Four representatives of Optum, the contractor working with the state to fix Vermont Health Connect, told legislative leaders Thursday that they expect to deliver an automated change-of-circumstance function as of the May 31 deadline set by the Shumlin administration.
"We are confident we will make the deadline," Matt Stearns, vice president of external communications, said in an interview after private sessions with legislators. "Testing is ongoing," he said, adding, "It is on track."
Since Vermont Health Connect launched in October 2013, corrections to policies have had to be made using a labor-intensive manual process. That led to backlogs that grew to 14,000 accounts by last summer. The Shumlin administration fired its first contractor — CGI — because of its failure to deliver promised functions such as the automated change of circumstance. Optum was hired to replace CGI. It first attacked the backlog and then turned its attention to creation of the change-of-circumstance function.
Gov. Peter Shumlin put pressure on Optum in March, saying that if the new contractor couldn't deliver a working change-of-circumstance function by the end of May, it would be time to consider abandoning the state exchange and moving its customers to the federal exchange.
If Optum meets the deadline, Stearns said, the function would be available only to staff at the state's health insurance marketplace, not to the public. That has long been the plan. Insurance customers would still need to call Vermont Health Connect to request changes in their accounts. Changes might be as simple as new address, or could involve changes in income that affect eligibility for federal tax credits and state subsidies.
House Speaker Shap Smith confirmed he met with the Optum group. "They said what I would have expected them to say. They didn't go into any detail," he said.
"The legislature wanted more direct information so we asked Optum to make themselves available to the legislature a couple of times," said Lawrence Miller, chief of health reform for the Shumlin administration.
Miller said he didn't attend the legislative briefings, preferring to let lawmakers quiz Optum officials on their own. "I talk to them all the time."