Here is my email to Commissioner Reece. Please feel free to use it, if you like, to help construct your email to him. There is real power in numbers, as youve seen already. Dear Commissioner Reece, I was in attendance at the Legislative Black Caucus public hearing on March 5, 2014. The information gained from the various speakers was very enlightening, but your comment about the SHBP being “robust” was very shocking. While Merriman-Webster provides several definitions of robust, none would seem to have wide application to the current health insurance plan for Georgia’s state employees. One definition in particular seemed to have gotten my attention, which is, “capable of performing without failure under a wide range of conditions.” It would seem, from reading many of the horror stories SHBP members have told on the Facebook page Teachers Rally Against Georgia Insurance Changes, or T.R.A.G.I.C., that one particular antonym for robust, “unsound” might be more accurate. Here are some of the reasons I feel that this applies to our plan. • Many people are being denied services and medications. One woman said she missed 2 months of chemo-therapy because BCBS would not approve her treatment! How can this be “robust” coverage? Several have written in to say that their doctors are writing prescriptions for 30 days, but BCBS will only allow 15 pills for 23 days, with the employee having to pay out of pocket, in the strictest sense, for the remaining days of medication. How can a “robust” plan do this? How is it that the doctor’s orders can be set aside? I’ve seen numerous posts about medications that employees had taken in the past, being completely denied under the current plan. An administrative assistant to one of the members of the House told me in person that the blood pressure medication she had taken for the past 2 years was denied and that she had to have special authorization to obtain the prescription. She must now have the medication authorized each month before BCBS will fill it. She is one of the lucky ones, as some cannot get their medications covered at all. • While the “fix-up” to a seemingly hybrid HMO/HRA plan will help many by allowing for co-pays for some services, the roll-out of this has come in dribs and drabs, leaving employees confused and frustrated. It seems as if we were given some things with the co-pays initially, but the caveat that only medication co-pays could use HRA dollars, left many people angry as they felt they should have the option to use that money as they needed for paying medical expenses. This information wasn’t released until roughly 3 weeks after the initial plan change was made public. We still have not received complete plan coverage, nor new insurance cards, for the plan revision that takes place on March 14, 2014, 5 days from now. • While doing research on guidelines for administering HRA plans, one thing that was on every site I viewed, was that employees should be well informed of the benefits the plan covered before the plan election by individuals and the open enrollment period. While that was done for the initial HRA plan, it was not done after the change, and there was no second open enrollment period. Many employees who had chosen the Gold level of the plan feel they and their families would have been better served if they had chosen the Bronze level. Also, many people who put the maximum amount allowable in a medical Flexible Spending Account (FSA), feel they are likely to lose some of their money they elected to put in the FSA account. Those elections cannot be reversed either. • The SHBP is one that will likely be unaffordable for many of the employees it covers. As one of the Representatives pointed out during the hearing, this just isn’t a plan that the everyday person can afford. The high deductibles still apply for many services such as hospital stays and many expensive tests like MRIs, to name a few. As you know, this insurance plan covers people with a wide range of income. The same plan covers the superintendents of school systems as it does those without degrees, like an administrative assistant or lunchroom manager. While I am not knowledgeable of other agencies in the state that are also covered by this plan, I’m sure these income ranges apply to them as well. It is my understanding that Governor Deal requested a SHBP that would cover the minimum requirements of the Affordable Care Act. Again, using Merriam-Webster as my resource, they define “minimum” as “the least quantity assignable, admissible, or possible.” That seems a better fit for our current health insurance plan, which seems in direct conflict with the definition of a “robust” plan, even when the changes to the HMO/HRA plan take place at the end of this week. Considering the aforementioned problems, I simply cannot imagine how, in good conscience, you and your colleagues at the Department of Community Health (DCH), could possibly create such a plan for the hard working employees of the state of Georgia. Changes should still be made to the current plan, ones that ameliorate those problems bulleted above in this email. In terms of next year, I believe it would be expedient and prudent, to avoid the problems with the SHBP of 2014, for the DCH to consider basing a new health insurance plan for 2015 on employee needs. One simple way to start this would be to send an electronic survey out to all state employees, so that their needs could be known to the department before plan options are set. Feedback could then be given to employees regarding plan choices and the benefits and premiums. Having members on the DCH board who are employees of the state, representative of each agency covered by the plan, would also help ensure that they have input as to the plan options for the coming year. This is, in large part, about informed choice: Create Heath insurance, Options with, Input from Concern Employees. I hope you and your colleagues will provide this for all employees of our great state. Regards, Cathy Abney Clark T.R.A.G.I.C. member
Posted on: Mon, 10 Mar 2014 03:06:15 +0000
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