Vt. Hires New Health Site Contractor

Montpelier — The state of Vermont is hiring yet another IT contractor to help manage problems associated with the health exchange website Vermont Health Connect.

The contractor, Optum, is a subsidiary of United Health Care, the second largest health insurance company in the United States. Sources said Optum will employ as many as 150 workers to eliminate a backlog of “change of circumstance” issues.

The Vermont Health Connect website does not allow users to notify insurance companies of divorces, marriages, births, address changes and other life circumstances. About 10,000 Vermonters insured through the exchange are affected by the problem, according to state officials.

Optum employees will also help the state with project management for CGI, according to several sources who are familiar with the ongoing negotiations with the company and who asked not to be identified.

CGI, the Canadian firm that built the website, has been working on Vermont Health Connect for more than a year and has yet to launch change of circumstance functionality for the website. When Vermont Health Connect was launched on Oct. 1, 2013, Vermonters who were required by law to purchase health care insurance through the exchange had great difficulty applying for plans through the website. For months, the site didn’t function properly (it was 2014 before the site provided users with online payment options, for example), and even now, key functionality has not been developed.

In addition to the change of circumstance flaw, small employers cannot yet buy insurance for workers through the exchange website. For that reason, the Shumlin administration has twice allowed businesses to purchase exchange insurance plans directly through Blue Cross Blue Shield of Vermont and MVP.

Mark Larson, commissioner of the Department of Vermont Health Access, told reporters on Tuesday afternoon that he could “not get into detail” about the contract (its duration, total cost and even the name of the firm in question) because the state and the company have not yet inked a deal. Sources said negotiations will be complete before the end of the week. Larson said the company did not go through a request for proposal process but instead used a modified bid process for vendors.

“Vermonters are frustrated by the pace by which the change in the change of circumstances requests” have taken place, Larson said.

“Critical services,” Larson said, must be functional for open enrollment in November, when Vermonters on the exchange must reup insurance plans.

“We obviously have had many Vermonters waiting longer than we feel comfortable with in order to get their change requests processed,” Larson said. “As we look forward to the important work around renewals and small businesses and automatic change of circumstances, we wanted to make sure we were most prepared in our work with CGI in those areas.”

The funding for the additional IT services will come from “existing authorized exchange grants” from the federal government, Larson said. Some of the money has been reallocated, he said. “We are in process of updating our grant request with the Centers for Medicare and Medicaid to address the reallocation,” Larson said. No funds from the CGI contract, which is worth $84 million, will be diverted to the new contractor. The state has so far paid CGI $51 million, and fined the company $5 million for delays.

“This contract does not imply any change in our contract with CGI,” Larson said. “There are important components of Vermont Health Connect that CGI continues to work on. Our focus is on making sure that those functions are deployed. Our focus is on quality, not a date certain.”

CGI’s scope of work will not change as a result of the new oversight contract. When asked whether CGI would meet a July 2 deadline, Larson equivocated. “There’s a lot of work left to do,” he said.