State employees facing delays in getting health insurance

jfrank@newsobserver.comOctober 24, 2013 

— Hundreds of state workers are having trouble signing up for health insurance, forcing North Carolina officials to extend the enrollment period for the State Health Plan.

The situation is drawing comparisons to the problems plaguing the roll out of the federal health care law, as complaints mount about premium increases and glitches with websites and clogged phone lines run by private contractors.

The enrollment period for the plan – which is managed by Democratic State Treasurer Janet Cowell – was scheduled to end Oct. 31. But on Wednesday, state officials extended the deadline to Nov. 15 because more than half of the 660,000 state workers and retirees in the system had not yet selected insurance coverage.

The State Employees Association of North Carolina says its members are trying to enroll but can’t access the system.

“The State Health Plan is having the same problems that have been cited for the (Affordable Care Act), and there’s been no suggestion that there be legislative committee meetings on the problems state employees have had,” said SEANC’s Chuck Stone, referencing the congressional hearings Thursday on the troubles with the federal insurance system.

Marge Foreman at the N.C. Association of Educators said some teachers are having trouble navigating an overloaded system. The company that designed the online sign-up portal may not have been prepared for the high volume, she said, and teachers calling for assistance are facing long wait times. Some waited more than an hour only to have the call suddenly disconnect.

SEANC officials are hearing the same problems and responding to more than a hundred calls seeking assistance.

“People are not able to get through on the phone and not able to get through on the website,” Davis said. “But they are calling us because they can get through.”

Longer phone wait times

Schorr Johnson, a spokesman for the state treasurer’s office, dismissed the comparison to the federal health insurance program. He said Thursday that the vendor who operates the State Health Plan’s telephone assistance line is experiencing “longer wait times than desired” and is working to remedy the problem. He could not provide details about the changes.

“It has been running fairly smoothly,” he said.

Unlike the federal system, Johnson said, state workers trying to enroll currently have health insurance and those that don’t pick a benefit plan will be assigned one. He said the treasurer’s office is not aware of any website problems and has not received many complaints. He refused to make Cowell available for an interview.

Gov. Pat McCrory’s office has fielded a few complaints about the system and he is aware of the issue, a spokesman said.

State workers are facing insurance premium hikes for 2014. The monthly premium for the enhanced insurance plan, known as the 80/20 plan, is increasing from $22.63 to $63.56 a month, said Toni Davis, a SEANC spokeswoman. It hits the same year state employees saw pay remain flat, she said, and comes even with the State Health Plan no longer running a deficit.

“What state employees were hoping for is that some of the funds would be reinvested into the health plans and the premiums would become lower,” Davis said.

Assessment slowing enrollment

But what’s complicating enrollment this year is a new program that requires state workers in the 80/20 and high-deductible plans to complete an online health assessment to get lower premiums.

The computer and phone delays are preventing some state employees from filling out the assessment. Others are reporting that they completed the form but the private company that manages the information lost it, SEANC officials said. “Since the State Health Plan is doing so well, why are we making state employees go through all these punitive measures,” Davis said.

The treasurer’s office said it is not aware of any cases where the vendor failed to relay employee forms. “The state health plan will work with members to make sure if there is any difficultly that it is resolved,” Johnson said.

State workers who complete the assessment can save $10 on their monthly premiums. They can save another $10 for selecting a primary care doctor and $20 for not smoking.

Wellness credits cut premium

Health plan officials call them “wellness credits,” saying they will encourage healthy behavior. SEANC officials call them “wellness surcharges” that hurt low-paid state workers.

“Penalties should not be exercised against employees who tried to get through and couldn’t get through (to fill out the assessment),” Stone said, again echoing calls at the federal level from lawmakers to delay parts of the national insurance mandate.

The state’s traditional insurance option that charges no monthly premiums for employees and retirees without dependents, known as the 70/30 plan, remains unchanged and not subject to the wellness requirements. This is the default plan for state workers who do not complete the benefits application.

SEANC officials believe the State Health Plan is trying to push state employees into the high-deductible plan because it will save the state money at the cost to employees. The organization is traveling the state to talk to its members and warn them about what they believe are hidden expenses and a “great cost shift to employees.” It’s the first tour of its kind since 2005, officials said.

“The plan is designed for the employee that does not look beneath the window dressing,” Stone said.

Johnson said the high-deductible plan and the wellness discounts were requested by plan members who wanted more options that “incentivized healthy living.”

Frank: 919-829-4698

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