Our goal is to make it possible for all Vermont businesses to purchase Catamount Health for their employees as a step towards every Vermonter having access to affordable, comprehensive health insurance.

Catamount Health is the state's newest health care program for uninsured Vermonters with premiums based on ability to pay.

Most uninsured Vermonters are eligible even those that are employed.

If an employee enrolls in Catamount Health, there is no cost to the employer.

Employers can choose to reimburse employees for both premium and out of pocket costs incurred by employees on Catamount Health.

Employers can also make employees aware of the benefits of Catamount Health:

• During the hiring process
• Through employee newsletters and the employee handbook
• By having enrollment forms and information for employees
• When the employment is terminated

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For business owners, employees and family members, Catamount Health may be the best option for health insurance if they:

• Are ineligible to join the company plan (for example, temporary employees or part-time employees, or if there is a waiting period for insurance eligibility).
• Lose coverage through a spouse due to death, divorce, loss of employment or any other reason.
• Are children or employees who lose access to the company plan upon leaving college.
• Are employees who are terminating employment and don't have immediate access to another health plan.
• Are former employees who are paying COBRA costs.
• Are employees, their spouses & their children who are either uninsured or enrolled in a plan with a deductible of $10,000 or higher.

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Who is eligible for Catamount Health?

You are eligible for Catamount Health if you have been uninsured for more than 12 months or if you have lost your insurance because you retired, lost or quit your job, got divorced, choose to leave COBRA, leave or graduate from college, a spouse died or are enrolled in a plan with a deductible of $10,000 or higher.

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What are the Monthly Premiums?

The premium is based on an individual's monthly household income (not assets).

* A household is defined as the number of related people living in the same house. Some exceptions apply. Please call 1 800 250 8427 for details. Rates effective January 1, 2010.

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Can a person enroll who makes more than the limit for a subsidy and who is offered insurance by their employer?

By state law, they cannot enroll in Catamount Health even at full price.

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If a business stops providing health insurance, can its employees enroll in Catamount Health?

If a business stops providing its employees health insurance, these employees must wait 12 months before applying for Catamount Health.

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What are the out of pocket expenses?

Annual out of pocket expenses are limited to $800 for an individual and $1,600 for a family plan. There is a $10 office visit fee and prescription drug co-pays of $10 for generic brands, $30 for preferred brands and $50 for non-preferred brands.

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What does Catamount Health cover?

Catamount Health covers hospitalization, prescription drugs, doctor's visits for primary and specialty care, mental health treatment and substance abuse. Though the benefits are mandated by the state, it is sold through Blue Cross Blue Shield and MVP.

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How is Catamount Health paid for?

Catamount Health is paid for by a combination of monthly premiums by enrollees, state and federal funding and an "employer assessment" charged to businesses of roughly $1 per day per the number of full time equivalent uninsured employees.

Employers with fewer than 4 full-time equivalent employees are exempt from paying this assessment.

An employer does not have to pay the Employer Assessment if a part time or full time employee is on Catamount Health.

Contact the State Department of Labor for details on the employer assessment.

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What About VHAP and Medicaid?

If an individual's household income is below the threshold for Catamount Health, they may be eligible for the state's other adult health care programs, VHAP and Medicaid.

Both VHAP and Medicaid's premiums are based on income and range from $0 up to $49 per month.

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How to apply for Catamount Health, VHAP, Dr. Dynasaur and Medicaid

If and individual is under the threshold for a state subsidy, fill out the Green Mountain Care Health Care Programs Application. If an individual is above the level for a state subsidy, fill out the Green Mountain Care Health Care Programs Application.

This application can be filled out on your computer, but it must be printed and mailed to the state at the address in the application. You cannot apply online at this point

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Efforts to Expand the Benefits of Catamount Health

The Vermont Campaign for Health Care Security Education Fund is a non profit organization founded as a project of AARP Vermont, Vermont NEA, the Bi State Primary Care Association and the Vermont Citizens Campaign for Health.

VCHSEF is working to educate Vermonters about, and help them enroll in, Vermont's public health care programs so that all Vermonters have access to affordable, comprehensive health care.

A priority for VCHSEF is to expand the eligibility requirements of Catamount Health so that businesses may have the option to purchase Catamount Health for their employees.

If you would like to be involved in these efforts, or would like more information about Catamount Health and your business, please contact the VCHSEF Executive Director, Peter Sterling, at peter@healthcaresecurityvt.org or 802-279-6840.

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