Vt. Stat. Ann. tit. 33, § 1805 - Duties and responsibilities regarding the health benefit exchange under the human services law

“Duties and responsibilities under the human services law”

The Vermont health benefit exchange has the following duties consistent with the Affordable Care Act:

• Offering coverage for health services through qualified health benefit plans
• Determining eligibility for and enrolling individuals in Medicaid, Dr. Dynasaur, VPharm, and VermontRx
• Creating and maintaining consumer assistance tools
• Creating standardized forms and formats for presenting health benefit options in the Vermont health benefit exchange
• Assigning a quality and wellness rating to each qualified health benefit plan and determining each qualified health benefit plan's level of coverage
• Determining enrollee premiums and subsidies and informing consumers of eligibility for premiums and subsidies
• Informing the U.S. Department of the Treasury the name and taxpayer identification number of each individual who was an employee of an employer but who was determined to be eligible for the premium tax credit
• Performing duties required by the U.S. Department of Health and Human Services or the U.S. Department of the Treasury related to determining eligibility for the individual responsibility requirement exemptions
• Informing the U.S. Department of the Treasury the name and taxpayer identification number of each individual who notifies the Vermont health benefit exchange that he or she has changed employers and of each individual who ceases coverage under a qualified health benefit plan during a plan year and the effective date of that cessation; and communicating to each employer the name of each of its employees and the effective date of the cessation.
• Establishing a navigator program 
• Reviewing the rate of premium growth within and outside the Vermont health benefit exchange.
• Crediting the amount of any free choice voucher to the monthly premium of the plan in which a qualified employee is enrolled and collecting the amount credited from the offering employer.
• Providing consumers and health care professionals with satisfaction surveys and other mechanisms for evaluating the performance of qualified health benefit plans and informing the Department of Vermont Health Access and the Department of Financial Regulation.
• Ensuring consumers have easy and simple access to the relevant grievance and appeals
• Referring consumers to the office of health care ombudsman for assistance with grievances, appeals, and other issues involving the Vermont health benefit exchange.