Integrated Eligibility and Enrollment (IE&E) Summary
Vermont's Integrated Eligibility and Enrollment (IE&E) Program envisions a world in which eligible Vermonters have a simple and easy way to apply for, access, and maintain healthcare and financial benefits without coverage gaps. The IE&E Program will pursue a phased, modular procurement strategy to implement a “customer-focused” system that starts with a Customer Portal, Case Management, and Rules Engine. The IE&E Program will build the new IE&E system outside legacy systems to ensure systems and services remain intact as new functionality is delivered.
The IE&E Program will ensure that the new IE&E system is extensible for future scalability and flexibility, leverage new and existing technologies, comply with relevant State and Federal laws and regulations, and provide maximum value for customers, staff, and taxpayers. The IEESM implementation approach will deliver incremental and timely business value and improved customer experience outcomes for Vermonter’s and state staff.
Program Overview
Approximately 1 in 3 Vermonters each year rely on the State to provide economic and healthcare benefits. Many operational and technical inefficiencies exist today, leaving Vermonters with an eligibility and enrollment experience that needs to be more cohesive, coordinated, and manageable. Vermonters applying for benefits must submit the same information multiple times and deal with call centers with limited access and coordination across programs. Vermonters face lengthy approval timelines and confusing information and cannot apply for all benefits simultaneously. State staff also face challenges as they deliver these services as processes are very manual and labor intensive, and customer information exists across multiple systems.
The IEESM procurement will optimize eligibility, enrollment, and member management functionality for all in-scope programs by replacing legacy eligibility and enrollment systems. The IE&E system will be composed of functional modules allowing Vermonters to apply for and receive health coverage and financial assistance benefits through a user-centric access point that is personalized, welcoming, and comprehensive.