Health Insurance

The VLCT Health Trust works with major carriers to provide competitive health insurance for municipal employees. As of 2012, our new Carrier Choice program allows members with fewer than 50 employees to choose their carrier and plan(s) from those available in the overall Vermont health insurance marketplace and to make use of many additional resources — such as Health Advocate and wellness programs — for no additional charge. 

If your municipality is not currently in the VLCT Health Trust, click here for information tailored to you.

Renewal and enrollment materials for 2013 are posted under the carrier headings below. Current groups that are not changing plans will probably only need their carrier's enrollment/change form for subscriber and dependent changes. Groups changing plans or carrier will please contact Kelley Avery to learn what paperwork is required. IMPORTANT NOTE: New groups MUST compile all completed health plan enrollment materials in a single packet and MAIL them to VLCT Health Trust, Inc., 89 Main Street, Suite 4, Montpelier, VT 05602 as close to December 1st as possible in order for the new accounts to be set up. After the setup process is complete, you will communicate directly with your carrier, or with VACE if using a VACE plan, to update subscriber information and pay premiums.

Consider making the most of a high deductible health insurance plan by combining it with an HRA or an FSA. VLCT Health Trust members can take advantage of group pricing on Cafeteria and Section 125 funding plans from Choice Strategies. Please visit the Health Trust's Cafeteria Plans page for more information and links to applications.

If you have any questions about the plans, please contact your Member Relations representative at 1-800-649-7915 or e-mail Larry Smith, Manager, Member Relations. Please direct questions about the enrollment process to Kelley Avery, Benefit Program Administrator. We all look forward to helping you develop a comprehensive benefit program for your employees.

Resources - General

• Employer Guidelines for Distributing Summaries of Benefits and Coverage (SBCs) (PDF)
  Important information for how to meet federal requirements for distributing plan information to employees, regardless of which carrier is used.


• Health Insurance Reform (on-site link)
  Explanations of how the U.S. Patient Protection and Affordable Care Act (PPACA) affects municipal goverments.


• Health FAQs (on-site link)
  Frequently asked questions about the VLCT Health Trust's health insurance plans.
• Request Information(on-line form)
  Please fill out this How Can We Help You Form for more information about our health insurance programs.

Resources - BlueCross/Blue Shield of Vermont (BCBSVT)

• BlueCross/BlueShield of Vermont (off-site link)
  The general Blue Cross website. Provides access to forms, benefit summaries, provider network look-up, list of services requiring prior approval, and more. Covered individuals can set up an online registration to gain access to account information and claims status, change their address or primary care physician, and much more.

Direct or via AIV

• BCBSVT Individual Enrollment/Change Form (PDF)
  Complete and submit directly to BCBSVT.
• BCBSVT Waiver of Group Health Insurance Benefits Form (PDF)
  Complete and submit directly to BCBSVT.
• BCBSVT Statement of Domestic Partnership (PDF)
  Complete and submit directly to BCBSVT.
• BCBSVT Out-of-Network Medical Claim form (PDF)
  Includes instructions for subscriber to complete form, attach relevant receipts, and submit all to BCBSVT.
• BCBSVT-Express Scripts Prescription Drug Claim Form (PDF)
  Includes instructions for subscriber to complete form, attach relevant receipts, and submit to Express Scripts.

via VACE

• BCBSVT-VACE Individual Enrollment/Change Form (PDF)
  Complete and submit to VACE.
• BCBSVT Out-of-Network Medical Claim form (PDF)
  Includes instructions for subscriber to complete form, attach relevant receipts, and submit all to VACE.
• BCBSVT-Express Scripts Prescription Drug Claim Form (PDF)
  Includes instructions for subscriber to complete, attach relevant receipts, and submit to Express Scripts.

Resources - MVP

• MVP Health Care (off-site link)
  The general MVP website. Includes information and tools to pursue wellness, find a doctor or facility, learn about plans and prescription coverage, and much more.
• MVP's Manage Your Account website (off-site link)
  Covered individuals can access MVP’s wellness benefits, check their claims status and cost history, change or add a primary doctor, order ID cards, and more. 
• MVP Recertification Form for Small Group Renewals (PDF)
  Complete, sign, and submit to the attention of Heather Blackman, MVP Health Care, 66 Knight Lane Suite 10, Williston, VT 05495. You must also include a copy of your most recently completed C-101 (Employer's Quarterly Wage & Contribution Report) with this form.
• Sample of C-101 (Employer's Quarterly Wage & Contribution Report) (PDF)
  This is a sample of the paper form. Employers that file online should provide a print of their most recently filed information.  
• MVP Attestation Form for Employers (PDF)
  Employers must use this form to certify that they do not provide more than 50% of the deductible for subscribers.
• MVP Individual Enrollment/Change Form (PDF)
  Complete and submit to MVP's Vermont office.
• MVP Waiver of Coverage Confirmation Form (PDF)
  Employees not obtaining coverage through the municipality must complete this form and submit it to MVP's Vermont office.
• MVP Affidavit of Domestic Partnership (PDF)
  Employees wishing to cover a domestic partner must complete this form and submit it to MVP's Vermont office.
• MVP Medical Claim Form (PDF)
  Includes instructions for subscriber to complete form, attach relevant receipts, and submit all to MVP's Vermont office.
• MVP-Medco Prescription Claim Form (PDF)
  Complete and submit to Medco, MVP's partner for prescription coverage.

Resources - CIGNA

• CIGNA (off-site link)
  The general CIGNA website. Includes a Provider Directory for looking up in-network doctors and facilities by zip code.
• MyCIGNA.com (off-site link)
  Covered individuals can conveniently view the status of their claims and deductibles, search for health information, and take their personal health risk assessment.