The Center for Consumer Information & Insurance Oversight
Vermont Health Insurance Marketplace Grants Awards List
Vermont has received six grant awards to build its Health Insurance Marketplace - Opens in a new window . This includes a Planning Grant, an Early Innovator Grant, three Level One Establishment Grants, and a Level Two Establishment Grant.
Summaries of Vermont's applications for each grant are provided below:
Establishment Grant Level Two Application Summary
Administrator: Department of Vermont Health Access (DVHA)
Award Amount: $104,178,965
Award Date: August 23, 2012
Application Due Date: June 29, 2012
Supplement Amount: $16,762,448 (December 18, 2013)
Level of Funding: Level Two
Summary: Vermont is receiving a Level Two Establishment grant to complete the projects necessary to meet the Exchange certification requirements and to ensure that the Exchange is ready to begin operations in October 2013. Act 48 established the Exchange in the Department of Vermont Health Access (DVHA), the agency responsible for the management of Vermont's publicly funded health insurance programs. This funding will primarily be used to develop the IT systems to facilitate the critical functions of the Exchange, and ensure operability with other State health care systems built as part of the greater eligibility modernization project. The development of these systems, and the associated business processes, will be supported by additional staff hired to assist the Exchange in meeting federal deadlines. Other specific projects that would be implemented include an outreach and training strategy, an organizational structure review to ensure a 21st century enrollment experience for consumers, and a comprehensive Exchange evaluation plan.
Administrative Supplement Award Amount: $16,762,448 (December 18, 2013)
Summary: Vermont will use the level two grant supplement to support work on the marketplace IT system and associated staff resources. The additional work on the Vermont Health Connect IT system comprises of both functional and non-functional requirements, reporting capabilities, and improvements to the security infrastructure.
Establishment Grant Level One Application Summary
Grantee of Record: Human Services, Agency of Vermont
Amount Awarded: $4,078,800
Award Date: December 22, 2014
Application Due Date: November 14, 2014
Level of Funding: Level One
The State of Vermont received funding: to complete additional SHOP/small business IT functionality; to augment contractual staff to support IT requirements; and for Project Manager and Business Analyst support.
Administrator: Vermont Agency of Human Services
Award Amount: $18,090,369; $2,167,747; $42,687,000
Award Date: November 29, 2011; January 17, 2013; July 9, 2013
Administrative Supplement Award Amount: $4,517,000 (January 29, 2013)
Application Due Date: September 30, 2011; November 15, 2012; May 15, 2013
Supplement Amount: $4,517,000 (January 29, 2013)
Supplement Amount: $5,741,223 (December 9, 2014)
Supplement Amount: $494,990 (December 17, 2014)
Level of Funding: Level One
Summary: Vermont will use Level One funding to further its planning, development, and design of the Vermont Health Benefits Exchange (Exchange). Funding will support further development or continuance of a number of activities that Vermont initiated during its Planning Grant phase, including stakeholder engagement, program integration, financial management, health insurance market reforms, business operations, and the development of an information technology platform that collects and manages information in a streamlined process across various state and federal agencies. Vermont will also use funds to support a number of staff positions for the Exchange and its sister agencies to ensure that Exchange implementation activities and coordination work move forward as planned. Funding for implementing Vermont's health insurance exchange platform is also included. Vermont intends to continue moving forward in the design of an Exchange that will provide interoperability with other government health care programs in the State, and a platform for the evolution of the single-payer health care system envisioned in Vermont statute.
Vermont will use its second Level One Establishment grant to implement and operate an In-Person Assister program. Vermont's In-Person Assister program will ensure that all Vermonters have access to enrollment assistance when seeking coverage on the marketplace (Exchange), especially for those who may be selecting an insurance plan for the first time. This program will operate as a complement to the Navigator program.
Vermont’s third Level One award will support the design, development, and implementation of the Marketplace portion of fully integrating Medicaid and CHIP into Vermont’s new integrated Marketplace eligibility environment; consumer support center functionality; individual and SHOP premium processing; a third-party administrator for Vermont’s SHOP employer assistance program; and additional staffing and technological resources needed to ensure operational readiness on October 1, 2013.
Administrative Supplement Award Amount: $4,517,000 (January 29, 2013)
Summary: Vermont will use its supplemental funding to cover additional costs related to the Exchange IT System, Financial Management, All Payer Rate Setting, Outreach and Education, and Staff Augmentation. With this funding, Vermont will hire a contractor to analyze and finalize cost estimates for Vermont’s sustainability model. Under the initial grant funds, Vermont was able to begin to examine methodologies for implementing all-payer rates within the Exchange. Vermont will use the additional funding to complete the development of these methodologies and coordinate payments within and outside the Exchange. The state will also implement cost containment pilot projects statewide to improve the viability of the Exchange and the affordability of the products offered. Vermont will also complete development of an informational website to educate Vermonters on the ACA. A contractor is needed to provide recommendations and streamline content development. Vermont also needs additional staff resources to ensure projects initially described are properly designed, structured and planned to meet Exchange establishment guidelines.
Administrative Supplement Award Amount: $5,741,223 (December 9, 2014)
Summary: Vermont will use the level one grant supplement to enhance the marketplace’s consumer engagement efforts. Vermont will provide resources for salaries and benefits, equipment, supplies, facilities and other ancillary staff expenses, and staff augmentation for renewals and change of circumstance incidents.
Administrative Supplement Award Amount: $494,990 (December 17, 2014)
Summary: Vermont will use the level one grant supplement to enhance the marketplace’s consumer engagement efforts and general office expenses. Vermont will provide resources for salaries and benefits for support service specialists, supplies, printing and reproduction, professional development, office space, and telephones.
Early Innovator Grant
Grantee: University of Massachusetts Medical School
Award Amount: $35,591,333
Summary: This is a multi-state consortia proposal led by the University of Massachusetts Medical School and will benefit individuals and small businesses in Connecticut, Maine, Massachusetts, Rhode Island, and Vermont. These consumers will be able to shop for, select, and purchase affordable and high-quality health plans consistent with national reform goals for 2014. The proposed project approach will be to create and build a flexible Exchange information technology framework in Massachusetts and share those products with other New England states. The proposal hopes to learn from the Massachusetts Exchange implementation and gain efficiencies so it can accelerate Exchange development for participating New England states.
State Planning Grant
Awarded September 30, 2010
Administrator: Vermont Department of Human Services
Amount Awarded: $1,000,000
- Analyze the current insurance market to determine the quality and type of health insurance coverage, the appropriate regulatory environment for implementing the Exchange, and the potential impacts on the market of various options.
- Assess various Exchange organizational models and the policy and fiscal implications of each, as well as resources needed to operate the Exchange
- Model potential funding mechanisms to achieve Exchange sustainability.
- Develop proposed legislation for the 2011 and 2012 sessions.
- November 5, 2019 FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities
- November 1, 2019 Enhanced Direct Enrollment Approved Partners (Updated)
- September 11, 2019 FAQ: Enhanced Direct Enrollment Participation Requirements for Non-Issuer of a Primary EDE Entity Environment
- August 15, 2019 Quality Rating Information Bulletin for Plan Year 2020 Health Insurance Exchanges Quality Rating System (QRS) for Plan Year (PY) 2019: Results at a Glance
- April 18, 2019 CMS-9926-F: Final HHS Notice of Benefit and Payment Parameters for 2020 Final 2020 Letter to Issuers on Federally-facilitated Exchanges Key Dates for Calendar Year 2019: QHP Certification in the FFEs; Rate Review; Risk Adjustment
- April 4, 2019 Guidance on Unified Rate Review Timeline: Timing of Submission of Rate Filing Justifications for the 2019 Filing Year for Single Risk Pool Coverage Effective on or after January 1, 2020
- March 19, 2019 2020 Final Actuarial Value Calculator 2020 Final Actuarial Value Calculator Methodology
- March 6, 2019 CMS-9921-NC: Request for Information Regarding the Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts
- February 28, 2019 Section 1332 Pass-through Funding Tools and Resources