Eligibility and Enrollment

• Eligibility Thresholds -  income limits to qualify for public plans and financial help
• Exceptional Circumstances Special Enrollment Period (SEP) Guidance
• Billing, Dunning, Grace Period Policy & Assumptions (updated September, 2017)
• Billing and Enrollment Timeline - describes VHC's policies and processes for billing of initial and ongoing enrollment (update November 2015)
• Transferring Plan Administration to a QHP Issuer - explains direct enrollment outside of open or special enrollment
• Special Enrollment Periods (SEPs) and Plan Administration Transfer for Individual Reflective Silver Plan Enrollees
• Open Enrollment and Qualified Health Plan Renewals for 2021  –  plan for Open Enrollment 2021
   

Plan Management

• Non-Standard QHP Design Approval Process
• Non-Standard QHP Approval Criteria
• 2021 Qualified Health Plan Certification Timeline - describes the timeline for certification of QHPs for 2021
• Cost Sharing Reduction Calculation Formula

Rules

• Health Benefits Eligibility and Enrollment Rule - the administrative rule governing Vermont Health Connect (also see archive at ESD Rules page)
• Public Charge and Immigration – What You Should Know

Reports

• Reports to the Vermont Legislature - this link directs to the Agency of Administration's Health Care Reform Resource Library

• AHS Reinsurance Paper - preliminary exploration of state-based reinsurance for Vermont

Evaluation

• 2019
  • 2019 VHC - Final CMS Report
  • Vermont Health Insurance Exchange Audit Report
  • VHC 2019 SMART Corrective Action Plan

   

  2018

  • Final FS VT HIX 2018
  • Vermont Health Connect CMS report_06-30-18
  • VHC 2018 SMART Corrective Action Final Plan 1June2019
     
• 2017 
  • 2017 CMS Audit Report - 2017 CMS Independent External Audit Report, Vermont intended corrective action plan. Statement of Appropriations and Expenditures
  • 2017 CMS Audit Report - 2017 CMS Independent External Audit Report, Vermont intended corrective action plan. Statement of Appropriations and Expenditures
     
• 2016
  • 2016 CMS Audit Report - 2016 CMS Independent External Audit Report, Vermont intended corrective action plan. 
     
• 2015
  • 2015 CMS Audit Report - Vermont executive summary, 2015 CMS Audit Report, Vermont intended corrective action plan.
  • 2015 Customer Experience Evaluation - reports from a project by the UMass Medical Center to evaluate customer experience
     
• 2014
  • 2014 CMS Audit Report - an independent compliance audit whose scope covered VHC policies, processes and controls related to implementation
  • 2014 Audit Findings Report - the Vermont Intended Corrective Action Plan to the 2014 CMS Audit Report

Questions about these documents? Email us at AHS.VTHealthConnect@vermont.gov