELIGIBLE FOR: Financial Help

11%ELIGIBLE FOR:

Advanced Premium Tax Credits Only

INCOME

INDIVIDUAL

< $35,010

FAMILY OF FOUR

< $71,550

INCOME

INDIVIDUAL

> $46,680

FAMILY OF FOUR

> $95,400

PLAN SELECTION AMONG INDIVIDUALS

ELIGIBLE FOR COST-SHARING REDUCTION

PLAN SELECTION AMONG INDIVIDUALS

NOT-ELIGIBLE FORCOST-SHARING REDUCTIONS

35%

23%

16%

25%

1%

PREMIUM

MONTHLY PREMIUM FOR MOST COMMON SILVER PLAN*

$466$120

67%

8%

18%

Catastrophic

Platinum

Gold

Bronze

Silver

Gold

Bronze

Silver

Platinum7%PLAN SELECTION PLAN SELECTION

FULL PRICEPremium: $466 Deductible: $1,900

Maximum Out-of-Pocket: $5,100

AFTER SUBSIDYPremium: $104 Deductible: $600

Maximum Out-of-Pocket: $1,250

vs.

67%

< 300% Federal Poverty Level > 400% Federal Poverty Level

(after subsidy)

300% - 400% Federal Poverty Level

52%of enrolled individuals 37%

of enrolled individuals

of enrolled individuals

(full price)

Median:

68%of new enrollments

62%of re-enrollments

QHP INDIVIDUALS RECEIVING FINANCIAL HELP