State Health Plan pushes for changes to address enrollment problems

jfrank@newsobserver.comOctober 29, 2013 

Kathy Merritt is quick to describe what it’s like for state workers and retirees to get health coverage for next year.

Complicated. Confusing. Difficult. “It has really been a nightmare,” she said.

Merritt, a 24-year veteran of state government, said she tried to call an insurance helpline more than once and spent 20 minutes on hold before hanging up the phone. It took her three tries to successfully complete an online health assessment.

And even now that she is enrolled, Merritt is trying to help her co-workers at Cherry Hospital in Goldsboro who are experiencing many of the same problems.

Weeks after the complaints began, State Health Plan officials are more readily acknowledging the situation and pledging to remedy the issues that are preventing hundreds of state employees and retirees from enrolling in an insurance plan.

Mona Moon, the plan administrator, said the state expects its members to wait 30 seconds or less when calling for enrollment assistance, but some are waiting for more than an hour.

“From our perspective, that’s completely unacceptable,” she said in a recent interview. “We wanted to make sure we are providing the best level of service.”

State officials noticed the problems soon after enrollment opened Oct. 1, but the congestion remains. The problems are being attributed to the new company hired to manage the enrollment process, South Carolina-based Benefitfocus. The wait times “have not dissipated like we’d like,” Moon said. “It’s clear evidence they didn’t have enough staff.”

State Treasurer Janet Cowell’s office said Tuesday that Benefitfocus added more customer service representatives this week at the state’s insistence, and the state will continue to push for better response times.

Andy Howell, the company’s chief operating officer, downplayed concerns Tuesday. He said an additional 75 employees were added in recent weeks to handle the high-call volume, which is consistently monitored. “We are likely to continue to add (employees) as we monitor volume,” he said.

Janet Ross, a 79-year-old retired state worker, tried for a week to sign up before she was enrolled. She said the process was frustrating. “I’d usually stay on the phone an hour and I’d finally hang up … , and I did that for four days,” she said.

Edith Faye Swanson, a 72-year-old retired teacher, said she started calling Oct. 8 and still hasn’t managed to enroll. “I’ve been on the phone from 12:08 p.m. to almost 2 p.m.,” she said. “I can’t get a real live person to talk to.”

A website Benefitfocus operates that allows state workers to complete a health assessment and earn a discount on their monthly premiums is also generating complaints.

Mary O’Neill, a recent retiree who worked at N.C. State University, said she still can’t access the assessment page and wants the State Health Plan to delay the $15 charge to those in the system who don’t complete the form. “It simply says it can’t access the information from the website,” she said.

Moon said the state experienced a problem with the wellness assessment website the first week, but it is now fixed. She said the state has not received complaints about the website and there are no plans to delay the charge, which is part of a new wellness program.

A week ago, state officials extended the enrollment period to Nov. 15 because more than half of the 660,000 state workers and retirees in the system had not yet selected insurance coverage.

Moon said the delay is not directly tied to the problems with enrollment, which the state employees association has compared to problems with the federal health insurance program.

The state hired Benefitfocus because the company touted its ability to handle large, complex health plans. The company announced it took the job “to simplify the plan’s complex benefit administration and streamline the benefit enrollment process.”

The company began managing enrollment in 2009 through Blue Cross and Blue Shield. Cowell’s office bid out different components of the health plan in 2012 to save $22.4 million; Benefitfocus bested one competitor to win the three-year contract.

Cowell’s office was not able to provide more details about the contract. Cowell did not respond to requests for an interview.

Frank: 919-829-4698

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