glad that you're here tonight thank you appreciate it our hope is that we can cover some information tonight about the health care reform activities that are occurring this fall and hopefully help provide some information that will be helpful to you in making choices that fit best for you and your budgets going forward there's a bathrooms in the back there's some snacks and food i have some coworkers with me if you want any materials or to sign up we're being recorded i think for public access t v so if you fascinate me so one thing that there is a request if you have questions i welcome them at any time stopping whenever you'd like to ask a question and will i will try to repeat them so that the you records them this isn't a microphone that will make me louder so if you don't hear me also please let me know and i am happy to speak up here ok great i'm going to work on that so i want to talk a little bit about our state health care reform goals and then talk about where the work that we're doing this year fit into that so we talked about our goals as being in four areas we want to make sure that for minors can reduce their health care costs and cost growth so right now to provide care to all the monitors both public and  private individual contributions employer contributions the whole package cost five billion dollars it's about five years ago is four billion dollars it's projected within the next four to five years to be six billion dollars put that into context the entire public education system in vermont costs a billion dollars so every four or five years our health care system is consuming the entire cost of our public education not to provide new and shiny your bigger things but really just to continue to provide the same care that vermonters enjoy today so one of our goals is clearly to help reduce that growth in the cost of health care that we're committed to assuring that have access to and coverage for high quality health care we're lucky in vermont to be able to have many many vermonters covered today we have about ninety three percent of remo who have some form of health coverage public or private today that in contrast i will pick on texas only once tonight i think twenty five percent of texans have no coverage today so if you think about your neighbors one in four of your neighbors if you were in texas would have no coverage at all compared during for months where ninety three percent of us have coverage our goal is to make sure that every vermonter has coverage and so that is part of what we're striving for as well we also want to improve the health of vermonters we don't want foreigners just to be covered but we want to actually improve their health there's an important connection between improving the health of reminders and reducing our costs as well and there's also a connection between controlling the cost and providing access to everybody so those to reap components really fit together  we also as the fourth piece want to assure greater fairness and equity in how we finance health care so if we think about the five billion dollars and where it comes from today some of it comes from our taxes some of it comes from our contributions to premiums to insurance companies some of it comes from our employers contribution to our coverage some of it is when we go to the doctor we pay a co pay or deductible there's all sorts of ways in which that money is raised today some of it really we started from scratch and the proposal was to do it we were doing today i think we would realize that some of it is just crazy making so you have some employers that provide coverage to their employees and their families so that they can cover the employees of other employers that don't provide coverage we know that schools large employers frequently cover not just their employees but many other for minors because they're known to have good coverage we have some employers that actually provide an incentive for their employees to sign up for somebody else's plan all of that creates a very we would argue unfair and in an equitable way that we produce five billion dollars to pay for vermonters care and we think that that we can make that system better and in doing so create is a more simple system where we don't pay so much for the complexity of what we do so that's our four goals that's what we're trying to accomplish in the long run when we talk about health reform we talk about it in three steps the first one is where we are today and frankly that's from decades in vermont are working on health reform if you go back for the past twenty years or so for mont institute or dr dinosaur which was coverage for kids v happened catamount which was expanded coverage for adults and we've done things with the insurance market to make sure that the monitor couldn't be denied coverage to make sure that the coverage included important services that vermonters enjoyed today so we've done a lot to get to where we are today then in twenty fourteen the affordable care act the federal health care reform starts and there are a number of components it will cut will go through in a moment that happened in tw are designed to make it easier to access health coverage options and to receive financial help to pay for them it does not get us all the way to our four goals really first i'm sorry about that and unfortunately you've missed the most exciting part of melbourne and asia as a whole big magic trick and there was fire and smoke and my boss actually probably called me from the outside three times a training over there for those who don't know that this is douglas seen as secretary of the agency of human services so welcome everybody i'm going to quickly go back my name is mark larson i'm commissioner of the department of health access my department is responsible for a lot of the health reform activities that are going on my goal tonight is surprising information about them and help answer your questions we've talked a little bit about vermont's for health care reform goals controlling universal coverage improving the health of our monitors and making the way we pay for health care more fair and equitable as then talking about how there are three separate phases to our health reform efforts where we are today the implementation in two thousand and fourteen of the federal health care law which will talk a lot about tonight and then in the in twenty seventeen the proposal to provide a universal publicly financed health coverage to every vermont resident which is not connected to employment where people would be covered regardless of their income their health status their age i'm not going to talk a whole bunch about that tonight because what we really want to focus on is helping vermonters have information to prepare for what's happening in two thousand and fourteen but i'm happy to take your questions about it sure so in this context we're time that we could controlling the cost of health care and saying that right now today it cost a little over five billion dollars to provide health care to all vermonters public and private employer sponsored privately paid for about five years ago it was four billion dollars within the next five years it's six billion dollars and the point i often make is that if we think about a billion dollars in context our entire public education system k through twelve is just over a billion dollars so about every five years our health care system consumes the entire budget of our public education system to continue to provide the same kind of coverage that people have today not to offer a billion dollars of new stuff but just to continue to do what we do today if we don't do something about that  the health and coverage of vermonters so tonight we're going to talk a lot about vermont health care act it might be important to know a little bit about the affordable care act and i like to describe it in as a story so folks in washington got together and they started talking about some things about private insurance that people don't like things like if you had a preexisting condition that you couldn't get coverage for it things like you couldn't keep your kids on your plan until they were old enough to have a job that might offer coverage for themselves things like if you had really expensive health care needs because of an injury an accident or illness that you could max out in your lifetime coverage and your insurance company could say sorry i we're just not going to pay anymore things like insurance companies being able to basically say no we don't want to cover you to be able to charge more for some individuals for the same plan that they charge for other individuals so there are a bunch of these things that folks said you know for consumer protection we can't do those things anymore and then the insurance companies came along and they said well ok let's say that we don't do those things unless you do something about it what people are going to do is they're going to wait till they're sick to sign up because if we can't tell them no what's to make them stop not paying us until they're sick and then we have to pay for them and then we go broke people thought well that's not a good thing so there was this notion of shared risk and shared benefit which became what's known as the individual mandate everybody has a responsibility  shared responsibility to have coverage that was the thing that went always print court the supreme court decided that it was constitutional and it stayed in place so then folks came along is that ok wait a minute if i have to buy coverage you better make it good and you better make it affordable and easy to access and so the law included a tax credit to help people pay for their premiums if they're not getting coverage at work it provided response requirements for what has to be covered and it included these marketplaces or exchanges to make it easier to compare plans and purchase coverage and together that became the package called the affordable care act obviously became a little bit controversial along the way  but it is the law and what we are focused on today is trying to implement that for this fall for twenty fourteen folks who came in late didn't hear me give you permission to at any point stop me with a question so right now we're three insurance companies yet we have blue cross we have m v p and we have cigna today yep today those three options will be there next year as well cigna does not provide coverage to small group and individual market and they're not proposing to next that you know when you're looking at them that there is there really similar products that you can compare to then enroll in a health plan in real time  and have your transaction process so that you go from picking a plan to getting a card very conveniently and to be able to secure financial assistance to help pay for care web based marketplace where a bunch of different products are available you can compare them easily based on a bunch of different factors that are important to you you can then press click and purchase one and that transaction is then processed for you if you think about it amazon or all use if you think about travelocity or any other website that does travel expedient doesn't own any planes right they're not going to pick you up in their plane and take you where you want to go they work with folks who have planes they put the information on the web for you to compare them easily side by side and then they facilitate the financial transaction for you with the person who has the plane so that when you go you have received a ticket and you can get where you want to go same basic thing for health coverage  open in rome and october first for plans that start january first in order to have a card in hand on january first we will have to have you and roll and pay your first month's premium by i think it's december twentieth to be able to have your card in hand january first and so you can do that on october first and have it all and you can do it later but that's the window for plans to start january first now i've already forgotten your second the second after question on the web or if you access our call center of our hotline or meet with somebody person they'll walk through the financial help options to important to say that there's two different ways of using vermont  at it die there a way that employers can buy coverage for their employees in which case the financial help is from the employees the employer is contribution or if you're not getting it as an employee you can access the financial in the tax credits you can't get both you can't have your employer offer coverage and offer to contribute and then get the tax credit on top of that knutson either or and so in both situations vermont health connect will allow you to see either what your financial help is through the tax credit or what your financial help is through your employer's contribution as you're picking your plan so it will show you that the  premium for this plan would be x amount your financial help would be this amount your monthly premium would be the difference so it will show you that on the screen customer service center a call center to vermont based cost center for anybody who wants to call up and be able to talk through their options with somebody on the phone we also have a number of resources for people who can sit down with somebody and help in person that includes navigators who are folks who work for organ is vermont organizations that we've contracted with who have a history of working with either small businesses or individuals to access health coverage that are going to be available throughout the state to be sitting down with folks in the community we're also working with brokers who have a history of working with small businesses to help them access health coverage they'll be trained as well in vermont health connect so that they can help people as well primary different is that a navigator is free and a broker you would still pay for their services better part of it is that a lot of the stuff that you have to provide in enrolling today you have to send paperwork to that report has to get processed the goal is that the website actually does a lot of the transactions in real time so for example today people are applying for viagra they have to provide documentation of citizenship that can be a pain to somebody has to go and get the documents you can then roll in medicaid if you don't meet the eligibility requirements for that it will provide a private insurance plan that you're eligible for it will also sort through the question of are ineligible for financial help all of for coverage for kids dr dinosaur does not change medicare for folks who are sixty five or older and and or disabled doesn't change know that changes the happen catamount are going to change so many folks in v a have because the eligibility for medicaid is going to go higher so a lot of folks who are in very happy today are going to move to medicaid in twenty fourteen that's going to be a benefit for them because they're not going to have to pay a premium and they're going to get more coverage some will move to the private plans on vermont health connect with financial help catamounts most nine thousand of the eleven thousand folks on catamount will move to private plans with financial help through them on health connect about twenty two hundred will move to medicaid starting in the next month or so we're going to be reaching out to all fifty thousand are minors who are in those two programs to help them transition to where they'll end up in tw fourteen we'll do everything we can for folks particularly this group who are in the happy be moving to medicaid that we will do everything we can to move them without  real transition because they won't have a a big decision to make and to that that would be fairly easy other folks who are moving to the private plans will have to make a decision about which plan to pick a but that these folks are going to go through a transition and we're prepared to do the whole plan to reach out to them to know what their choices are yeah you do not  trade some people qualify that's right medicaid is just one planet in vermont we don't have multiple medicaid plans if you qualify for medicaid you're in the medicaid plan and there won't be these just it's so medicaid doesn't have the gold bronze platinum silver thing and we're going to talk about that for anybody who has no idea what that means medicaid stays like medicaid is today except that they'll be more people in the income level will be higher with some people who are above the income threshold for medicaid will still be able to spend down into medicaid that option doesn't go away the underlying easy one to explain his foster kids of qualify for medicaid but they're still going to qualify for medicaid regardless of their income that's that's just a benefit that is categorically offered to foster children and there are other examples of that those don't change so three different ways of getting support the coverage the private plans are standardized every private plan has to offer these ten different services very consistent with what people know in private insurance today in fact the difference is that it adds a few things primarily pediatric oral and vision care so dental and vision care for kids has to be included in all the plan now so when you compare private plan done vermont health connect and you're wondering you know why are they different they're not different because of what they cover you don't have to look at them and think well does this one include prescription drugs and does this one not they all include prescription drugs so they are all consistent that way it's under twenty two so twenty one and younger so what tends to differ today in terms of private plans is how much do i pay a premium compared to how much do i pay out of pocket through co pays deductibles and co insurance and so these funny things about metal levels are a way to try to describe the the range of options so a platinum plan generally ninety percent of the cost of the plan is going to be covered by your premium ten percent is going to be covered by copays deductibles or co insurance the other end of the spectrum bronze sixty percent is going to be covered by a premium forty percent could be covered by co pays and deductibles and co insurance different people have different likes and dislikes of these options so if i'm young and really really healthy and i never use any health services i'd rather have a lower premium and face the risk of if i as some day want to go to the doctor i might have a higher co pay are a higher deductible therefore they might be fine with that if i use a lot of health services and i know i'm going to use a lot of services i might prefer to have a higher premium but not pay so much in  to someone that would be the rest yeah so we're not going to decide for people what we're going to do is make it easier for you to compare and pick a plan that works for you e let me go a little bit further and will explain some of that i think and if i don't please remind me to come back to that point yes so whether you're getting coverage as an employee or you're getting coverage as an individual on your own the plant will be broken down by these same metal levels so if you want a higher premium lower out of pocket plan you'll be able to i'm going to cover some of the new expanded options that employers will have with this as well i want to comment that in the individual and small group market so folks who are buying insurance on their own or folks who are getting coverage through small employers today a lot of the plans are actually down here where there are even higher deductibles and co pays and people are  said is that all the plans in the individual small group market have to be at least bronze or better it it's not going to cover things like braces but it's going to cover things like regular cleanings and like cavities in fillings so sense yes you would not have to have a separate plan for your kids if you want supplemental coverage beyond that you still might be interested in it but generally in the  may go a few steps and then come back to that now i have two things that i have to member come back to me big trouble first i want to cover financial help so again the distinction if you get coverage through your employer and your employer is contributing to your coverage that's your financial help if you don't get it at work and you are purchasing as an individual you can access state and federal financial help to help pay for the premium it's based on your modified adjusted gross income which is a line on your federal tax reform your to federal tax form folks up to four hundred percent of federal poverty level qualify to pay based on as a percentage of their income what does that mean though here's some examples household of one four hundred percent of federal poverty level is about forty six thousand dollars so if you make forty six thousand dollars or less you would qualify for some form of financial help and or medicaid you know or medica household of four that would be ninety four thousand dollars for the household where you would be able to access financial help if you're buying coverage as an individual for your family so a lot of vermonters will be eligible for financial help again you would go on the website or you could do it over the phone you could also do it in paper still but let's talk about the website go on the website put your information i mark larson i have a host hold of three my income is forty five thousand dollars it's going to tell me you qualify for financial help and it would show me the price of the plan and the amount of financial help i qualify for and it would show me what my monthly premium would be as the difference to the first question would be do they qualify for medicaid is their income below the level of qualifying for medicaid if so they're going to qualify for medicaid they're not going to have premium if they're over that threshold then their financial help is going to kick in and their premium will be based on a percentage of their income based on where they fit with their calculation of their financial he tax you still get the the example you have so it doesn't matter how much you owe you don't have to it's not and it also can be applied monthly against your premium you don't have to wait til where it will count too late here's the plan that i picked here's the premium here's how much i qualify for a federal tax credit i am ras actually will send the financial help that you qualify for to the insurance company every month and you'll get the bill for the difference and at the end of the year the i r s will know how much financial help you hadn't already reconciled in your in for taxes all in real time you don't have to do any on a monthly basis you don't have to do anything else except pay for the premium that you get the bill for we never touch that i mean some people worry about from own health tonight getting our hands on your tax credit we never touch it it goes direct we communicate with b insurance company and the i r s and then the money goes directly from the i r s to the insurance company all through my health c yes so then you reconcile it at the end of the year where based on when you go and file next year's taxes you'll then have to calculate what was your modified adjusted gross income it will calculate how much did you draw down on a tax credit during the year if it's more than what you should have gotten you'll have to pay if it was less you'll get a refund it's all tied back to last year's tax return so the starting point is how many members of your family did you claim in your tax form last year and what was your modified adjusted gross income which is one of the lines of your tax form last year you can modify it during the year but say the you have a new child you can go in and update it for that new information if somebody gets married they can go and update it if their works yeah so last year's tax return somebody receives a significant capital gain to their income is high but then they don't have that income  so their income is lower if their financial help is determined based on last year's information they're not going to qualify for financial help you can go in and update the information to say that that's no longer accurate here is what i attest to now again if you're way off when you file next year's taxes it's going to get reconciled so you you want to try to keep it as up to date as possible you can modify it multiple times if let's take a seasonal work or a farmer who earns a lot of income at one time of year and then not a lot of another you can adjust it over the course of the year so that again your financial help that's helping with your premium is accurate as you go so that you're subject to less risk in terms of the reconciliation on your next year's taxes one out of pocket expenses so there's a lot of plans today that have no limit in out of pocket expenses that means that your premium sixty three hundred twelve thousand seven hundred for families there are some folks who have plans now with lower out of pocket maximums than there are some folks who have no out of pocket maximum and this change will impact people differently depending on where they are today but it's important to know that in the future all plans will have an out of pocket maximums for how much somebody would have to pay out of their own pocket and the deductibles and co pays or included in the out of pocket max are the money that you pay for your deductible is counting towards your out of pocket max as well there are no doc deductibles on preventative care so if you're going for your annual physical  there's enough room in here that you could still pay off a lot out of pocket even with the max so if you if paying out of pocket is what you really don't want to do generally people say i'd rather pay it in my yes you are still going to pay a little let's take that scenario and generally healthy i have a very unfortunate accident tonight if up to that point i haven't paid any out of pocket expenses then in a brand i paid less than my premium for the first ten months of the year then if i had a plan that is true however my out of pocket max platinum plan is going to be smaller so that let's take the fifty thousand dollars even though i've paid more in my premium i might have an out of pocket max of one thousand dollars where here i might have an out of pocket max of six thousand dollars and less risk of out of pocket ok financial help similar to financial help with premiums there is financial help with out of pocket expenses so for individuals who are two hundred fifty percent of federal poverty level or below you in essence get lower deductibles and lower out of pocket maxes so even if you're paying for a silver plan you're going to get out of pocket  expenses more like a platinum or gold if you qualify you don't have to worry about any of that the website's going to figure that out for you it's going to tell you what you qualify for  so what's it look like i mean generally it's going to look like any other website where you look at options and you you purchase something it's going to have the little toolbar up here so that you know where you are in the process and how many steps you have left to go there's going to be places where you can press i don't understand this term please give me a definition of that there's going to be information about the call of the hotline if you want to be able to call somebody happens at really understand this can you talk me through it general picture of what it's looking like small businesses  i think an important change so today what tends to happen is that employers go out and they try to pick a plan that they think will be well best to meet the needs of their range of employees or they pick maybe one or two plans maybe a large employer has three options but for the employer there's always this trick of figuring out i know i have some folks who are young and healthy and want low premium they don't really care as much about the out of pocket expenses because they don't plan to use very much but then i have other employees who use a lot of in health services and they want more of a platinum plan and you have to balance that in terms of options with them on health connect you can say i'm going to choose my contribution level i'm going to pay this amount or this percent i'm going to base it on let's say the silver plan and my employees can choose any and v p plan because they don't like blue cross because they've been telling people that there's the only option sorry friend blue cross i didn't say that  you can say the same thing i'm going to set my contribution level and my employers can pick any plan that they want and vermont health connect that's the full choice menu still grandfathered plans so there was this provision that said if you have a plan and it hasn't changed and there's a bunch of rules about what hasn't changed means you can continue to keep it  schools have a grandfather plan and so they can continue to offer that plan that's different from the remote health connect ones as long as it's still the same plan within the rules but otherwise there's no difference between public nonprofit private employers and how they're treated in terms of  choice than they have in the past and not have to deal with this you know which plan is going to be the average good for most of the employees and let's say that fifty percent of my employees paid and employees oh in their contribution so if i say i'm willing to pay let's say a silver plan the silver plan costs four hundred dollars and i say i'm willing to pay two hundred fifty dollars so my employees contribution for this silver plan would be one hundred fifty dollars let's say the platinum plan i lose everybody here costs two hundred dollars more than the silver plan my employee irq contribution is going to be the same the two hundred fifty dollars if my employer wants to buy up to the platinum plan they're going to pay the two hundred dollars difference as part of their employer employee contribution so similarly if they want to buy down to a bronze that option would be available as well so the employee has a lot more choices without having to complicate the situation for the employer there's the employers still going to get that one aggregated bill how much does the employer pay how much does each employee that then gets run through your payroll system so the question was why would the employer do this instead of the from the employer's perspective i'm going to be able to set my contribution two hundred fifty dollars a month and if it could be regardless of which plan the employee chooses so i to really think about what's the right choice given the options available next year compared to what we have this year and today as b employer i generally know that if i don't offer coverage it's going to be hard for my employees to get good coverage really expensive to buy as an individual right now if you don't qualify for be happy or catamount you're not going to get any financial help to pay for your premium and it's just hard to buy coverage as an individual today so i know if i want to if i want to help my employer i have to provide coverage and a lot of employers have tried to provide the best coverage that they can even though a lot of we go back to the metal levels it hasn't been very good coverage but i felt responsible because i don't want to leave my employees hanging out to dry with financial help and with them on health care act it could be different if i have been offering really crappy coverage trying to do my best and really not able to financially contribute very much at all my employees might be better going to vermont health connect as individuals and accessing the financial help and they're going to get the same good options that i would be able to offer as an employer that might be true for a lot of employers and employees and it might be wrong for others to give to extremes if i am a law firm and i have ten employees and we are super successful we just you know we win all the cases and we pay really really well because of it employees probably are going to qualify for financial help and if i had been providing full coverage on my dime they're not going to be better as individuals they're going to be better with my favorite if i'm a small retailer that has generally fairly low wage workers and i have really struggled to provide any contribution to their coverage they're going to qualify for financial help probably more than i can offer and the best thing that i might be able to do is to help them sign up as individuals as opposed to buying a plan myself there's a lot of folks who are in between where they're really going to have to figure out what's the best thing to  do they're going to have to figure what are the tax implications of one choice versus another but generally this is the year to make sure that you rethink because in a lot of cases people are going to be better off as individuals now where in the past they were worse off as couple of basic but important parts so fifty employers fifty employees it's fifty full time employees  thirty so thirty hours a week or more is considered full time part time and seasonal employees don't count when you add the fifty or less or more if you have more than one business let's say i have one business that twenty six employees and another that's twenty six employees if they're under common ownership i don't have to twenty six's i have one fifty two that's a question that i generally suggest if you're not clear of the answer you should talk to your tax preparer your attorney i'm not good at advising that i don't wan be in that role generally if you're paying people the one tax id number that's an indication that you're you're talking about common ownership if you have a business was site in multiple states you can provide all of your employees your employees with coverage through them on health connect or you could bride your vermont employees with a plan through vermont health connect and your non vermont employees plan through their state health benefit exchange because every state going to have one so you have a choice starting from coverage e you have the choice of all in vermont or you can purchase them separately for their own state exchange first small business there's a two step process i might say three but let's start with you first i go on as the employer i set my contribution amount i pick the is it the full choice option or the one carrier option and then i upload a list of my employees who are eligible for coverage as simple as uploading an x l file on on to the web then step two you encourage your employees who are on that list to then log on to remount health connect they'll log on sam mark larson i he would then search to make sure that the list that doug provided included me and then it would show me here is your options it would let me know what my employer's contribution is so i could look at the plans and they would show me that this the price for this plan is x dollars my employer's contribution is x dollars y dollars and therefore my monthly premium would be z and i could then pick the plan that i want then the information would go back to my employer to then pay the first month's premium and then that would get processed and we would all get our c yet they could choose an indian individual they could still be the tiered planned individual to person family so under your coverage they could decide if you offer full family coverage and they only want to enroll one of them they could just enroll that one india would roll in their employer's pla task bar up here so that you can go through the steps of comparing but not pick there is another resource on our website it's there today where you could go on and pretend you're an individual and find out what that would cost based on your income your household income the problem is if you're if dad is offering coverage to me as an employee and i decide i don't like it i want the individual option better i cannot get financial help as an individual if i have access to an employer plan i could say no i don't want that employer plan and i could go purchase a full price plan as an individual but i couldn't get financial help why you would do that i don't know again it's an either or on financial help if my employer offers it i cannot get a ta plan the only scenario that is covered is if there's a provision about an affordable coverage if doug offers me a plan that is more than nine percent of my income i can go on as an individual and not have to deal with the employer provided coverage and then get financial help moral reasons political reason i just don't want to be can i choose a private plan instead i believe the answer is yes but then the question is how could i afford it if if my income is low enough to qualify for medica when we talked about employers thinking through the option there are a bunch of tax implications employee benefits health benefits are pretax if i say in stead of contributing five thousand dollars to your health benefits i'm going to raise your wages five thousand dollars there's different tax implications of that folks are playing with all sorts of things i could say you know instead of providing health coverage i'm going to provide a dental plan for your family that would have different tax implications and wouldn't preclude somebody from going on as an individual employers across the state are thinking about all sorts of different options if they want to switch from providing health coverage to something else it's important to think through the tax implications of that because they they  there are small business tax credits still today some of this is federal tax credit available for businesses that are twenty five or less that have fairly low average wages and there's information on our web site about this to see if your business might qualify there's still a lot of vermont businesses that would qualify that haven't access  we will have there's a calculator on our website if you want to go through the calculation about do i qualify for a small business tax credit today some employers who don't offer coverage or who's them who do offer coverage and whose employees remain on in church pay an employer assessment that is still in place next year so if you're thinking about would i like to drop coverage and let my employees go on as individuals one of the things they have to factor in is the employer assessment in the vast majority of cases i'm sure somebody come up with some different but the four hundred seventy six dollars annual assessment per employee is probably going to be less than you would pay if you  your first four employees aren't counted and then it's no change so yes it's going to stay that way ye so right now we use that money to help pay for coverage for lower and middle income vermonters to get coverage we're going to use that money for the same purpose next year so that if employers don't provide coverage that we have resources to provide to help people for  this is for people who don't contribute to health care employer assessment which includes the option of i offer they turn it down and they remain uncovered the one that's confusing me and i'm happy to work with you to resolve it in terms of getting the right information would be i offer they don't accept but they accept some other piece that i'm confused about so we're going to sort that out we're going to we're going to work together sort that question and it's important i understand it yeah the important thing i want folks to know is that that employer assessment is still in place so if you're thinking about what's the best option for me you know you don't want to forget that piece of the of the the puzzle twenty seven thousand we're talking about universal probably fast care so those are three important timeframes to keep in mind i see this is a continual from the standpoint of idea is that if you're being offered a plan at work that the system is designed the idea is to prevent that person then from getting financial employer when the employer uploads the list of employees and says that i will support these employees getting coverage and contribute then the finance the tax credits not available any longer and so as soon as the employer is contributing a dollar then it's not wages other than good yes that is perfectly fine you can you can jack up wages you can you can do those things yes jacking contributions to h s a there we plan to you can continue to do that one for my health and i want to be mindful of your times you've been very generous with your time i want to make sure i haven't missed anything there was this whole thing about large employers having to either provide health coverage or pay a federal penalty that was delayed a year or so for twenty fourteen you don't have to worry about that whole topic we've talked about this whole should i offer coverage or not a couple of questions that we are for as consideration is true is that you can't treat full time employees differently in terms of offering coverage so let's say i have ten full time employees i couldn't say to these five our offer you coverage because you've been here for ten years but i won't cover these five if you're going to offer coverage to one full time employee you're going to have to provide coverage to all of your full time  differentiate between full time contribution level by a full time employee oh yes you can and i believe you can offer differences in terms of teared employment drop coverage in terms of single couple and family yes  so you can say i'll cover these five but not those five so we're still trying to sort out and i apologize for not having a clear answer could you say for the five that have been here for twenty years will cover will contribute ten thousand dollars to your premium for the year and for those who've been here less will do five thousand can i contribute differently that is not resolved yet it will be resolved before october what i want to encourage back here we have these little cards that has the information that's on the screen right now we have a lot of tools available on our website the individual calculator where you can go in and look at your the potential financial help that you qualify is on our web site the plan options and  proposed rates are on our website we have a bunch of frequently asked questions first small businesses and for individuals so there's a lot of stuff on the website we urge you to go there we hope you find it helpful any question that you have that i haven't entered or you can e mail them to them from our health connect up state that bt dot u staff monitor this every day and we respond to those e mails then we you can also follow us on facebook we're very interesting on facebook please like us and we are also tweeting information just so you can if you have a plan that goes through march you could stay on that plan till march and when that plan runs out you could go to vermont health connect and roll in a plan that starts in be if you want to you know back out of your existing planet i don't know what the ramifications of backing out of that contract really would be  proposed to the final breaking news to morrow how we expect to announce the so the blue cross and m v p have proposed plans that now have final rates the last step is that as vermont health connect we have to pick which of the plans that they've offered will go on health connect we plan to make our final decision tomorrow so that vermonters will have information about which plans will be available on which of the medal levels and at what price so by the end of this week all of that should be available on our website for people to look at between now and october when they could then start the process of  nightmare so the medicaid plan is the same as it's always been it doesn't change we also have navigators available if you actually want to sit down with somebody to walk through that contact information for all of those would be available on our website so the idea is that you can access the website the call center generally what we've seen and is that the prices for the plans are consistent with what's been in the market today i think particularly on the individual side you might see options that might be better than what you have it all depends on what you have today and that's the  but again by the end of this week you should be able to go on and compare what you have to the options that are available you can use the calculator to put in your information to see if financial help  qualify for we have completed our time and i'm going to let representative mccullough have the last word don't mean bold statements today about what the technology will be able to do october first we actually hope as a next step to be able to use the same technology for the purchase  medicare supplemental planned we're not ready for that this year though but generally this same technology could be used for that purpose as well we hope long term to be able to to use it for that purpose continue to purchase as they do today thank you all i appreciate