State begins negotiations for 90-day insurance contracts; questions remain
CHICAGO — More than 400,000 state employees, dependents and retirees — many of whom were concerned about severely limited choices for health insurance coverage — should have a full range of options — at least temporarily.
The state Department of Healthcare and Family Services on Tuesday told a legislative panel that it would negotiate emergency 90-day contracts with a number of providers, including Urbana-based Health Alliance, within the next three days.
"Our goal will be to do that because we want to get this in place and maintain continuity of care," department Director Julie Hamos said. "I'm sure that right now notices are going out to people who are anxiously awaiting the actions of today."
Hamos made her remarks following a nearly 3-hour-long special meeting of the Legislature's Commission on Government Forecasting and Accountability, which was called after a Sangamon County judge's ruling last week threatened to leave thousands of state employees and others without health insurance coverage on July 1. The meeting was held in downtown Chicago at the Michael A. Bilandic Building.
"I think after Friday's court ruling there was a lot of confusion," Hamos said. "What I think was most distressing to public employees in this entire last two months' period is to think that they had very few options, and it was going to be either a PPO or Blue Cross, which was only in 38 counties. The court's ruling had that effect."
Now, Hamos said, "I think that they can get the assurance that there will be lots of different options for health care plans, although it's only for 90 days at this point."
The emergency contracts, which Hamos said would be negotiated with both providers from the current state fiscal year and the one beginning July 1, could be entered into and approved by state procurement officer Matt Brown in the next few days.
"I think he's working very closely with us. He's standing right there. We weren't necessarily going to let people out of this room," she said, joking. "The (health insurance providers) are already coming up to us and saying, 'We're authorized. Let's sign these contracts. Let's go.' So we are really hoping to finalize this very quickly."
The negotiations were expected to begin Tuesday afternoon, she said.
State employees, dependents and retirees still must choose a health insurance provider by Friday, according to Janice Bonneville, deputy director for benefits at the state Department of Central Management Services. But they will be able to amend that choice, either by submitting a form by fax, by mail or in person by June 24, she said.
"If they've made a decision and they want to change it, they need to fill out a new form and sign it," she said. "What I've basically been telling members is that if you've made a decision and something has happened to make you change that decision, assuming you've saved copies of what you've sent, take another copy, mark through it. Do the new form, staple it to it and write on it that this new form supersedes the form I sent on this date. And put it back in the mail.
"We're going to get it. And we can react to that. What I can't do is tell members that you can wait until the 24th or the 30th. We have to have time to process things."
It's unclear what will happen after the emergency contracts expire.
"This will ensure continuity of coverage for thousands of my constituents for at least the next 90 days," said Sen. Mike Frerichs, D-Champaign, one of 12 legislative members of COGFA.
After that, he said, "we'll see what the courts rule."
Sen. Jeff Schoenberg, D-Evanston, a co-chairman of COGFA, said it's possible that the legal issue, which is related to COGFA's authority to oversee health insurance contracts, could remain in the courts for more than 90 days.
"If we can't get it resolved from the courts in 90 days, as I understand it, it goes for another emergency procurement, there's a public hearing and it goes before" Brown, the procurement officer, he said.
If the courts find that the procurement process was invalid, "then an entirely new procurement would begin," Brown said. "And I don't think it would be fair to say that it would take less than six to nine months."
"We can't control the time frame by which the courts operate," Schoenberg lamented.
Hamos said "we just don't know what happens after that."
State Rep. Chapin Rose, R-Mahomet, said Tuesday night that Gov. Pat Quinn should just continue the existing contracts, including Health Alliance's, for two years, as lawmakers have suggested in legislation they sent him.
The primary vote taken Tuesday by COGFA allowed the department to approve so-called open access plans with PersonalCare and HealthLink. Negotiating short-term contracts with Health Alliance and Humana did not require approval of the commission.
Gov. Pat Quinn did not attend the meeting, which was held across the street from his Thompson Center offices, but he did send his chief legal counsel, John Schomberg, and his senior health policy adviser, Michael Gelder.
"Governor Quinn takes his responsibility as the state's chief executive very seriously," Gelder said. "It's his responsibility to provide health insurance to the state's employees and everyone else covered by the state's group health insurance program."
These "professionals" have mishandled this situation and completely confused the indivuals depending on this very basic benefit. Hamos, Brown and each individual involved with this chaotic situation should be ashamed. Their lack of fiduciary responsibility is an insult to 400,000 state employees, dependents and retirees depending on their actions. Perhaps a comprehensive audit of the procedures adopted and followed is appropriate because something is drastically wrong.
Employees "can submit a form by fax, mail, or in person...."
Fails to mention that University employees MUST do it on-line by noon on Friday or default into the program that is most expensive for the state and paradoxically most expensive for the employee as well. I've checked on-line several times over the last 24 hours, and Health-Alliance is not listed, nor is PersonalCare HMO. The only usable option for UIUC employees, and indeed for most state workers not residing in the Chicago suburbs or in Springfield, is PersonalCare OAP, a much more expensive plan that covers less than the HMOs.
In 30 years as a state employee I've come to learn that state workers are expected to put in long hours for minimal (and decreasing) pay and benefits, and must always assume that the state is lying to them about options and benefits like retirement, healthcare, vacations, job security, the possibility of raises, etc.
QCHP, BlueAdvantage HMO and HMO Illinois are the only three available now.
BlueAdvantage and HMO Illinois are not available in this area, which leaves QCHP.
QCHP is a self-insured plan and the state is way behind on payments to vendors. This has caused vendors to not accept it, require patients to pay the states share ahead and various other issues.
The OAP's that were offered were both self-insured by the state as well. Which raises a few questions.
Would the state be timely on paying vendors for these new self-insured plans or would the same problems arise?
If self-insured is the way to go, why not put everyone in the same self-insured pool which should lower the costs for QCHP?
If self-insured is not the way to go, given the state probably should not take on new financial risk, why get rid of the only HMO's available in so many counties?
As it is, I'll just default to QCHP if this does'n't get done with better options then the OAP's for this area. There are just to many questions still on what providers will be covered by the OAP's, and no straight answers at all.
If you have ALREADY SUBMITTED a Benefits Choice Election Form, simply submit a second form indicating your updated choice. CMS will ensure you are covered by whatever provider was indicated on your most recently submitted form. If you have NOT ALREADY SUBMITTED a Benefits Choice Election Form, do nothing. If you do NOT submit a form, and your current provider is available again, you will automatically stay with your current provider.
However, IF Governor Quinn truly "takes his responsibility as the state's chief executive very seriously" as stated by his senior health policy advisor, M. Gelder, all Quinn has to do is sign SB178 extending the current healthcare for 2 years which would give the state time to correct the mess made by the Dept. of Healthcare and Family Services. Obviously, they are following Quinn's directions though -- so this entire fiasco lands right in the lap of Governor Quinn. When both Republicans and Democrats agreed and passed SB178, why would Quinn announce he intends to veto this bill? He must owe favors to "someone" in Chicago!
Exactly. I don't know what Governor Quinn's problem is with SB178 but it would certainly give the necessary breathing room. I have a feeling we'll be back in the same boat and looking at another emergency extension in 90 days.
I want to continue with Heath Alliance and have been watching the CMS website for updates. The Health Allliance website sure sounds like they will be back as an option but I'll feel better when it's official.
I watched the hearing on the internet, and the strangest moment -- by far -- was when Hamos said they were shocked to find "exclusivity" in some of the contracts. Huh? It truly seemed as if she was totally ignorant of the 30-year history of Health Alliance with the state. They've certainly had every opportunity to write an RFP that would list "exclusivity" as forbidden, but they never have.
What was never answered was why, if OAPs are so wonderful and the state wants to self-insure, the Chicago area still has an HMO option. That is one question I'd really like answered.
When all is said and done, it is amazing the Governor just doesn't sign S.B. 178. Almost as amazing as his office sending constituents to a full voice mail box. You'd almost think he doesn't care what people think.
The other odd thing is that Health Alliance "exclusivity" is strange, considering at that some, even quite a few, of the physicians with Carle do take other medical plans and have for some time.
I don't know what the "exclusivity" agreement is, but it must not be all that exclusive.
Yeah, I got a full voicemail box too. I called back later though and spoke to a woman. She said the office has been receiving a lot of phone calls and she has to empty it a couple of times a day. Ah well, at least I got everything explained from the past week- it all happened so quickly! I doubt I was the only confused person....oyvay IL...

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