April 7, 2016
The budget impasse has raised questions about health insurance coverage
when UIC personnel need to see medical practitioners.
By Susan S. Stevens
YOU SPRAINED your ankle. Or, your child’s asthma has flared up. You have insurance through your job at UIC, but your doctor wants you to write a check or put the bill on your credit card. What do you do?
FIRST OF ALL, yes, you still have insurance despite the State of Illinois having no budget for this fiscal year. It simply is that the Illinois Central Management Services (CMS), the unit of State government that handles employee insurance, does not have the legal authority to pay claims or premiums to vendors providing fully insured HMO coverage. Those payments stopped in September last year. (See further details toward the end of this article.)
EMPLOYEES WITH fully insured HMO plans should have no problem. These -- such as BlueAdvantage, HMO Illinois, Health Alliance, and Coventry HMO -- have agreed to continue paying claims to healthcare providers on their normal schedule.
BUT FOR the others …
Who can help you?
THE STATE of Illinois pays the direct cost of each claim, rather than paying a monthly premium, to the Quality Care Health Plan (QCH\IP) and two Open Access Plans (OAPs). The State has placed these payments on hold. Katie Ross, Senior Director of Human Resources Administration, University of Illinois, said out-of-network dental and mental health providers have been asking employees to pay up front and await reimbursement.
SEEK TREATMENT as needed, according to CMS. “As a covered plan participant, your medical, prescription, dental and vision coverage is still in effect and has not been reduced in any way. Claims continue to be processed by the plan administrators in accordance with the applicable plan design.”
IF YOU are asked to pay up front for a service, contact the administrator of your insurance plan, CMS said. “Your plan administrator will contact the provider to try to find a resolution. If a resolution cannot be reached and the provider continues to ask for an upfront payment, you should make arrangements with your provider to be reimbursed once the provider receives payment from the plan, including any interest that may apply to your claim.”
FOR IN-NETWORK providers, only your normal co-payment or co-insurance should be requested. However, if your doctor, pharmacist, or other health care provider insists on immediate payment, and you cannot pay, contact your plan administrator immediately. You should find a phone number on your insurance card.
Phone numbers for:
HealthLink OAP 800-624-2356
Coventry OAP 800-431-1211
Delta Dental 800-323-1743
HealthLink OAP 800-624-2356
Coventry OAP 800-431-1211
Delta Dental 800-323-1743
IF YOU still do not have the right phone number, call the Central Management Services Group Insurance Division at 217-558-4486 during normal business hours.
ROSS POINTS to a set of frequently asked questions on the CMS website: http://www.illinois.gov/cms/Employees/benefits/StateEmployee/Documents/Budget_Impasse_FAQs_092415.pdf
EMPLOYEES WHO have a specific question or concerns regarding a medical claim payment can contact the CMS Member Services group by phoning that 217-558-4486 number or emailing CMS.WebsiteBenefits@illinois.gov.
FOR INQUIRIES regarding the State’s hold on dental claims: 844-350-4432. General customer service questions, including claims, should continue to be directed to 800-323-1743.
What to expect in the future?
DESPITE THE budget impasse, insurance premiums are still being deducted from your paychecks. That will continue. Some good news: if you pay your medical bills yourself, you may be offered nine percent interest when the State reimburses you if payments are delayed too long.
CMS SAID it will update information as it becomes available at http://www.illinois.gov/cms/Employees/benefits/StateEmployee/Pages/QCHPQCDPClaimPaymentDelay.aspx
A CMS spokeswoman issued the following statement March 22:
“DUE TO decades of fiscal mismanagement, the State Employee Group Insurance Program has been underfunded for years. Healthcare providers and carriers have regularly managed payment delays of eight months or longer. These payment delays will continue until the General Assembly passes a balanced budget. We are hopeful that the General Assembly will act soon to pass a balanced budget and enact real reforms so claim payments to our group health insurance program can resume.
“CMS AND the health plan administrators are working diligently with healthcare providers to try to avoid having providers charge members up front for services and to ensure there is no interruption of service. Any state group health insurance member having any problems receiving services should first contact their health plan administrator directly for assistance. Members may also contact the CMS Group Insurance Division at 800-442-1300 for further assistance.”
CMS ADDED: “A list of all healthcare vendor websites and contact information is available at www.benefitschoice.il.gov.”
State employee contract unsettled
ALONG WITH the State budget, a new contract for the State’s largest employee union – AFSCME – is in limbo. Negotiations have been underway for months. While the negotiations cover the full range of employee benefits, such as salary, they also pertain to insurance.
GOVERNOR BRUCE Rauner said in a statement Jan. 15 that only employees who choose the State’s “expensive, platinum health plan will see twofold increases to help cover a fraction of the cost of this plan.” He said AFSCME was “misleading at best” when it said the State would double health insurance premiums. Rauner said no increase in premiums was proposed except for the platinum policyholders.
EVERYTHING IS on the table, University of Illinois President Timothy Killeen said in a March 7 letter to the UIC Academic Professional Advisory Council Executive Committee and others. Rauner is seeking a ruling from the Illinois Labor Relations Board (ILRB) confirming that an impasse has been reached. “The Governor continues to urge that AFSCME take the State’s ‘best and final’ offer to its membership for a ratification vote, and the State may be able to implement its last offer if the ILRB agrees that an impasse exists,” Killeen wrote.
KILLEEN ALSO noted that the University will broadly communicate any changes for the University community.
State Senator Kimberly A. Lightford is opposed to
the State of Illinois skipping pension payments.
ACCORDING TO Illinois State Senate Assistant Majority Leader Kimberly A. Lightford (D), in March, during a committee meeting at the Capitol, officials from Gov. Bruce Rauner’s office and Senate Republicans “defended their plan to skip pension payments to make the governor’s budget appear balanced,” Lightford said.
“IN ORDER to bridge any gap in State spending, the legislation backed by Gov. Rauner and sponsored by Senate Republican Leader Christine Radogno would give the governor unprecedented power to raid local government accounts and skip pension payments –despite decades of evidence detailing the perils of doing so,” Lightford added.
SENATE DEMOCRATS do not support skipping any payments.
“IT’S BEEN nearly 100 years since we’ve known about this problem, and it seems some people still haven’t learned from past mistakes,” Lightford said. “Avoiding paying our pension liabilities forces an unfair burden on workers and does nothing to get Illinois back on track. In times of crisis, leaders find solutions to problems. They don’t run from them.”
AS EARLY as 1979, Moody’s and Standard and Poor’s warned Illinois that its AAA bond rating would be in jeopardy if it did not tackle its increasing unfunded pension liabilities.
“THE GOP push to skip pension payments comes even as the State’s pension debt tops $100 billion,” Lightford said. “Studies have shown that more than 40 percent of that debt is due to past lawmakers and governors skipping or shorting pension payments.
“THIS, TO me, would be a big mistake,” Senate President John Cullerton said during committee debate on the Republican proposal.
CULLERTON’S LEGAL team found reports dating back to 1917 cautioning against the massive debt accumulating for future taxpayers because not enough was being invested in the pension funds.
“JUST LIKE skipping credit card payments, shirking responsibility and skipping pension payments now only makes the situation worse down the road,” Lightford said.
SENATE DEMOCRATIC leadership has advised Governor Rauner’s budget officials and Republican colleagues not to pursue skipping pension payments.
THE LEGISLATION is SB 2789.
Chancellor Michael Amiridis will speak at the SUAA Annual Meeting.
THE MEETING will begin at 9:30 a.m. Chancellor Amiridis will speak at 11 a.m. A lunch will be served at noon for $15.
ALL APs are invited to the monthly APAC meeting at 12:30 p.m. on scheduled dates Meetings are held either in Room 4175 of the College of Medicine Research Building, 909 S. Wolcott, or Room 2750 of University Hall on the East Campus. Next meeting is Wednesday, April 13, in CMRB 4175. For information, call (312) 996-0306.
Taking the Lead and Effecting Change
TAKING THE Lead and Effecting Change will be an APAC Professional Development Committee presentation to help attendees understand what it means to be a leader and what it takes to be effective. In this presentation, attendees will assess their personal leadership style, learn when and how to adapt it, discover the importance of working with a team, and how to lead change regardless of their position in the workplace.
THE SPEAKER will be Antoniah Lewis-Reese, a project manager, change agent, and strategic advisor currently applying her talents as the Executive Assistant to the Dean at the UIC School of Public Health. She holds a Master’s in Business Administration from Roosevelt University and has nearly 20 years of professional experience in strategic management, process improvement, and enhancing organizational effectiveness.
OVER THE course of her career, she has both supported and assumed leadership over a number of initiatives aimed at improving enterprise efficiency and communication. Her recent efforts at the School of Public Health have been focused on evaluating strategic plan progress, facilitating an examination of organizational design, and establishing a college-wide staff engagement program. In her spare time, she enjoys reading, traveling, advocating for education and social justice, and advising small business owners in change management and marketing strategy.
THE WORKSHOP will be held on the West Campus, Friday, April 15, noon to 1:30 p.m., Room 932, SPH-PI, 1603 W. Taylor St., or on the East Campus, Friday, April 22, noon to 1:30 p.m., Room 401, University Hall, 601 S. Morgan St. To register, go to
MEMBERS OF the APAC Professional Development Committee are Julie Kong, Kim Mayfield, and Tracy Sikorski.
Labels: SURS and Benefits
Keep Up With UIC on Social Media
ACADEMIC PROFESSIONALS and others can find many UIC offices and organizations on social media sites:
- Facebook: facebook.com/uic.edu, facebook.com/uicnews, and facebook.com/UIC-Senate-194632287237111/
- Twitter: twitter.com/thisisuic?lang=en and twiter.com/uicnews
- YouTube: youtube.com/uicmedia
- Instagram: Instagram.com/thisisuic
- Chancellor Michael Amiridis: Instagram.com/uicamiridis
- Office of Business and Financial Services: https://www.facebook.com/OBFSNews, and https://twitter.com/UI_OBFSNews
Labels: Resources and Prof Development
Editor’s Note: “The Continuing Crisis” is a section of APAC News which links to news pertinent to the State budget crisis and other financial matters as they affect the University and Academic Professionals. These news outlets are not affiliated with or endorsed by APAC.
CHICAGO STATE, preparing for layoffs, tells employees to turn in keys, March 30, 2016: http://www.chicagotribune.com/news/local/breaking/ct-chicago-state-keys-budget-crisis-20160329-story.html
DEATH SPIRAL hits Illinois universities, Daily Eastern News, March 25, 2016: http://www.dailyeasternnews.com/2016/03/25/editorial-death-spiral-hits-illinois-universities/
GOVERNOR BRUCE Rauner shackles higher education in Illinois, Chicago Tribune, March 25, 2016: http://www.chicagotribune.com/news/opinion/commentary/ct-rauner-illinois-colleges-map-grants-perspec-0316-jm-20160315-story.html
ILLINOIS UNIVERSITIES worry about future without budget, State Journal-Register, March 10, 2016: http://www.sj-r.com/news/20160310/illinois-universities-worry-about-future-without-budget
SIU PRESIDENT outlines budget cut proposals, Capitol Fax, March 9, 2016: http://capitolfax.com/2016/03/09/siu-president-outlines-budget-cut-proposals/
NORTHEASTERN ILLINOIS University begins furlough days, Capitol Fax, March 8, 2016: http://capitolfax.com/2016/03/08/neiu-cant-sustain-operations-through-summer-announces-furloughs/
SPRINGFIELD’S COLLEGE funding war deepens, Crain’s Chicago Business, March 8, 2016: http://www.chicagobusiness.com/article/20160308/BLOGS02/160309834/springfields-college-funding-war-deepens
ILLINOIS POLITICIANS hell-bent on destroying higher education, Huffpost Chicago, Feb. 24, 2016: http://www.huffingtonpost.com/matthew-dietrich/illinois-politicians-hell_b_9306598.html
UNIVERSITIES LEFT footing the bill as budget crisis deepens, Inside Higher Ed, Jan. 7, 2016: https://www.insidehighered.com/news/2016/01/07/universities-left-footing-bill-budget-crisis-looms-illinois
HOW GOVERNOR Bruce Rauner is remaking Illinois, New York Times, Nov. 29, 2015: http://www.nytimes.com/2015/11/30/us/politics/illinois-campaign-money-bruce-rauner.html?smid=nytcore-iphone-share&smprod=nytcore-iphone&_r=0
BUDGET DEAL will bring cuts, NPR Illinois, Nov. 25, 2015: http://wuis.org/post/illinois-issues-budget-deal-will-bring-relief-it-will-also-bring-cuts#stream/0
PRESIDENT KILLEEN: University future dire if budget fight drags on, News-Gazette, Nov. 11, 2015:
Labels: Budget Crisis
APAC News is published by the Academic Professional Advisory Committee of the University of Illinois at Chicago.
Editor: William S. Bike
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Treasurer: Kathy Stauffer
Web Chair: Jeff Alcantar
Web Chair: Jeff Alcantar