Note: With the everchanging benefits landscape, this article was out-of-date before the print issue of Inside Illinois was delivered. We encourage you to visit NESSIE for a full summary of the current health care choices and the status of Benefit Choice.
State officials continue to volley with employee health insurance, though the court they’re playing on keeps changing.
The Illinois Commission on Government Forecasting and Accountability on June 14 became the latest state committee to weigh in on the ongoing and confusing saga, granting the state’s Department of Healthcare and Family Services permission to enter into emergency 90-day contracts while challenges by Health Alliance and Humana HMOs work their way through court.
The complicated issue became more so last week after a Sangamon County judge stopped enrollment in the two replacement plans, PersonalCare and HealthLink open access plans.
Though COGFA’s response created the emergency contracts program, that doesn’t mean the June 17 Benefits Choice deadline has changed – despite the fact that only just over half of all university employees had made a choice by June 15.
“On June 13 the university was directed by CMS (Central Management Services) to tell employees in the discontinued plans that they must select a new plan or be defaulted into Quality Care,” said Katie Ross, associate director, Human Resources Administration, though on Wednesday she said that directive could change.
“It’s important for people to understand that this is not an extension of the current contracts, which expire on June 30,” she said. “These will be new contracts specifically engaged for this 90-day period – although at this time we do not know which vendors will be included.”
CMS reportedly was negotiating terms of the 90-day contracts following the COGFA decision, which officials said included talks with Health Alliance and other current or canceled plans. Officials noted at the hearing that a deal could be struck within days.
“We are waiting for CMS to clarify who the vendors will be, what the impact of no choice is, and what, if any, default there will be,” Ross said.
If and when the courts and the state finalize the plans to be offered, employees will have another Benefit Choice period to make changes, according to Ross.
“The special enrollment that CMS will conduct at some point after the close of Benefit Choice also will provide a second opportunity for employees to make a plan selection if they find that the selection made now is not optimal,” she said.
She said the NESSIE website is being updated to allow Urbana campus employees to make health-plan changes without having to resubmit a paper application. Employee health plan changes made online through NESSIE will be accepted through 11:59 p.m. June 17. Changes made with the paper form (available on NESSIE) should be submitted by 5 p.m. June 17. Employees may fax the form to 217-244-3135 or delivered to the University Payroll and Benefits Services office, Room 177 Henry Administration Building.
At the June 14 COGFA meeting, Ross said, CMS officials indicated employees who have not made a choice would not have to re-enroll if the 90-day contracts with their current providers were approved. However on Monday, CMS had indicated not making a choice, despite the emergency contracts, would default an employee into QCHP.
She said her office is still waiting on CMS direction on that discrepancy and that employees should monitor the state and university websites for clarification and the most up-to-date information.
Ross, who last month testified before two insurance-related legislative committees, said university officials continue to push for clarification and a decision from state officials that will benefit employees.
“This has been a frustrating and challenging Benefits Choice period for many employees,” she said. “We support the interests of our employees by communicating with our legislators and state agencies to help them understand the impact of changes.”
She said the effort was reflected in COGFA’s decision to grant the 90-day extension to provide continuity of care for employees and their families.
Meanwhile, officials at CMS say the state is appealing the Sangamon County judge’s decision stopping enrollment for PersonalCare and HealthLink, which could further muddy the “choice” landscape and further confuse applicants. It’s also unknown what the next step will be once the emergency contracts expire.
For the most up-to-date information on the state employees’ health insurance issue visit NESSIE or CMS online.
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