Sen. Frerichs: Retirees shouldn't wait to enroll

Sen. Frerichs: Retirees shouldn't wait to enroll

SPRINGFIELD — Although there still could be some change to the Medicare Advantage program, state Sen. Mike Frerichs is urging retired state employees to attend upcoming seminars on the health care plan and to sign up during the enrollment period that runs from Nov. 12 to Dec. 13.

The Quinn administration and the Department of Central Management Services are working to see if Urbana-based Health Alliance can be added to the retiree health care contract that already has been awarded to four providers, United Healthcare, Humana Health Plan, Humana Benefit Plan of Illinois and Aetna Life Insurance Co.

Health Alliance underbid competitors for the state contract by potentially millions of dollars, but its bid was thrown out on a technicality.

"There are negotiations, and the administration is working to make some changes to do something differently, but I don't want to get people's hopes up unnaturally," Frerichs, a Champaign Democrat, said Thursday. "We may get some sort of a resolution that creates a new open enrollment period in the future, but that will be in the future and there will be an opportunity to switch later if we work that out.

"Right now they should go ahead and enroll."

In most East Central Illinois counties, retirees can choose from a United Healthcare PPO and Coventry Advantra HMO. Information on the options is available at:

In the meantime, CMS and local legislators are hosting eight seminars in the next three weeks in East Central Illinois:

— 9:30 a.m. and 1:30 p.m. Wednesday at the Bremer Center at Danville Area Community College, 2000 E. Main St., Danville.

— 9:30 a.m. and 1:30 p.m. Nov. 15 at the Illinois Terminal, 45 E. University Ave., C.

— 9:30 a.m. and 1:30 p.m. Nov. 19 at the Tuscola Community Building, 122 W. North Central St., Tuscola.

— 9:30 a.m. and 1:30 p.m. Nov. 27 at the Grand Ballroom of the Martin Luther King Jr. Student Union, Eastern Illinois University, 600 Lincoln Ave., Charleston.

The coverage period for the new retiree Medicare Advantage program begins Feb. 1.

"I'm hopeful we'll have some positive changes," Frerichs said. "There are lawyers working on this, but I don't think this should change people's plans for the enrollment. We don't want people to think that they should hold off on enrolling with the hope that something better is imminent. We are working with the governor's office, but there are limitations on what can be done without putting the state at risk of lawsuits and other things."

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Sid Saltfork wrote on November 08, 2013 at 8:11 am

Thank you, Mr. Kacich, for helping to get the word out.  It is confusing for many elderly state retirees.  Imagine people in their 70's, and 80's waiting for information from their ex-employer, and getting it late.  There is no explanation in it regarding the local area's providers who will accept the plans.  Physicians, and others at the clinics do not want to give out any incorrect information so they are reluctant to answer questions their patients may ask.  The insurance offices at the clinics need to know that the patient is a state employee retiree before they can answer questions.  The meetings are important for people to learn the differences between the plans, and who accepts them.  Sadly, there will be some elderly retirees who will find that they have no health insurance coverage after Dec. 13th, and never able to get it back, because they were not clearly understanding the forced change from Medicare to a Medicare Advantage plan.

Rocky7 wrote on November 08, 2013 at 10:11 am

Let's be brutally frank about this matter.  It is part of the "War On The Ederly" waged by the current administration in Washington and in SPringfield,, IL. Regrettably, the good Senator Frerichs MIGHT just be part of the problem.

Skepticity wrote on November 08, 2013 at 10:11 am

Please, please, PLEASE!!! 

News-Gazette, distinguish between State retiree health care options and MEDICARE ELIGIBLE State retiree health care options. 

My understanding is that the latest ripoff that is being reported (that ends the option of Health Alliance coverage for some retirees) is about the Medicare Advantage plans that the state is offering, and this only applies to Medicare Eligible retirees (i.e; 65 or older). 

Everything that I have found indicates that retirees under 65 can continue regular State retiree coverage through the same plans available to current employees. 

State retirees I know that are under 65 and are NOT Medicare eligible have NOT received a letter. 

Please stop refering to the whole group of retirees. as though all retirees are in this mess. Please note that the unfair changes implemented by CMS are for MEDICARE ELIGIBLE RETIREES.  As time passes we will all be subjected to this, but the time frame is different for those not yet 65. 

If I am mistaken in this, then please feature a story that clearly explains the changes, and clearly define the catagories of retirees affected. 

Sid Saltfork wrote on November 08, 2013 at 12:11 pm

You are not mistaken regarding the group affected.  It is only those retirees who are on Medicare.  If a retiree is under age 65, they would not be on Medicare.  If the retiree never paid into Social Security, they would not be on Medicare.  Only the retirees who received a letter (late by the way) from CMS are those affected.  This thing has nothing to do with the Affordable Care Act either.  At least, that has some navigators to assist.  CMS has been late with information, and non-assistive in providing answers to questions.  The deadline for making the decision on a plan is Dec. 13th.  After that, it is assumed that the retiree chose to "opt out" of any employer benefit insurance plan. 

Oh wait.... I used the word "benefit".  According to the ex-employer, the State of Illinois, health insurance is not a "benefit".  Therefore, it can be "diminished, or impaired".  If health insurance is not a benefit, what are benefits?  The state supreme court is still wrestling with a decision on the mattter.  Wanna bet who wins?

caregiver wrote on November 08, 2013 at 12:11 pm

A managed care coordinator at MD Anderson Cancer Center, Houston, TX, a world leader in cancer treatment and one of 11 such centers in the US paid at a higher rate than normal by Medicare because of its reserach mission, told me a patient receiving treatment under a retiree health plan who is enrolled in Medicare Parts A and B and changes to a Medicare Advantage plan must follow this procedure to determine whether MD Anderson will accept the new plan: Enroll in the Medicare Advantage plan and receive an ID number. Give the ID number to the patient's  "home" department at MD Anderson (e.g., leukemia), which will contact the Medicare Advantage insurance carrier to find out if the necessary procedures are covered. If the answer is no, the plan will not be accepted. If the answer is yes, the home department will notify the managed care coordinator who will contact the carrier to request a signed agreement (called a Single Patient Financial Agreement) naming the patient and specifying the enhanced rates at which MD Anderson will be paid. This agreement must be renegotiated annually (usually with a May 31 ending date) once the year's rates have been received by MD Anderson from Medicare. If the agreement is not signed by the carrier, the patient must pay for the services rendered or receive treatment elsewhere, using his/her Medicare Advantage plan (since the patient will no longer be enrolled in Medicare Parts A and B). In my view this procedure puts the patient at risk of losing essential healthcare and incurring great financial burdens. The managed care coordinator suggested that Illinois might consider permitting MD Anderson patients to retain their existing coverage at least until the next open enrollment period (October 15 - December 7, 2014) so that they may have a chance to see whether Illinois' new Medicare Advantage plan is accepted at MD Anderson before they have to choose between that plan and Medicare Parts A and B supplemented by a medigap policy.

Sid Saltfork wrote on November 08, 2013 at 1:11 pm

The question that begs is why the ex-employer forces it's Medicare eligible retirees onto Medicare Advantage plans which costs the ex-employer more money than if the ex-employer gave the retiree the money to purchase a Medicare Supplemental plan with the employee paying a portion of the cost as they are now for their insurance.  The retirees would remain on Medicare also. 

Of course as a state employee retiree, I have come to not trust my ex-employer who did not make it's share of the pension contributions while I did.  Do any of you trust the State of Illinois?  Would you want it making decisions on your health, and savings?

BlahBlahBlah2013 wrote on November 08, 2013 at 1:11 pm

"already has been awarded to four providers, United Healthcare, Humana Health Plan, Humana Benefit Plan of Illinois and Aetna Life Insurance Co."

Huh? Wonder how the "winners" would feel about special exceptions being made for HAMP? What's the point again of having an RFP process in place? Isn't it kind of a waste of everybody's time if every time HAMP loses it cries about it and somehow gets the rules changed in its favor? Kind of makes a person not take the whole thing too seriously.

Can we replay the World Series until the Cardinals win? Lol. This whole thing reminds me of dealing with a 2 year old. The  2 year old in this case is named, HAMP.


Sid Saltfork wrote on November 08, 2013 at 3:11 pm

The 6,000 of us affected in this area really don't give a hoot about whether Health Alliance does well economically, or not.  We are concerned about being able to see our physicians, and having "comparable" health insurance.  We all are over age 65, some way over age 65, and most of us have health problems with age.  Health Alliance is not our concern with the exception of Carle physicians being involved as our physicians. 

The article is about the public service retirees who are eligible for Medicare being shoved into a new program that removes them from Medicare, and leaves them in limbo.  Many things are not explained by the ex-employer regarding the Medicare Advantage plans.  For example, the Social Security Administration indicates that a person with end stage renal disease maybe rejected by Medicare Advantage plans.  Yet, the ex-employer does not mention it.  Imagine a person with renal disease enrolling in a Medicare Advantage plan before Dec. 13th thus being removed from Medicare, and later being told by the Medicare Advantage plan administrator that they have been rejected by the company. 

The last enrollment period was just this last May.  Previously if the retiree did not choose a different health insurance plan, CMS took that for an automatic preference by the retiree to stay in their current plan.  Now, the same old people are being told that they must enroll in a Medicare Advantage plan; and if they do not, it is assumed that they have "opted out" of any earned health care insurance. This whole thing was incompetently, or purposefully, slapped together by CMS at the last minute. 

Marti Wilkinson wrote on November 08, 2013 at 8:11 pm

My father retired from the state of Illinois after decades of employment, and he relies on Health Alliance for much of his medical care. He has been a brittle diabetic since his early 40's, and is now in his 70's. Since he retired he has also had a triple bypass and now relies on a pacemaker. So his assorted health issues makes the insurance issues a real concern. I'm hoping that he and my mother can get things sorted out. 

Sid Saltfork wrote on November 08, 2013 at 8:11 pm

I hope that they can also.  It would have been helpful if CMS, or others, would have provided "navigators" to assist the elderly retirees in understanding the plans as they pertain to each retiree's health needs.  There is another meeting this next Wednesday on the 4th floor of the Terminal Building to discuss, and hopefully explain the plans.  For those of us with a serious pre-existing condition, this forced switch can be devastating.  Try to get them to attend what meetings are available before Dec. 13th.  You may want to attend with them to assist with avoiding confusion.  There was quite a bit of confusion with little specific answers at the meeting I attended this past Wed.  The most accurate information is obtained by calling the two vendors offerred for Champaign County.  Go to State of Illinois on Google, go to agencies, go to your father's pension system which will give you the CMS website providing the phone numbers for the plans.  Talk to the representatives of each plan specifically as it applies to your father's medical conditions.  Do not depend on CMS for answers.  They have not sent out explanations of the offerred plans, and needed forms yet to the retirees affected.  There is some partial information available on their shiny new website though.

Lostinspace wrote on November 08, 2013 at 2:11 pm

I'm on Medicare and I'm over 65;  I've heard nothing from anybody.

Sid Saltfork wrote on November 11, 2013 at 4:11 pm

I talked to a representative of one of the "offerred" Medicare Advantage plans today. I asked the usual questions about whether my primary physician accepted their plan, whether they would pay for tests "rejected" by Medicare as my current insurance does, and the times when the plan can be renewed or dropped for a return to Medicare.  The last question drew an unusual answer.  The representative informed me that the plan would be good for one year unless my ex-employer, the State of Illinois, informed the insurance carrier that I had been dropped from coverage.  She indicated that could happen at anytime during the one year. 

Is that the "choice" in "pension reform"?  All of the Medicare retirees are put on a private Medicare Advantage plan in January.  "Pension reform" passes in the spring with the "choice" of keeping the COLA, and losing ALL health insurance; or accepting the CPI (1/2 of the COLA), and keeping insurance that the ex-employer may pay for in the future.  Also, there would be no cost of living increases for the next five years.  For an elderly retiree; the "choice" would be having no insurance from the spring until switching back to Medicare in Jan. 2015; or being intimidated into giving up their financial future.  No medications, no physician visits, no tests, and no treatment for illnesses unless you sign away your earned retirement.

AFSCME will not pursue a legal challenge to the state violating it's constitution regarding "diminish", and "impair".  The reason is simple.  Very few retirees pay dues.  Many were "fair share" when they were employed.  Others of us paid full dues both in employment, and in retirement; but lawsuits cost money.  The retirees local does not have the money for the future lawsuit.  The retirees will have to depend on other labor groups, or a class action suit to defend themselves.  If AFSCME will not pursue the future lawsuit; why can AFSCME negotiate in contracts what retirees may, or may not, receive that was constitutionally guaranteed?  Unions need to be held accountable even if it embarrasses their members like me.

The judges are exempt from "pension reform".  Retired General Assembly members will be exempted from "pension reform".  Union leadership will not be affected by "pension reform".  The current employees will be affected after they retire.  The only people "sharing the pain" from being affected by "pension reform" will be the elderly people who earned, and paid into their pensions.  Oh well, it is illinois........