University Council > University Benefits Committee November 17, 2009
UNIVERSITY BENEFITS COMMITTEE MINUTES
November 19, 2009
Present: Terry Borg, Virginia Cassidy, Abby Chemers, Dennis Davito, Kay Forest, Ray Foster, Deborah Haliczer, Amy Levin and Pam Rosenberg
The meeting was called to order by Deborah Haliczer at approximately 10 AM. Deborah welcomed everyone. She introduced Amy Levin, Acting Associate Dean, College of Liberal Arts and Sciences, who is the newly appointed faculty representative.
The agenda was approved after an item was added. The minutes were approved.
Benefits Office Update
Approximately 120 to 130 individuals attended the retirement session held in the HSC. Employees reported that it was helpful for SURS to be here for one-on-one counseling sessions.
The Illinois public universities finalized their arrangement to contract directly with Prudential for optional employee disability coverage. As a result, approximately 75% of those enrolled in the optional insurance will see a decrease in the rates. The others may see an increase in the rates. Overall, the total costs will be less as the middleman agency was eliminated.
Old Business
A. Deferred Compensation Programs
No updates.
Domestic Partner Benefits
Differences between employee benefits for married couples and domestic partners will be discussed at the Board of Trustees Legislation, Audit and External Affairs Committee meeting in March 2010. {This meeting has been rescheduled to February 4, 2010} The State of Illinois takes the position that opposite sex couples can be married, so state health insurance benefits are available only to same sex domestic partners as they cannot be married. Illinois would have to change the definition of marriage for same sex partners to be eligible for SURS death benefits. NIU domestic partner benefits for same sex couples compare in a generally positive way to the other Illinois public universities’ domestic partner benefits for same sex couples.
Annuitants Association (AA)
The AA is concerned that annuitants are experiencing problems getting medical services given that Illinois is significantly behind on payments for claims reimbursements to medical providers. They want to know if the Benefits Office has seen an increase in questions from annuitants. Dennis reported that HRS doesn’t have access to the annuitant’s health insurance records so they refer annuitants to CMS Group Insurance Office. Many do call or come into the office, but such callers and visitors are not generally asked whether they are active employees or retired. Deborah noted that she attended the AA Meet and Greet Event at Barnes and Noble and that there was a lot of interest on this topic.
It was reported that Irene Rubin has resigned from the AA Board and from her lobbying/organizing efforts.
Annual Report
No update.
New Business.
A. Health Insurance Reimbursement Discussion
Much discussion ensued on this very serious topic. The state is significantly behind in medical claim reimbursements to medical providers. Accordingly, late payments to medical providers for health insurance claims are negatively impacting employees and annuitants. Some medical providers are requiring payment up front. In some cases, people are being denied or postponing medical services because they can’t afford to pay the medical providers up front in full. Locally the Kishwaukee Health Network is considering becoming an out-of-network provider. Such a decision could have severe financial consequences for employees that use these local doctors. The HMO option with Unicare will not be available to state employees after December 31, 2009. This will impact 36 NIU employees who live in the Chicago area.
Dennis reported a little more than 50 percent of the state employees are enrolled in HMO’s and the others are enrolled in Quality Care. Payments to medical providers for health and dental claims under Quality Care are six and seven months behind, respectively. If the Quality Care medical provider is out-of-network, payments are nine to ten months behind. CMS reported that payments to the HMO’s are now behind too. Contractual payments to Health Alliance are approximately one month behind. It is unknown if payments are being made to medical providers when the claims fall under secondary insurance. Payments to medical providers for claims filed under Worker’s Compensation are more than 1.5 years behind
In the meantime, employees continue to pay their medical premiums each pay period. The state says employees cannot stop paying premiums. Various legal actions (like court injunctions) have been raised. Some employees have asked HRS to change them from Quality Care to an HMO but CMS has refused, saying they cannot do so due to IRS regulations.
CMS has posted an update on their website, under the Benefits Programs tab, to explain that funds are not available to pay the medical providers in a timely manner. CMS has revised the update when payments are made so employees with Quality Care can track when doctors are being paid. CMS has set up a Customer Service Hot Line for individuals being negatively impacted due to the State’s late payments (1-866-465-9889). The Attorney General has set up a web form for individuals to file complaints - http://www.suaa.org/aboutsuaa.htm
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