Silly me. I thought I would drop by the State Capitol yesterday afternoon for the information session about changes in the public employee health insurance plan choices. Just me and thousands of others, it turned out.
There was no parking anywhere near the capitol. The capitol auditorium turned out to be a limited venue for the demand. Hallways were clogged with lines wandering up and back, elevators were running at their normal slow speed, and it was generally chaos.
The basic change is that the Hawaii Employer-Union Health Benefits Trust Fund decided to offer the choice of a slightly lower cost health plan that provides a lower level of benefits.
In the past, employees covered under the default plan paid 10 percent of medical costs, with 90 percent paid by the insurance. They will now have the choice of an 80/20 plan with lower monthly premiums.
In addition, HMSA, the local not-for-profit provider, has been displaced as administrator of the primary 90/10 insurance option by a for-profit mainland company, Summerlin Life & Health Insurance Company, after EUTF decided it could not offer competing 90/10 plans.
And that decision was based on a technical requirement of the EUTF’s newly upgraded computer system rather than a more substantive reason, according to an explanation provided by the University of Hawaii Professional Assembly
When the EUTF decided to add a lower cost 80/20 benefit plan, they felt they need to eliminate one of the 90/10 providers; either HMA or HMSA for technical reasons having to do with the number of code spaces on the EUTF computers.
Did I read that right? The number of spaces on a form utilized by the EUTF’s fancy new computers dictated the shape of the coverage offered to the tens of thousands of public workers? Whew.
This is the same computer system that was recently upgraded, causing a two-week hiatus in EUTF’s processing of enrollments and claims.
UHPA also offers the following observation:
However, there are differences in the panels of participating physicians between HMA and HMSA. Further, if you travel to the mainland, the Blue Cross system of the hospitals and physicians will not require any up-front cash payment for services; they’ll accept your HMSA card. HMA also has a panel of participating hospitals and medical facilities on the mainland, but it is not as extensive. Hospitals or doctors may be required to get telephone approval for your charges you incur, or you may have to pay for the medical services and then submit them for reimbursement upon returning to the Hawaii.
The company announced in December 2008 that it was pulling out of the commercial preferred provider insurance business in Nevada.