Insurance | FJG/FYI
Quick Facts about Catamount Health
What is Catamount Health?
Catamount Health is the subsidized non-group insurance coverage proposed to be provided to uninsured Vermonters starting October 1, 2007. With a few exceptions for those who lose their coverage involuntarily, persons must be without health insurance for at least 12 months to be eligible for Catamount Health.
What is the Employer Assessment?
Many employers equate the Employer Assessment with Catamount Health, when actually the two are not linked. The Assessment is a funding mechanism, mostly for Catamount Health but also for other health reforms, such as information technology investments. The Assessment is not a “premium” and doesn't make employees eligible for the Catamount plan. It is not based on whether an employee enrolls in Catamount Health. It is not even based on whether the employee has insurance from any source. It is only connected to the Catamount insurance plan in that the Assessment will annually increase at the same rate as the Catamount insurance premiums.
Which employers are covered by the Assessment?
ALL employers who withhold Vermont taxes and file unemployment insurance reports must file and maintain documentation relating to the Assessment.
Which employers will have to pay the assessment?
- Employers who offer no insurance coverage.
- Employers who offer insurance to some, but not all, employees.
- Employers who offer insurance and not all employees take the insurance, if any of those employees remain uninsured.
When does this start?
The Assessment went into effect on April 1, 2007. The first quarterly payments will be due July 15, 2007. This means employers must plan now for the record keeping that will be necessary to accurately report the hours worked by employees in any of the three categories above.
How is the Assessment calculated?
The total hours worked by any employees in each of the three categories above are added up. This total is divided by 520 (which is the total number of hours that a full time employee would work in a quarter). That produces the number of “Full Time Equivalents” (FTE's) the employer has in the three categories. To lessen the impact on very small businesses, the first 8 FTE's are exempt, therefore to determine the quarterly assessment, subtract 8 from the FTE number and multiply the result by $91.75. You can find a simple, interactive Quarterly Employer Assessment Calculator at http://www.brsvt.com to help employers estimate their assessment liability.
What about part time and seasonal workers?
The original legislation called for a study on this issue. The study committee recommended exempting (not counting) the hours of any employee working fewer than 20 weeks per year in a job that was intended to last fewer than 20 weeks per year, as long as the employee has insurance from another source. This proposal passed in the House and is currently in the Senate. Controversy has arisen over a separate proposal to also exempt all long-term part-time employees with coverage elsewhere. Consequently, employers should act as though seasonal/part-time will be included in the assessment.
Useful Links
- For VT Department of Labor FAQs, worksheets, fact sheets and other help for employers, click here.
- For an employer-focused reports and fact sheets about the Catamount Health Plan, the Medicaid Cost Shift and health care reform in general, sponsored by Business Resource Services, Inc., click here.