Health plan enrollment starts soon; deadline pushed back

SPRINGFIELD — State employees and retirees can begin enrolling in new health plans next week, but they're going to get some extra time to make their choices, state officials said.

By law, the enrollment period starts Sunday, but it will be extended beyond the end of May because protests filed by Health Alliance Medical Plans and Humana both excluded from this year's insurance plan selections are still pending, according to the state's Central Management Services department.

Under the current HMO plans in effect through the end of June, Health Alliance and Humana together cover about 115,000 state members, with 99,474 of those people covered by Health Alliance.

Both companies filed protests after their proposals to continue covering state employees and retirees for the new benefits period starting July 1 were rejected.

"By law, the benefit choice period must begin on May 1," CMS spokeswoman Alka Nayyar said in an email. "Once a final decision is reached, we can make any necessary adjustments to the ending date of the benefit choice period to ensure that members have sufficient time to make an informed decision regarding their health care benefits for FY (fiscal year) 12."

Determinations on those protests aren't expected to be made until about mid-May.

"We're still a couple of weeks away from a decision," Matt Brown, the state's chief procurement officer, said Friday.

Humana and Health Alliance have through the end of the day Monday to file supplemental information, and then the state Department of Healthcare and Family Services has a week to weigh in on the protests, he said.

"Then the deliberative process begins," he added.

State employees were sent letters recently and will be given updated information on this website: http://bit.ly/kygOcz, Nayyar said.

Health Alliance spokeswoman Jane Hayes said Health Alliance is still evaluating some of the documents the company requested on the insurance contract awards, but the information from the state is incomplete.

"So far we haven't gotten everything we asked for," she said.

One important piece of information the state hasn't supplied is the evaluation of the insurance bids done by an outside consultant, Hayes said.

"We've been given some documents, but not really everything we need to understand clearly what they were thinking," she said. "Everything we have so far is it just doesn't make sense."

Meanwhile, the Illinois State Medical Society and its 12,000 physician members have expressed their own concern about the exclusion of the two HMOs in a letter to Gov. Pat Quinn.

If the newly selected HMO plans (both through Blue Cross and Blue Shield) don't manage to establish contracts with downstate doctors, many state members will be forced to switch doctors or sign up for one of the Open Access Plans the state has proposed to offer through PersonalCare and HealthLink.

The results would be "further access to care limitations for state employees and additional costs for covering newly migrating OAP (Open Access Plan) enrollees," said Dr. Craig Backs, chairman of the medical society board, in his letter to Quinn.

Furthermore, he wrote, the state is more than seven months behind paying doctors for the care they've already provided to state employees, and these delays adversely affect physician practices and make doctors question their participation in state-sponsored health plans.

Hayes said downstate lawmakers continue to question the state's contention that the selected insurers will help the state save more than $102 million in the upcoming fiscal year and more than $1 billion over the 10-year life of the contracts.

State Rep. David Leitch, R-Peoria, has scheduled a public hearing on the state insurance contract situation for 10 a.m. May 2 at the Arbor Hall auditorium at Illinois Central College North Campus, Peoria.

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Fuzzybeard2016 wrote on May 01, 2011 at 12:05 am
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Am I the only person out here thinking that something is very, very, WRONG about the way this story has developed? According to the story approximately 115,000 beneficiaries of the 2 health plans that are not having their contracts renewed will have a so-called "choice" of two different health care plans that will be offered by the SAME COMPANY!

I may be reading far too much into this festering mess; but I truly think that some money or influence is changing hands behind the scenes. From the article:

"Health Alliance spokeswoman Jane Hayes said Health Alliance is still evaluating some of the documents the company requested on the insurance contract awards, but the information from the state is incomplete.

"So far we haven't gotten everything we asked for," she (Jane Hayes, spokesperson for Health Alliance) said.

One important piece of information the state hasn't supplied is the evaluation of the insurance bids done by an outside consultant, Hayes said."

This sounds like withholding evidence to me. Earlier in the article, this rather curious nugget caught my eye:

""By law, the benefit choice period must begin on May 1," CMS spokeswoman Alka Nayyar said in an email. "Once a final decision is reached, we can make any necessary adjustments to the ending date of the benefit choice period to ensure that members have sufficient time to make an informed decision regarding their health care benefits for FY (fiscal year) 12."

Determinations on those protests aren't expected to be made until about mid-May.

"We're still a couple of weeks away from a decision," Matt Brown, the state's chief procurement officer, said Friday.

Humana and Health Alliance have through the end of the day Monday to file supplemental information, and then the state Department of Healthcare and Family Services has a week to weigh in on the protests, he said.

"Then the deliberative process begins," he added."

To me, this sounds like stall tactics from the State to ram through this (apparent) back-room deal through, but to what end?

Apologies for ranting on, but this is something hat not only affects my self and my family; it also affects a great number of people in the immediate area, and I am not going to let this happen without speaking my mind.

Fedupwithstatereps wrote on May 03, 2011 at 4:05 pm

There is something very rotten and dirty about how this whole thing! "One important piece of information the state hasn't supplied is the evaluation of the insurance bids done by an outside consultant, Hayes said." This is an indication the state is hiding something.

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