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By Julie Edgar
WebMD Health News
Reviewed by Katherine Swartz, PhD
July 12, 2013 -- Vermonters can expect to pay slightly lower premiums than those initially proposed by the two insurance carriers approved to sell plans on the state's new health insurance Marketplace, called Vermont Health Connect.
The Green Mountain Care Board -- the regulatory authority for insurance and hospital rates in Vermont -- announced this week that it negotiated 4.3% to 5.3% rate cuts in individual and small-group plans offered by Blue Cross Blue Shield of Vermont and MVP Health Care. The rates go into effect Jan. 1.
Vermont approved six "metal" plans in its health insurance Marketplace, also called an Exchange. There are two bronze, two silver, one gold, and one platinum plan, each with different combinations of copayments, coinsurance rates, and limits on annual out-of-pocket spending.
Every plan must cover the same services, but the companies pay a bigger share of costs going from the bronze to platinum. Bronze plans pay about 60% of the average person's health costs. Silver plans pay 70%, gold plans 80%, and platinum plans 90%. Customers pay the remaining costs. (For example, customers pay 40% of the costs under a bronze plan.) Bronze plans have the lowest premiums, while the platinum plans have the highest.
In Vermont, final rates for mid-range silver plans are from $395 (BCBS) to $410 (MVP) per month for a single person. Family plans range from $1,111 (BCBS) to $1,151 (MVP) per month. About 100,000 state residents are expected to buy insurance through Vermont Health Connect.
Lower-income Vermonters can expect to pay 0.5% to 8% of their income on health insurance premiums, according to Robin Lunge, Vermont's director of health care reform. Financial aid in the form of state subsidies and federal tax credits are available to ease the financial burden for about 49,500 residents.
Under the Affordable Care Act, signed into law in 2010, each state must have a health insurance Marketplace in place by Oct. 1 for coverage starting Jan. 1, 2014. Most Americans will be required to have health insurance starting Jan. 1. Vermont is one of 17 states, along with the District of Columbia, that will run its own Marketplace.
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