The administrator of the Hawaii Employer-Union Health Benefits Trust Fund, or EUTF, has warned legislative leaders and both state and county personnel officers that vacancies, furloughs, and other issues have created a massive backlog that could leave thousands of public employees unable to access the health care they are paying for after January 1.
The warning came in a November 5 letter from Jim Williams, EUTF administrator, who said the problems will come to a head at the beginning of 2010, following the end of the current “open enrollment” period during which public workers can select from at least two new health plans.
Employees who change benefit plans and schedule appointments for January may find that their health service provider is unable to confirm eligibility and coverage through the carrier/plan administrator, because their records have not been processed and transmitted by the EUTF.
The crisis at the EUTF is “a stark snapshot of the gross incompetence of the Lingle-Aiona administration”, said one employee who forwarded a copy of the letter to iLind.net.
“If people are upset now, just wait until January,” she said.
Williams letter describes a “perfect storm” of problems hitting the agency.
First came the unexpected delay in the open enrollment period, caused by the Lingle administration’s delay in contract negotiations.
Then, due to changes in the makeup of EUTF health plans offered to state employees, those enrolled in HMSA, the state’s largest health insurer, will have to enroll in a new plan in order to maintain their HMSA coverage.
Those changes are expected to bring 10,000-15,000 enrollment forms which must be processed by EUTF staff before the requested insurance can go into effect.
The expected surge in enrollments comes on top of a an already significant backlog, the result of a long-planned upgrade in the EUTF computer system that required a two-week shut-down in processing.
Primarily as a result of the recent EUTF computer system conversion, the EUTF enters November with a significant backlog. There are 3251 enrollment forms waiting processing, 529 forms waiting for scanning, and another 766 forms to be indexed.
Layoffs through the state are expected to bring in another 800-1,100 forms for processing, and increased retirements could result in another 500 retiree forms by the end of this year.
In addition, the EUTF usually fields 4,000 telephone calls per month, but the open enrollment and changed medical plans brought 3,000 calls in the first three days of November.
Given current work schedules and staffing levels, the six (6) employees in the Customer Service section currently can handle about 300 calls per day. As of Novemer 2, 1898 voicemails and 87 emails had yet to be retrieved and responded to, resulting in daily inquiries from the Ombudsman’s Office and other agencies.
But the EUTF is seriously understaffed and the current workload, according to Williams, is “beyond the EUTF’s current capacity to handle.”
The EUTF has only six employees in its Enrollment section, 9 vacant positions which have been open since July 2008, and the agency is coping with the impact of two furlough days per month in the midst of the crisis.
Williams concludes that “we will be extremely challenged to provide even a minimally acceptable level of service to active employee, retirees, and their dependents.”
It’s going to be a wild new year.
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“The crisis at the EUTF is “a stark snapshot of the gross incompetence of the xxxx-Aiona administration”, said one employee …”
A wild new year? — it’s only November and the negative attacks of the gubernatorial campaign are already springing up in the free media (read: this blog)
perhaps, it is the gross incompentance of the past 20 years of creating an inflexible union-based government structure — that prevents a triage approach to solve such a problem
there certainly are many government employees that could be found in the bowels of the government that could be pulled onto an emergency assigment on a “temp basis” to meet this need — but of course that would be unthinkable in a government structured to obstruct creative thinking and problem solving
There are lots of people out there who are long time public servants but have never held a unionized position but are covered by the benefit plans but enjoy none enjoy of the employment security (e.g., so-called “professional” employees). It is of little consolation to them, especially the HMSA/PPO members most immediately affected by this situation, to read your condescending dismissal of their difficulties as caused by something over which they have no control.
If you have something to contribute, do so; don’t vent your spleen here or, if you feel you must, then give specifics. Otherwise, spare us your mean-spiritedness, or go stew yourself in it — alone.
Through circumstances, I have needed to deal with EUTF over the past two or three months to make some changes in our family coverage.
Aside from some glitches in the ‘phone system that jumped me to the back of the queue a couple of times, I have found the customer service staff to be courteous, knowledgeable, and quick-to-respond as appropriate (sending/processing forms, etc.).
I recall a long-ago newspaper story about the ongoing backlog in processing both Employee Retirement System (ERS) and EUTF transactions – and the vacant positions with which both these offices must cope.
Bill (above) is right – if there is a hiring freeze or other impediment to fully-staffing these offices, it ought to be thawed.
By the way, I have found ERS to be exceptionally responsive as well. It’s probably against the rules, but might there not be retired state employees who would be willing to jump in to help as volunteers?
Isn’t Jim retiring at the end of this year?
I retired at the end of 2008 – is that relevant?
The EUTF staff may be great but that is rather irrelevant to the problem. But, as they say in the tv adds, it gets better. EUTF is verifying dependents between now and Dec 31 through a New Jersey company. Come the new year, children, spouses and even the disabled may not be able to obtain health care. A November 4th mailing says if you don’t get your documents to the New Jersey firm hired to run this by December 31, coverage for ALL dependents is cancelled back to October 16. It isn’t clear what happens if you get the documents in but there are problems with them, nor is there an appeal process.
This could be a bureaucratic Katrina.
“If you do not return the Verification Form and Required Documentation by December 31, your EUTF benefits coverage for all dependents will be canceled effective October 16”. No year given but I just talked to Secova after a 15 minute wait and it will be retroactive.
Has anyone considered the effect if claims have to be reimbursed retroactively? If EUTF tries to recover from individuals, that would trigger a string of bankruptcies and the Leg would be faced with appearing callous in the face of horror stories. They don’t do well with callous 😉 Talking to two doctors, they face not getting reimbursed for treating patients between now and the end of the year but in this economy they aren’t about to demand full payment up front, . They are at real risk and of course we have so many spare doctors. Same thing for hospitals. EUTF has dumped the risk and probably the cost on doctors and hospitals, two of our frailer institutions. That should end well.
Does anyone else find the requirement to “verify” our dependents offensive? Are they really saving money by hiring a company to hound us and make us prove that our spouses are legal and our children are ours?
Note that the memo was addressed only to supervisory level types, not to the employees. And that the looming crisis is not mentioned in the 10/09 employee newsletter.
How is it that HMA/Summerlin can provide 90/10 at the current rate but HMSA can not?
If you’re a HMSA PPO member, your screwed.
The EUTF’s requests to fill vacancies are probably in limbo somewhere between Georgina Kawamura’s and Linda Lingle’s desks. Maybe Lt Gov Aiona — acting gov for another week while Linda tours Asia — can find the paperwork, sign it, and let the EUTF fill these needed positions.
People need to re-read Mr. Williams’ letter. This is not about unions blocking the filling of vacancies or EUTF employees being rude or unhelpful. This is about the failure of the executive branch whose leadership has constantly ignored or not understood the consequences of its own actions, whether it was imposing furloughs or repeatedly refusing to fill vacancies in a vital state agency like EUTF.
EUTF apparently arbitrarily chose Summerlin over HMSA because their computer program could only handle one company at 90/10! An interested reporter might ask why Summerlin stopped providing coverage back in Nevada, its corporate base.
http://v-traffic.net/health-insurance/summerlin-health-insurance/
http://www.imxinc.com/wps/portal/Summerlin_NV#
An interested reporter might also ask about similar situations in Iowa, Illinois, Mississipi, Arizona, etc.. Clearly we are banking on an unstable company!
“issues have created a massive backlog that could leave thousands of public employees unable to access the health care they are paying” and so it goes; the continuing unravelling of the corrupt, incredibly mismanaged banana republic known as the State of Hawaii. The laughing stock of america.
Wrong Jim. I meant Jim Williams. And, no, I don’t know if even that is relevant.