Third strike for Health Alliance?
Wednesday, Oct 2, 2013 - Posted by Rich Miller
* Is this yet another waste of time? We’ll see…
The state has selected four new contractors for state retiree health coverage, effective Jan. 1, 2014, and Health Alliance Medical Plans isn’t among them.
That will require 6,000 retirees who get their care through the Carle health system to change where they go for medical care by the end of the year, Health Alliance spokeswoman Jane Hayes said Wednesday morning. […]
None of the selected insurers has Carle in its provider networks, which is why current retirees in the state system would have to change where they go for health care, Hayes said.
* Health Alliance has a vast provider network that it’s built up over many years. There are legit worries about not enough doctors to go around. That was also the case two years ago…
Health Alliance wasn’t selected for state employee and retiree health coverage in 2011 contract selections, setting off a public uproar, legislative action and a court challenge, and was eventually restored as an insurer for employees and retirees.
* But this battle to dethrone Health Alliance goes beyond 2011. Rod Blagojevich tried to do it, too. From 2004…
Meanwhile, another health-care related issue involving the state has drawn the attention of federal investigators. A spokeswoman for Health Alliance, a longtime health insurance provider for state employees, said Friday that federal agents had questioned officials from the firm. The spokeswoman said Health Alliance was not being investigated.
Health Alliance and state workers complained after the Blagojevich administration earlier this year dropped the insurance provider after trying to rebid the insurance contract. The resulting outcry forced the administration to extend the state’s existing insurance contracts, including Health Alliance’s.
State Sen. Rick Winkel (R-Champaign) said his contacts at Health Alliance have told him the U.S. attorney’s office had contacted the company regarding irregularities in the bidding process.
* Meanwhile, another state move is causing some consternation out there as well. Just one of many e-mails from a retired state employee reader…
Rich, I received a letter today that was from a company that is representing CMS. They are doing an audit check to make sure my dependents are still qualified to be on my insurance plan. They are asking for a copy of my federal tax face page and property tax statement for 2012. There were other ways to prove if your wife or kids are allowed to be on your plan. I have been married for 39 years and worked for the state for 23. I guess they are trying to purge the insurance rolls and remove unqualified people. The company doing this work is from Indiana. You would think CMS would be able to do this without hiring a out of state company. Failure to comply with this will result in cancellation of the dependents insurance.
- wordslinger - Wednesday, Oct 2, 13 @ 11:06 am:
–They are asking for a copy of my federal tax face page and property tax statement for 2012.–
To which you should reply in a manner not allowed here.
There are much less intrusive ways to verify eligibility.
- lincolnlover - Wednesday, Oct 2, 13 @ 11:07 am:
Without getting into the whole Chicago vs downstate thing, I’m not sure the people making this decision took anything other than pure price into account. If Carle is the best health care provider in your area and you live 50 miles from any other health facility (as some in central and southern Illinois do), it makes sense to have them as a provider. Geography and access also need to be part of the decision making process.
- Illannoyed - Wednesday, Oct 2, 13 @ 11:18 am:
My comment isn’t about the insurance issue and the intrusive audit, but about state purchasing. I am a retired state employee who, in 2012, was no longer allowed to write a freaking $1,500 contract to the person who had done indexing professional (for god’s sake) for a dozen years because the indexer lived in Indiana and the State of Illinois “had an absolute preference for Illinois contractors.” How much do you suppose the Indiana company is making on these audits? And who is the political connection?
- Huggybunny - Wednesday, Oct 2, 13 @ 11:28 am:
Here we go again…my guess is the cost is all that CMS looked at,like what happened in 2011. They awarded the contract to BCBS which didn’t even have networks set up in Central/Southern IL, so in essence, no doctors to go to–and the doctors that were in the area weren’t accepting new patients, let alone 1000’s more. This decision does not surprise me, coming from CMS (Can’t Manage Stuff)!
- Federalist - Wednesday, Oct 2, 13 @ 11:33 am:
Anything the state can do to hassle state employees will be done! That is what this is all about.
As far as to the eligibility requirements for dependent care, I find this most interesting. On the surface this seem to be a reasonable request if all possibilities have been taken into account. For instance, if the child is older and is on disability from SS then why would anyone claim them as a dependent and why would the state want the parents tax returns. They tax returns of the child SS disability yes, but that is it.
Furthermore, it will be interesting to see how much of a stickler the government will be as they seek to enroll those into ACA/ObamaCare. I am betting the Feds will be so anxious as to get as many on the roles as fast as they can that detailed proof of eligibility will not be a prime concern. We shall see, providing the truth ever comes out.
It is also interesting that the state, to the best of my knowledge and my State Senator does not deny it, still provides medical assistance to illegal aliens through the ALLKids program. A 2010 state audit found over 54,000 illegal aliens in this program.
But meanwhile let’s hassle state employees as much as we can. And I don’t won’t to hear about whether it is the Republicans or Democrats at fault as I don’t see either party addressing the issues I have mentioned.
- Fed up - Wednesday, Oct 2, 13 @ 11:34 am:
Hmmm it’s almost as if you could say the the Quinn administration is incompetent
- Norseman - Wednesday, Oct 2, 13 @ 11:45 am:
Word, it’s not just a copy of your tax return. It has to be a copy that you obtain from the feds. They don’t trust that you will not phony up a tax return on your tax software.
This is going to be a difficult process for a lot of folks.
- Norseman - Wednesday, Oct 2, 13 @ 11:47 am:
Correction. It has to be a copy of the copy you obtain from the feds.
- Norseman - Wednesday, Oct 2, 13 @ 11:52 am:
Regarding the bid that Health Alliance lost. I was under the belief that CMS was bidding for vendors to provide Medicare Advantage coverage which will become effective 1/1/14. I’m not sure how this will affect the regular health coverage of state employees and non-Medicare covered retirees.
- east central - Wednesday, Oct 2, 13 @ 11:57 am:
Something is wrong with this “audit” to put it mildly. Are persons being asked to send to a non-governmental agency documents with personal information that makes them vulnerable to all sorts of privacy breaches and scams? (I am not sure I would trust sending it to a governmental agency either). This has the appearance of a phishing scheme.
Is this something our Attorney General would find acceptable?
- RetiredStateEmployee - Wednesday, Oct 2, 13 @ 11:59 am:
And how would a get a copy from the feds while the government is shut down. All the IRS hotlines are closed. Will the IRS website work?
- kimocat - Wednesday, Oct 2, 13 @ 12:11 pm:
I took the requirement to mean that you had to provide a copy of the coversheet on your 2012 federal tax return and if you did not have that copy, you could request it from the feds.
- Nieva - Wednesday, Oct 2, 13 @ 12:29 pm:
That is what I used kimocat. I blacked out all the income amounts. I made a couple of calls and it is legit, but you would think CMS could have made this check without an outside contractor being involved.
- Bigtwich - Wednesday, Oct 2, 13 @ 12:33 pm:
From the CMS web site:
“NOTE: Due to the Federal government shutdown and possible subsequent delays in the government’s processing of IRS tax transcript requests, those members who need to order a federal tax return transcript should go ahead and do so. If a response is not received within two weeks, members should request an extension of the documentation deadline to HMS. Members should refer to Question 13 in the Dependent Verification Audit Frequently Asked Questions document for instructions regarding how to order the transcript and Question 10 for instructions on how to request an extension. The deadline for requesting an extension is October 25th.”
- Ethics - Wednesday, Oct 2, 13 @ 12:33 pm:
Why can’t they get this from il dept. of revenue. Why the irs?
- Nearly Normal - Wednesday, Oct 2, 13 @ 12:35 pm:
From the CMS website–
State-Sponsored Medicare Advantage Plans
The Department of Central Management Services (CMS) announced today that the Medicare Advantage procurement has concluded and contracts are being awarded to the winning vendors. All members who will be offered a Medicare Advantage plan option, whether they live in Illinois or in another state, will have access to a nationwide Medicare Advantage PPO plan. Certain members residing in Illinois, depending on residential county, will also have access to a Medicare Advantage HMO plan. It is the Department’s intent to award the following contracts –
Aetna Life Insurance Company - a Medicare Advantage HMO Plan;
Humana Health plan - a Medicare Advantage HMO Plan;
Humana Benefit Plan - a Medicare Advantage HMO Plan for the counties of Livingston and Knox; and
United Healthcare - a nationwide Medicare Advantage PPO
Although it is the intent of CMS to award to the winning vendors, the award process includes a 7-day dispute period which will end next Wednesday, October 9th. Impacted members will be sent letters from CMS regarding the procurement and the next steps they need to take regarding their health insurance coverage. More than one mailing will likely be sent as additional information is finalized and enrollment/seminar dates are scheduled.
Once all matters are finalized, the letter(s) will, at a minimum, include the following information:
Plan design, including copayment amounts, deductibles and coinsurance percentages
Provider networks
Enrollment dates
Effective date of the new coverage
Monthly premiums
Opt out information
Seminar dates, locations and times
Members who receive the letter and do not want to elect one of the new Medicare Advantage plan options will be instructed on how to opt out of their current health plan. Impacted members who do not elect one of the new Medicare Advantage plans offered will have their coverage terminated.
As there are certain formalities that must be followed before the procurement is finalized, limited information remains available, both in the CMS Benefits Office and with the selected vendors. We would ask that you refrain from contacting the vendors until this process is complete as their staff is not yet familiar with the plan(s) being offered. Your patience and assistance is appreciated.
Please check back to this website page often as information will be posted here once it is known.
- Formerly Known As... - Wednesday, Oct 2, 13 @ 12:38 pm:
=== Health Alliance has a vast provider network that it’s built up over many years. There are legit worries about not enough doctors to go around. ===
If none of the other providers have stepped up to build a comparable provider network of their own after all these years, then there is definitely a cause for concern. They need to step up and provide a similar level of choice.
Otherwise, it is inappropriate to punish state workers by getting rid of Health Alliance and failing to offer a comparable level of choice.
=== contacts at Health Alliance have told him the U.S. attorney’s office had contacted the company regarding irregularities in the bidding process ===
Wow.
Instead of trying to outcompete and outperform Health Alliance, some of these other companies may have been trying to game the system?
Sick.
- RIO1945 - Wednesday, Oct 2, 13 @ 12:39 pm:
As a State retiree, I too received this request a few days ago. Hadn’t heard anything previously. Yes, they wanted the front page of the Fed 1040, but they were very clear in saying that all income info should be covered/blacked-out. And, yes, they wanted a recent credit card or other bill from the last 60 days showing my spouse’s name along with my own. The alternative was last year’s property tax bill, but again, all financial info could be blocked-out. Finally, for an adult son still on my policy as a dependent, we had to provide a copy of his birth certificate. While this seemed rather intrusive, I decided to comply as I was able to block any “sensitive” data.
- Arthur Andersen - Wednesday, Oct 2, 13 @ 12:43 pm:
Kim, they are asking for a 2012 IRS tax return “transcript” available only by request from the (shutdown) IRS along with birth certificates for your kids (to make sure they are legitimate.)
Worst CMS move in recent memory.
Oh, and Health Alliance continues to be on double secret probation for being a little too uh, Foxy in its marketing 10 years ago? C’mon man.
- RIO1945 - Wednesday, Oct 2, 13 @ 12:49 pm:
Just a quick follow-up. This change is to implement the “mandatory” Medicare Advantage program for retired Medicare-eligible. CMS has a bit more here: http://www2.illinois.gov/cms/Employees/benefits/StateEmployee/Pages/State-SponsoredMedicareAdvantagePlans.aspx
- Irish - Wednesday, Oct 2, 13 @ 1:14 pm:
Per the SOP in Illinois government operations is to not think but just act. The whole state insurance program is a joke. A couple of years ago they started to try to get everyone off of the Quality Care insurance and into an HMO of some sort. They raised the rates on the Qchp insurance to force people to move. What they don’t take into account is that very few if any of the HMO’s are statewide. So If I have a child on my insurance anfd that child is going to a University in another county they have no access to an in network doctor or hospital. The only way is to have the Quality care insurance. In order to have network doctors for my kids in school I have had to pay the increased rates for the Quality Care program. I doubt that the legislators or bureaucrats in charge of the insurance program are even aware of this. And probably wouldn’t care if they did know.
- ryan - Wednesday, Oct 2, 13 @ 1:16 pm:
For some reason I was thinking it was DHS that chose the providers, not CMS. Is that not the case?
- mythoughtis - Wednesday, Oct 2, 13 @ 1:21 pm:
Irish - are you overlooking the Healthlink OAP, which functions like a PPO, not an HMO? You don’t need referrals, most doctors/hospitals are in one of the networks. Rates just a little higher than the HMOs.
- just asking - Wednesday, Oct 2, 13 @ 1:42 pm:
How come no medicare supplements which I thought were part of the procurement?
- anonymouse - Wednesday, Oct 2, 13 @ 1:54 pm:
My friend, a state of Ill retiree spoke to a representative of HMS in Indiana. The rep told him he needed to supply a certified copy of the front page of his 2012 1040 from the IRS.
I need to supply same and have requested a copy 0nline from the IRS. The IRS says 5 to 10 calendar days for the request, prior to the Shutdown. So, the Oct 25 deadline may be not able to be met because of the Shutdown in DC. SERS apparently has no answers, nor does CMS. It’s a cluster of magnificent proportions.
- Cindy Lou - Wednesday, Oct 2, 13 @ 2:02 pm:
I read about the upcoming retiree audit online via CMS the day before the letters were to be mailed to retirees (Sept 25th by mail date to go). I called the number for my 2012 tax transcript immediately. It was total automated call, and (knock on wood) with the 5 to 7 day they gave me to expect, my transcript should have left their office prior to the ’shutdown’.
I trust the fun and games being played in this state about as far as, well, you get the idea. Anyway, the letter clearly states that all they really need is the top section. It goes on to state financial can be blacked out. Besides this 2012 transcript, they want an additional proof more current (within last 60 days) and of course my bank account statement or mortgage statement is what they’re looking for.
I also need to provide court documentation on guardianship of my little one. Of course I suppose CMS who required such proof when little one was added isn’t ‘good enough’. Ok, so I copy and send off to this out of state company (pfft). So what next? Does this company decide there’s a chance there’s been a switch? Is little one being on 2012 federal tax transcript proof enough> Who knows? The 2012 bit wasn’t proof enough to prove I didn’t dump my hubby within the last 60 days.
Totally BS. A state worker already being paid can walk right over and view my already documentations. I guess somebody needed to award a private sector contract. I also bet there will be additional questions even after paperwork and copies of documents are sent in. It was also noted that if your dependent does not qualify, payback of premiums to July 1st will be required.
- retired and fed up - Wednesday, Oct 2, 13 @ 2:28 pm:
I will be in really bad shape due to the Medicare Advantage Plans. I moved to NW Indiana when I retired last year to help care for my 89 year old mother. Not one of the new plans has a physician within 60 miles of me, about the distance I now live from Chicago. I have well controlled diabetes, glaucoma and heart problems because with BC/BS HMO and Medicare I have been able to get excellent needed medical care. My physician out here also is treating a previously undiagnosed thyroid condition, which could have been fatal. I guess this is one way to deal with the pension crisis - ill off the retirees. I also now get the privilege of paying a monthly premium for this after 30 years of State service. Thanks AFSCME!
- retired and fed up - Wednesday, Oct 2, 13 @ 2:29 pm:
That should have been kill off retirees. I am quite ill with a respiratory infection now and just saw my doctor this morning.
- Cindy Lou - Wednesday, Oct 2, 13 @ 2:41 pm:
Retired n fed-up, I too was very concerned over the mandated Medicare Advantage bit. My husband is not affected January 1st yet but will be next July. Up until recently when CMS added the notation that retirees with dependents not old enough for Medicare would ‘at this time’ not be required to do the Medicare Advantage. All along a family must have the same insurance provider selection (meaning if husband had health alliance hmo me and little one had to have that selection also).
I’m ten years younger than husband. I can not enroll in their Medicare Advantage for a number of years. So what happens when the ‘at this time’ statement becomes ‘tough luck lady’. So is the game plan to force me and kiddo off eventually? Of course that would be after they all decide how much of husband’s pension they’d like to downsize after they settle on their ‘pension reform’.
- Curmudgeon - Wednesday, Oct 2, 13 @ 2:55 pm:
== Formerly Know As == That reference to federal investigators asking questions was in reference to CMS insurance bidding during Blago’s first term, not the current action. CMS solicted & received bids & THEN changed the rules for ranking after seeing that Health Alliance was going to win.
Early newsmedia reports — originating from the C-U Gazette — state 6000 State retirees will have to switch from Health Alliance. But is that just in Champaign County or the CU metro counties? Just U of I retirees? The number seems awfully low if we’re talking total retirees using H.A. in the combined 5 State systems.
NONE of the Medicare Advantage providers selected are current State employee/retiree providers on CMS’ FY14 insurer list, so doesn’t that mean EACH AND EVERY State-employed, State University, and Downstate teacher retiree will have to switch to a new insurer by Jan. 1?
And what about the vision and dental insurance?
Has Bill Black seen this yet?
- retired and fed up - Wednesday, Oct 2, 13 @ 2:57 pm:
So Medicare eligible retirees are put in two classes - those with younger dependents who can keep what they have and those without who can’t. Most likely those without are older and appear to be discriminated against.
AFSCME Steward, Any Comment?
- Anyone Remember? - Wednesday, Oct 2, 13 @ 3:00 pm:
Outside of Chicagoland, there isn’t always a sufficient number of vendors in many lines of business to make changes smooth / possible. Such as Steve Schnorf has previously pointed out about Springfield real estate.
https://capitolfax.com/2011/11/03/the-man-and-his-money/
HMOs - if the political leadership at CMS were serious about reducing health care costs, they’d try to come up with an easy to use plan that can be used by out of state retirees / snowbirds / employees with college students out of HMO area. It wouldn’t be easy, but, going back to the first HMOs, have they ever tried?
- Quincy - Wednesday, Oct 2, 13 @ 3:00 pm:
I called yeserday and HMS told me to write them a letter and ask for a extension and they will give me one for 30 days. And if the shut down is still going on in 30 days I have to write them again and ask for another extension. This just a nother realson to get riad fo cms they are breaking this state.
- Nearly Normal - Wednesday, Oct 2, 13 @ 3:05 pm:
Cindy Lou, you and family will not have your insurance changed until both spouses are Medicare eligible and your dependent is not on your insurance. So, you can hopefully breathe a little easier for a while.
- Anon - Wednesday, Oct 2, 13 @ 3:30 pm:
HMS seems to have offices in lots of states, but not in Illinois. They do dependant audits for many companies - here is a link pushing their service:
http://dependentcheck.com/
Maybe someone will recognize the names of their executives (the names mean nothing to me) - here is a link to a list of their executive officers:
http://investor.hms.com/management.cfm
and to a list of board members:
http://investor.hms.com/directors.cfm
- #shutdown - Wednesday, Oct 2, 13 @ 3:40 pm:
Just an FYI - I just tried to both call and use the online tool to order my tax return transcript and neither works.
- AFSCME Steward - Wednesday, Oct 2, 13 @ 4:03 pm:
The changes in medical are the work of CMS not AFSCME. AFSCME lobbies on behalf of retirees, but does not directly represent them. I would suggest that retirees contact their state reps to express their concern.
Additionally, rather than blaming AFSCME, look at what AFSCME was able to accomplish in the last contract negotiations. CMS was planning to charge retirees as much as 25% of their income towards medical costs. The AFSCME contract dramatically reduced that amount. Retiree payment for medical is currently being lidigated. The AFSCME contract really helps retirees if the court case should fail.
“So Medicare eligible retirees are put in two classes - those with younger dependents who can keep what they have and those without who can’t. Most likely those without are older and appear to be discriminated against.
AFSCME Steward, Any Comment?”
- Federalist - Wednesday, Oct 2, 13 @ 4:08 pm:
@AFSMCE steward,
Your comment below is entirely accurate. Unfortunately, no one really represents those already retired at the bargain table or anywhere else for that matter.
The changes in medical are the work of CMS not AFSCME. AFSCME lobbies on behalf of retirees, but does not directly represent them. I would suggest that retirees contact their state reps to express their concern.
- LINK - Wednesday, Oct 2, 13 @ 4:08 pm:
Maybe I missed it but does anyone know why they are trying to push out Carle and Health Alliance?
Thanks.
- Federalist - Wednesday, Oct 2, 13 @ 4:12 pm:
@ Retired and fed up,
Certainly AFSCME did not do a lot for those of us already retired- particularly if you were hired before April 1, 1986 and are not and never will be Medicare eligible.
Having said that, without them the Governor and GA would have made it even worse for us.
Again, no one represents those of us who are retired. And no one in the GA or Governor’s Office is desirous of such representation.
- Cheswick - Wednesday, Oct 2, 13 @ 4:15 pm:
== Why can’t they get this from il dept. of revenue. ==
I’m guessing that Revenue is prohibited due to privacy laws.
On another note, this whole purging of the insurance rolls sounds like busy-work money making scheme for somebody.
- Concerned Retiree - Wednesday, Oct 2, 13 @ 4:21 pm:
Two of the 6 bids which were rejected were for Medicare supplements rather than Medicare Advantage programs. One was a bid by Health Alliance.
There is a big difference between the 2 types of insurance. Medicare Advantage means you give up original Medicare and the right to purchase a supplement and purchase a private insurance package; this private insurance must include most benefits in original Medicare but may not include prescriptions and may have a variety of co-pays, deductibles, etc. Medicare Advantage is not accepted everywhere that original Medicare is accepted.
By rejecting both bids for Medicare supplements, the state has limited the choice that retirees have.
- Norseman - Wednesday, Oct 2, 13 @ 4:24 pm:
=== Why can’t they get this from il dept. of revenue. ===
Would it be that dependents are listed on the fed form, while they are not listed on IL1040?
- retired and fed up - Wednesday, Oct 2, 13 @ 4:25 pm:
I spoke with the AFSCME retiree person today and AFSCME did negotiate the Medicare Advantage Provision for Medicare eligible retirees during contract negotiations. CMS agreed and took bids for who would provide that service, but AFSCME negotiations put the provision in place. Sorry, Steward, but you are wrong.
- retired and fed up - Wednesday, Oct 2, 13 @ 4:29 pm:
Doesn’t AFSCME represent those in its retiree chapter?
Also the fact that there are no supplement plans is a huge problem, Advantage plans are almost always much more expensive for the insured and choices of who you can see are quite limited. So once again thanks.
- jake - Wednesday, Oct 2, 13 @ 4:36 pm:
For retirees in the Champaign-Urbana area, which has a higher fraction of its population as state retirees than any comparable population center in the state, this is insane. It is not just that we would have to leave long-established relationships with Carle physicians, but there would be no place else to go, because no other provider in east central Illinois has the capacity to absorb all the people who would be displaced. It’s marching-on-Springfield time again.
- retired and fed up - Wednesday, Oct 2, 13 @ 4:37 pm:
I also don’t appreciate that I paid Medicare taxes for over 50 years and now will have to give it up or opt out and purchase a supplemental plan on my own at great cost with reduced benefits after having given the State of 30 years of my life.
- mythoughtis - Wednesday, Oct 2, 13 @ 4:43 pm:
In order to get ahead of the ball game (as an active employee I won’t get asked for my proof for another month), I tried the IRS website. It would not work for my spouse’s SSN. when I tried miene, it told me I had to use my spouse’s since his name was first on the return. So, I filled out the form, and will have to mail it in to get this transcript.
Here’s a thought. Ask for our marriage license and our own copy of our tax return. Period. Quit calling us all dishonest until and unless you can prove we are.
- enoughalready - Wednesday, Oct 2, 13 @ 4:45 pm:
At what point are the decision makers at CMS removed from their jobs for sheer incompetence?
- Nearly Normal - Wednesday, Oct 2, 13 @ 5:48 pm:
I told my colleagues who are in the Chambana area to contact their state senators and reps. They need to know and hopefully can put some pressure on CMS. That helped in the past and CMS had to renegotiate with Health Alliance.
- DuPage Dave - Wednesday, Oct 2, 13 @ 6:05 pm:
CMS is assuming that you are not married if you don’t file a joint federal return. There’s no requirement that married people file a joint return. Typical reason why people say that they can’t manage stuff.
- Just Wondering - Wednesday, Oct 2, 13 @ 7:02 pm:
Can someone provide a source for the CMS statement that Medicare eligible retirees with non Medicare eligible dependents will not be part of this initial Medicare Advantage dictate.
?
- RNUG - Wednesday, Oct 2, 13 @ 7:26 pm:
ryan @ 1:16 pm:
Over the last 10 years, the employee health insurance has moved back and forth between CMS & DHS & now CMS again as of, I believe, last year
- SwimMaster - Wednesday, Oct 2, 13 @ 8:19 pm:
“Note: At this time, members who have one or more dependents on their coverage who do not have Medicare as their primary coverage will not be required to change to one of the new Medicare plan options. ” Quote found at http://www2.illinois.gov/cms/Employees/benefits/StateEmployee/Pages/State-sponsoredMedcarePlan.aspx
- Retired SURS MD - Wednesday, Oct 2, 13 @ 11:45 pm:
When you contact your lawmaker (all retired SURS,SERS, TRS etc on Medicare should do so immediately) please ask them why they voted for SB 1515. Other commenters more knowledgeable about such things can explain the significance of this.
- Concerned almost retiree - Thursday, Oct 3, 13 @ 8:35 am:
I took a job with the state mostly for the ‘good’ medicare supplement that I would have when I retired. I knew I would have to pay because I couldn’t work the 20 years for the premium free health insurance, but the premiums were similar to what I could by a medicare supplement for and the coverage was better.
Now retirees are being forced into a medicare advantage plan which is being phased out and limited in lots of areas. CMS said they would also include a medicare supplement and now it appears that isn’t going to happen.
This is jus an example of why I don’t want a medicare advantage plan and would rather keep medicare that I have already paid for for almost 50 years and purchase a supplement.
Although the U.S. Department of Health & Human Services issued a 3 percent increase in Medicare Advantage payment rates a few weeks ago, UnitedHealth is reassessing its outlook for the program.
The chief executive of UnitedHealth, the country’s largest provider of Medicare Advantage plans, said the company may have to cut benefits, change provider networks or exit some markets to ensure its Medicare Advantage plans remain profitable.
That’s because UnitedHealth is preparing for more cuts next year – as much as 4 percent – in the Medicare Advantage program, which UnitedHealth CEO Stephen Hemsley called “significantly underfunded” during a conference call Thursday, Fox Business reported.
We did not expect the fastest-growing, most popular and most effective of the Medicare benefit options serving America’s seniors would be underfunded to this extent in 2014,” he added, reported Bloomberg.
Consequently, the forecasted cuts “will cause UnitedHealthcare to reduce benefits and pull back access in certain markets and will affect the growth prospects and earnings potential for our overall Medicare Advantage offerings across all our markets for 2014,” Hemsley said.
His comments came amid UnitedHealth’s report of its first-quarter earnings, which sank 14 percent to $1.19 billion, compared with last year’s $1.39 billion, according to the Associated Press.
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