Vermont has cut ties with the vendor of their health insurance exchange, CGI, after continued complaints and errors with the online portal. Vermont Health Connect will transfer control of their state-run exchange to Optum over the next two months.

CGI also constructed the federal health exchange and Massachusetts’s state-run portal; both the Bay State and federally run fired CGI for similar problems earlier this year. Vermont has spent more than $70 million on their exchange.

The shift to a new vendor comes as part of a "new management structure to ease frustrations for Vermonters affected by the change of circumstance issue," according to a press release from the administration of Gov. Peter Shumlin.

Among the plagues to Vermont Health Connect, individuals who lost coverage or moved to Vermont after the April 1, 2014 open enrollment deadline cannot enroll in a plan through the online platform, a hiccup that must be corrected manually on the back-end by Health Connect officials. Both individuals and navigators continue to have difficulties logging into the website. 

The website was not up and running until October 2013, which delayed open enrollment, and was never fully functional even into the summer of 2014. The system was able to enroll individuals starting in January, but couldn’t handle enrolling small groups, most of which had to wait until April 1, 2014 to enroll their participants.

“The debacle of the website in Vermont with CGI is similar to what was experienced elsewhere, but we’re still experiencing it, and the fact is that because brokers were taken out of the loop, lots of people were significantly impacted because they no longer had somebody that they could work with who knew what was going on," says Scott Baldwin, president of Vermont Brokerage Services.

Brokers ‘out of the picture’

While the state exchange did train navigators to guide individuals and small groups under 50 lives into plans, they often didn’t have the expertise that longtime brokers and benefit advisers did.   

In most cases, the state navigators did not have to be licensed and went through basic training. According to one broker who went through the navigator training, Sandra Anderson, the training was very basic — the first day covered generic terms such as what a deductible was. And because the website was not fully functional during her August training, they couldn’t practice interacting with the portal until later that fall.  

Anderson has received many calls from frustrated users who did not receive the guidance they needed from state navigators. She believes that these users will still need the help of experienced brokers in the next few years to explain this confusing system, but beyond that, the role of benefit advisers within the exchanges is unclear.

“They basically took brokers out of the picture,” says Baldwin of the Essex-based brokerage firm, about the new Vermont Health Connect, which under state law only allows for those small groups to seek coverage through an exchange, not through private brokers. He adds that he’s “not optimistic that brokers will be included” in the future even under a new vendor because the state legislature is now trying to open the exchanges to small groups up to 100 lives, which would exclude them from seeking coverage outside the exchange.

Small brokers like Vermont Brokerage Services, which previously had 60% of their medical book consisting of small groups with under 50 lives, will need to “reinvent ourselves” to stay in business, he adds. 

“The small company that needs help and direction won’t be able to get it because brokers have been locked out. A lot of brokers won’t be servicing the people that need it the most,” says Baldwin. Many of their clients don’t have HR directors and needed their broker for other guidance beyond health care, but now that won’t be financially feasible without the medical piece of the pie.

“This new company can’t make it any worse,” says Anderson about Vermont’s decision to switch vendors. “I’m hoping that the new system will be more updated. [CGI] got paid a lot more money than what we received for their services."

Only last month, according to Baldwin, many people didn’t receive bills if their zip code began with a zero. Problems like these are likely why the state decided to finally switch vendors. 

Linda Odorisio, a spokesperson for CGI, provided the following statement: "CGI is proud of the role it played in helping 85% of eligible Vermonters enroll in a health plan via Vermont Health Connect. With a majority of our exchange development work complete, we look forward to providing ongoing hosting services in Vermont for one of the country’s most successful health insurance exchanges."

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