December 9, 2016
Unstable Situation Concerning Health Insurance
IT TAKES a long, long time for many health
insurance claims to be paid. And no end is in sight.
THE STATE of Illinois is more than a year and a
half behind in paying some of bills. Once in a while, there’s a breakthrough on
insurance payments. But many doctors, dentists, and other health care providers
are still waiting. And some of those providers want State employees to pay
up-front, then collect from the State when they can. Not only current
employees, but also retirees, face these problems. The State deficit is the chief
reason, complicated by the lack of a State budget and a labor contract impasse.
THE ILLINOIS comptroller’s office on Nov. 23 had a
$10.7 billion backlog of unpaid bills and was five months behind in paying
vouchers for such things as health care, comptroller’s spokesman Rich Carter said. As of Nov. 22, the State needed $140 billion
to pay all of its bills and pension obligations, the Illinois Policy Institute
said.
CENTRAL
MANAGEMENT Services reported Nov. 11 that the State had been releasing funds collected from employee
premiums to pay claims submitted during part but not all of last year.
DETAILS:
Quality Care Health Plan (administered by Cigna)
Claims
processed through May 8, 2015, have been released to QCHP-contracted providers
(as of Dec. 2, 2016).
Claims
processed through Feb. 20, 2015, have been released to non-QCHP-contracted
providers (as of Dec. 2, 2016).
HealthLink OAP
Claims
processed through June 22, 2015, have been released.
Coventry OAP
Claims processed
through July 22, 2015, have been released.
Quality Care Dental Plan (administered by Delta
Dental of Illinois)
Claims
processed through Oct. 31, 2015, have been released to PPO-contracted
providers. Claims processed through Sept. 19, 2015, have been released to
Premier-contracted providers. Claims processed through April 4, 2015, have been
released to mon-network providers.
For up-to-date
information, employees can visit https://www.illinois.gov/cms/Employees/benefits/StateEmployee/Pages/QCHPQCDPClaimPaymentDelay.aspx
EMPLOYEES CAN check the status of their Delta Dental
claims at http://deltadentalil.com/ to see if they are
among the claims being scheduled for payment. For inquiries regarding the
hold/delay on dental claims, call (844) 350-4432. General dental plan customer
service questions should be directed to 1 (800) 323-1743. See the notice to dentists at http://soi.deltadentalil.com/SOIUpdate201609.pdf .
IF YOU are experiencing extenuating circumstances due to a health insurance payment delay
issues, first contact your health insurance plan for assistance. If
not resolved, or if you are denied services, contact CMS at CMS.WebsiteBenefits@illinois.gov
or 1 (800) 442-1300, selecting 1 at the first three
prompts.
OTHER RESOURCES? KATIE
ROSS, senior director
of the U of I Human Resources Administration, points out a University website,
which contains some news articles with the most recent information: www.hr.uillinois.edu/benefits/state_healthcare_update.
THE MYBENEFITS Marketplace website, which went live
Sept. 30, may also help. MyBenefits Marketplace is the State’s new online
system to provide self-service tools to assist employees with health, dental,
and life insurance, and flexible spending account (MCAP/DCAP) plans. Employees
can access this system through NESSIE or UI New Hire. Employees will use this
system to enroll in or make changes to their state insurance benefits as a new
hire, when experiencing a qualifying change in status (i.e., add/drop a
dependent and other changes), or during the State’s annual Benefit Choice
period.
SPECIFIC QUESTIONS or concerns regarding a
claim payment? Contact the CMS Benefits Group Insurance at CMS.WebsiteBenefits@illinois.gov.
U of I officials and the
University Office of Government Relations staff met with several legislators and senior officials in the governor’s office
repeatedly this autumn. “Their meetings kept our employees’ access to
healthcare at the forefront and encouraged the recent agreement for dental
claim payments,” Ross said. “They have worked tirelessly to advocate on behalf
of faculty and staff on these important healthcare issues, and will continue to
do so.”
“THERE HAVE been some
good developments, not great, but something,” Ross said.
A NEW complication arose Nov. 15, when the Illinois Labor
Relations Board declared an impasse between Governor Bruce Rauner’s administration and the American Federation
of State, County and Municipal Employees Council 31, the State’s largest
employees’ union, on a new worker contract. With an impasse declared, the
governor may unilaterally make decisions on healthcare coverage, and for health
insurance, U of I employees’ health insurance is covered by the AFSCME
contract. University employees
do not have the option of going outside the State system to obtain health
insurance, unless they provide proof of other non-state coverage.
“WE INTEND to appeal that ruling to the courts,”
AFSCME spokesman Anders Lindall said.
The labor board and union urged Rauner to resume contract talks, and the union
said it does not want to strike.
The State council of AFSCME on Nov. 30 filed suit to stop Governor Rauner from
imposing contract terms because he has declared negotiations deadlocked.
LACK OF a State budget continues to be a huge
problem. Rauner and Democrats who control the General Assembly have restarted
budget negotiations, but the election campaigns thwarted compromise. There is
no sign the uncertainty will end any time soon.
RAUNER DEMANDS that lawmakers approve parts of his
economic “Turnaround Agenda” before he agrees to a broader budget plan.
Democrats say Rauner should bypass his proposed agenda for the time being so an
agreement can be reached on a spending plan.
U of I President Timothy Killeen recently sent employees
an email, saying: “Although the labor board ruling may be a noteworthy step in the
process, it is impossible to predict with any certainty the end result and
impact on University employee healthcare costs during this lengthy ongoing
litigation and negotiation process.”
“IN THE meantime, U of I System
leaders continue to voice concerns to state leaders, including advocating on
behalf of faculty and staff about the State’s claim payment delay,” Killeen said. “Our efforts have
helped spur some progress on dental claims, and we continue to vigorously oppose the
State’s suggestion that it may collect premiums retroactively. These advocacy efforts
will continue. I hope you will join our advocacy efforts, and I will continue to update you as the
process unfolds.”
ROSS SAID, “Based on the public
statements from both the State and AFSCME, we might expect to see some
additional plan choices and potentially some level of cost increase to employees.
However, actual changes are still unknown
at this time, and are subject to the ongoing negotiations and any
further ILRB proceedings.”
THERE HAS been speculation –
acknowledged as a special notice in the 2017 Benefits Choice flyer – that the State, if it raises employees’
contributions for healthcare coverage, may backdate that increase and demand
premiums retroactively. The University has asked the State to begin charging
new premiums only after employees have been given another opportunity to fully
consider all plan options and any associated new costs.
AFSCME HAS not had a contract for its 40,000 members
since July 2015. The union says employees covered by the top insurance plan would
have to pay 100 percent more in health care in the first year of the contract, followed by
up to ten percent increases per year. There are also no pay increases over the
four-year term of the contract. Lindall called that a “pay cut,” which he said
would amount to $10,000 lost over four years for the average employee and perhaps more for
those with family coverage. AFSCME has
pushed for no increases in healthcare premiums for the first year followed by a
5% premium increase per year for the out-years of the contract.
THE STATE maintains that the
2012-1015 AFSCME contract, in aggregate, qualifies as a platinum healthcare
plan. But Lindall says that the vast
majority of State employees are not opting to use the top coverage. Going
forward, members may need to opt for cheaper plans to hold premiums in check and
accept higher copays, Lindall indicated.
APs Nervous About Preservation of Notice Rights
IN TROUBLED times, job security is a–if not the–top
concern for all Academic Professionals. This security is being questioned.
PRESENT
RULES regarding Notices
of Non-Reappointment or Terminal “T-Contracts” for Academic Professional
employees have been reviewed by University administrators.
WITH THE State deficit crisis, and after two
years of partial funding from the State, a key reason for UI to make a change
in notice rights would be to save money.
TOP UNIVERSITY spokesman Thomas Hardy in the
Office of University Relations at the University of Illinois offered
reassurance. “In times of fiscal crisis, a common and logical mantra is that
‘all options are on the table.’ I don’t believe there was any discussion that
notice rights would be ‘terminated,’ and discussion of somehow lessening those
notice provisions does not appear to be an option at this time.”
APS EXPRESSED concern during a Nov. 8 meeting of UIC’s
Academic Professional Advisory Committee. One said notification rights are “one
of our most valuable benefits.” Another termed it “a last vestige of what APs
hold dear.” Others explained that APs can be discharged without reason or
recourse. Notification of Appointments (NOAs) are already in place for 2016-17,
so policy changes will not occur this year.
HERE IS what APs have now (contingent upon
sources of funds):
·
Six-month notice for employees of less than
four years in their post
·
One-year notice for employees with more than
four years
·
For full details, visit https://www.hr.uic.edu/UserFiles/Servers/Server_2716/File/d_policies/1200/hr1205.pdf
A CHANGE to Article IX, Section 11 of the
Statutes would need to occur, , following faculty review, Interim Associate
Vice President for University Human Resources Jami Painter said.
U of I System
President Tim Killeen said
at a June UPPAC meeting that he highly values the AP role and is not ignoring
it. However, he said, notification periods are long in comparison with other
Big Ten schools, and a U of I task force was examining the issue. Painter noted
that many other institutions allow themselves to declare financial exigency and
shorten notice rights.
APAC CHAIR Colleen Piersen, also Assistant
Head for Administration, said that UPPAC members were recently informed that
the working group on notice rights had not convened since Spring Semester when
it met several times. Moreover, the group was asked only to examine the
situation, not take action. Nonetheless, employees remain concerned as
the state continues to restrict funding to institutions of higher education and
layoffs and furloughs are considered or implemented at public universities
statewide.
UNIVERITY OF
Illinois at
Urbana-Champaign employees who currently receive termination contracts may be
eligible for an internal relocation program (http://cam.illinois.edu/ix/ix-c/ix-c-26.htm). Maureen Parks, former Associate Vice
President for University Human Resourcesin University Administration, said it
is a positive approach to the problem. UIC does not have a formal relocation program
at this time.
APAC Meetings Scheduled
ALL
APs are invited to the
monthly APAC meeting at 12:30 p.m. on scheduled dates. Meetings are held either
in Room 270 of the College of Pharmacy Building, 833 S. Wood St., or Room 2750 of
University Hall on the East Campus. Next meetings are Tuesday, Dec. 13, in Pharmacy 270, and Tuesday, Jan 10, in UH 2750.
For information, call (312) 413-9299.
APAC’s Tiffany Raber Wins Award
 |
| Tiffany Raber (left) with fellow BVIS award-winning students. |
WEBSITES TO KNOW
BENEFIT BEAT
RECORDED WEBINARS from UIC Career Development
Month are now posted. The links are available at https://www.hr.uic.edu/careermonth/. Click on
the webinar title to launch its recording.
VISIT THESE web pages to explore
information on the site and learn more about what you can do now to grow in
your career.
QUESTIONS OR comments? Send an email to mycareeruic@uillinois.edu
THE CONTINUING CRISIS
 |
Governor Bruce Rauner has
been at the center of recent news
stories covering the State budget crisis.
(Photo by Steve Vance.)
|
PUBLIC EMPLOYEE union files lawsuit to stop Governor
Rauner from imposing contract terms, Chicago
Tribune, Dec. 1, 2016: http://www.chicagotribune.com/news/local/politics/ct-rauner-union-workers-lawsuit-20161201-story.html.
RAUNER SCORES big win over union on contract talks, Chicago Tribune, Nov. 16, 2016: http://www.chicagotribune.com/news/local/politics/ct-rauner-afscme-labor-board-met-20161115-story.html.
HIGHER ED employees may face furloughs, Illinois Public Media, Nov. 14, 2016: http://will.illinois.edu/news/story/education-desk-higher-ed-employees-may-face-furloughs.
UNIVERSITY HAS cut more than 500 jobs in last 18
months, News-Gazette, Oct. 6, 2016: http://www.news-gazette.com/news/local/2016-10-06/ui-has-cut-more-500-jobs-last-18-months.html.
MANY PROFESSORS leaving Illinois, Crain’s Chicago Business, July 30, 2016: http://www.chicagobusiness.com/article/20160730/ISSUE01/307309989/why-are-so-many-professors-moving-out-of-illinois.
ILLINOIS FACING $8 billion budget gap, $10 billion bill
backlog, Progress Illinois, July 14,
2016: http://progressillinois.com/news/content/2016/07/14/illinois-facing-8-billion-budget-gap-10-billion-bill-backlog?utm_source=PI+Extra+7.14.16&utm_campaign=PI+email+7.14.16+&utm_medium=email.
LABOR BOARD denies Governor Rauner’s request to
expedite union case, State
Journal-Register, July 7, 2016: http://bit.ly/29lrGby.
NEW UNION at NIU certified, Progress Illinois, June 16, 2016: http://progressillinois.com/news/content/2016/06/16/new-union-northern-illinois-university-gets-certified?utm_source=PI+Extra+6.17.16&utm_campaign=PI+email+6.17.16+&utm_medium=email.
Vol. 9, No. 3 December 2016
APAC News is published by the Academic Professional Advisory Committee of the University of Illinois at Chicago.
ISSN 1946-1860
Editor: William S. Bike
Staff: Susan S. Stevens
Chair: Colleen Piersen
Vice Chair: Ahlam Al-Kodmany
Secretary: Mary Berta
Treasurer: Kimberly Mayfield
Web Chair: Jeff Alcantar
http://www.apac.uic.edu
ISSN 1946-1860
Editor: William S. Bike
Staff: Susan S. Stevens
Chair: Colleen Piersen
Vice Chair: Ahlam Al-Kodmany
Secretary: Mary Berta
Treasurer: Kimberly Mayfield
Web Chair: Jeff Alcantar
http://www.apac.uic.edu
June 15, 2016
Health Insurance Premiums Could Rise Suddenly; Higher Rates May be Charged Retroactively
“THE GOVERNOR’S current proposals either significantly
increase costs or significantly decrease plan quality,” said Janet Smith, President of UIC United
Faculty.
IN AN April 4 memo from CMS, Michael
M. Hoffman, Acting Director of CMS, wrote, “…we will be suspending the
roll-out of new premium rates and plan designs until early Fall” when, “…a
second Benefit Choice Period with new plans and rates would then take place…”
IN ANOTHER recent memo from CMS, it “unbelievably says that when the
new plans go into effect, we will be retroactively charged an unknown amount
based on the plans we chose,” Smith said.
THAT MEMO says, “Personnel should be aware that
these premiums may be subject to an increase, pending the outcome of an ongoing
legal dispute between the State and AFSCME and that this premium increase may
be applied retroactively to July 1, 2016. In other words, once the legal
dispute is resolved, a higher premium likely will apply—not only going forward,
but also for the period from July 1, 2016, to the date of the increase.”
APAC, THE UIC United Faculty, the University
Senate, and the Staff Advisory Council worked with President Timothy Killeen, and the result was a
University Task Force that will make recommendations to the President on how to
proceed.
UIC UNITED Faculty is working with an attorney who
“believes that the Governor’s proposed changes violate the State Employees
Group Insurance Act and Illinois Labor Law,” Smith said. “If we are asked to
pay for our healthcare retroactively, we will take the issue to court.”
FOR MORE information, email uicunitedfaculty@gmail.com.
How Higher Education Improves the Economy
- Businesses look for and locate in communities that have quality higher education opportunities.
- Often the institution of higher education is the community’s largest employer.
- Higher education employees purchase or rent housing; and employees purchase goods and services locally, supporting employment in grocery stores, restaurants, home repair businesses, gas stations, mom and pop stores, and on and on and on.
- Universities contract out in their local areas for a variety of products and services (construction projects, printing services, food venders, etc.) providing employment in local communities.
- Higher education employees pay taxes to support local governments, public schools, police and fire services, snow removal, etc., generating jobs in local communities.
- Students graduate and often locate in the community. Some of these educated individuals create small businesses; and as these businesses grow, they hire additional employees.
UIC EMPLOYEES are urged to do what they can to increase public awareness of the
importance of higher education to Illinois and to local communities within the
State, and to advocate for higher education funding wherever possible.
APAC Officers, Committee Chairs Named
 |
Colleen Piersen has been
re-elected as Chair of APAC.
|
EXECUTIVE COMMITTEE members are: Chair, Colleen Piersen; Vice-Chair, Ahlam
Al-Kodmany; Secretary, Mary Berta;
and Treasurer, Kimberly Mayfield.
MEMBERS OF subcommittees are: Building
Community/Education, Tracy Sikorski, Mary Berta, and Jennifer Pletka; Communications, William S. Bike; Chancellor’s Academic
Professional Excellence (CAPE), Ahlam
Al-Kodmany; Professional Development, Julie
Kong (Co-Chair), Kimberly Mayfield
(Co-Chair), and Tracy Sikorski;
Representation, Michael Moss;
Bylaws, Nester Komolafe; University
Professional Personnel Advisory Committee (UPPAC), Ahlam Al-Kodmany, Collen Piersen, Kathy Stauffer, and Tracy Sikorski (alternate); Statue
Universities Annuitants Association (SUAA), Ben Ramirez; and Grievance, John
Brach.
APAC Meetings Scheduled
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 Tuesday, July
12, in UH 2750. For information, call (312) 413-9299.
APAC PROFILE
 |
Tiffany Raber, with one of
her award-winning works of art-
a self-portrait done in ink pen on grey art
board.
|
TIFFANY RABER, who is working on her MFA in Biomedical
Visualization at the UIC College of Applied Health Sciences, is APAC’s graduate
assistant. In this role, she is required to “wear many hats, based on need,”
she noted.
RABER CREATES documents for the APAC monthly meetings,
including the agenda and minutes, and monitors the PACADEMY listserv. “When
needed, I also work with the APAC website and assist APAC with basically
anything they could use an extra hand with,” she said. “I’m here to act as an
extra resource for anybody related to APAC.”
ONE OF her goals is to “help spread the word
about APAC to more Academic Professionals, and even students,” Raber said.
“This is a great organization and also very beneficial. I would like to be the
main source of communication who helps make others more aware of the benefits
of APAC. I plan on doing this by helping with marking visuals including the
website, flyers, logos, and more.”
BIOMEDICAL VISUALIZATION, traditionally termed medical
illustration, is a niche professional field with a broad spectrum of possible
concentrations. A biomedical visualization professional is responsible for
creating scientifically accurate visuals to help with better comprehension of a
difficult scientific and/or medical concept. “Thanks to technology, this can be
communicated by pencil and paper, animation, 3D modeling, and even virtual
reality,” Raber explained.
“MY GRADUATE degree program is very intensive and
doesn’t allow me to deviate from my studies often,” Raber said. “But one
interest I cannot give up is working out. I have been an athlete my entire life
and ran Division I track and field—400-meter hurdles—in college. Almost every
morning I work out bright and early to allow myself some ‘me time’ before
beginning the day.”
RABER EARNED a BS in Biology and a BFA in Drawing
from Ball State University in 2014. To contact her, email traber2@uic.edu.
BENEFIT BEAT
APPLICATIONS FOR the 2016-2017 Staff
Leadership Mentor Program (SLMP) are being accepted now until Friday, June 24,
at http://go.uic.edu/slmp through UIC
Human Resources.
THE STAFF Leadership Mentor
Program is a structured mentorship program that matches mentors and mentees and
provides guidance and support over the course of a year. This program develops
the careers of individual employees and strengthens UIC's organizational continuity
through knowledge-sharing and employee engagement. All Academic Professional and Civil Service
employees are welcome to participate in the mentoring program as a mentor or
mentee, or both. About 60 minutes a month is all it takes to keep your skills fresh
and to help yourself and others grow.
VISIT THE website http://go.uic.edu/slmp
to apply, to get more details about SLMP, or to peruse mentoring resources.
THE UNIVERSITY gets more mentee
applications than mentor applications. You do not have to be an expert with
many years of experience to share your knowledge, experiences, and guidance. If
you have been in your field for two or more years, please consider being a
mentor.
THE CONTINUING CRISIS
ILLINOIS CREDIT rating approaches junk status: Progress Illinois, June 9, 2016: http://progressillinois.com/news/content/2016/06/09/illinois-credit-rating-takes-another-hit-moodys?utm_source=PI+Extra+6.9.16&utm_campaign=PI+email+6.9.16+&utm_medium=email.
HIGHER EDUCATION in Illinois is dying: New York Times, June 3, 2016: http://www.nytimes.com/2016/06/04/opinion/higher-education-in-illinois-is-dying.html?_r=0.
FISCAL SHAME: Illinois without a budget: Fiscal Times, June 2, 2016: http://www.thefiscaltimes.com/2016/06/02/Fiscal-Shame-Illinois-Has-Gone-Nearly-Year-Without-Budget?utm_source=PI+Extra+6.2.16&utm_campaign=PI+email+6.2.16+&utm_medium=email.
NONPROFIT AND university workers need overtime, too, Progress Report, June 1, 2016: http://thinkprogress.org/progress-report/getting-an-education-on-overtime/.
STUDENTS OF color take biggest hit in Illinois
higher education funding crisis: Chicago
Reporter, May 12, 2016: http://chicagoreporter.com/students-of-color-take-biggest-hit-in-illinois-higher-education-funding-crisis/
UNIVERSITY FUNDING lifeline solves nothing: Crain’s Chicago Business, April 30,
2016: http://www.chicagobusiness.com/article/20160430/ISSUE07/304309997/university-funding-lifeline-solves-nothing#utm_medium=email&utm_source=ccb-opinion&utm_campaign=ccb-opinion-20160430
GOVERNOR RAUNER’S interim grade: Chicago Tribune, April 12, 2016: http://www.chicagotribune.com/news/opinion/zorn/ct-rauner-failing-madigan-cullerton-illinois-budget-perspec-zorn-0413-jm-20160412-column.html
GOVERNOR APPOINTS conservative to represent faculty on
IBHE: Academe Blog, April 24, 2016: https://academeblog.org/2016/04/24/gov-rauner-appoints-a-right-wing-crackpot-to-represent-faculty-on-the-illinois-board-of-higher-ed/
ILLINOIS LAWMAKERS propose measures to fund struggling
universities during budget impasse: Progress
Illinois, April 20, 2016: http://progressillinois.com/news/content/2016/04/20/state-lawmakers-propose-new-higher-education-funding-measures?utm_source=PI+Extra+4.20.16&utm_campaign=PI+email+4.20.16+&utm_medium=email
U OF I prepares for layoffs: Capitol Fax, April 20, 2016: http://capitolfax.com/2016/04/20/u-of-i-prepares-for-layoffs/.
RANK-AND-FILE legislators key to breaking budget
impasse: Progress Illinois, April 11,
2016: http://progressillinois.com/quick-hits/content/2016/04/11/illinois-lawmakers-rank-and-file-legislators-key-breaking-budget?utm_source=PI+Extra+4.11.16&utm_campaign=PI+email+4.11.16+&utm_medium=email
ILLINOIS DEMOCRATIC Congressmen urge Governor to act on
higher education funding: Progress
Illinois, April 22, 2016: http://progressillinois.com/news/content/2016/04/11/illinois-democratic-congressmen-urge-rauner-act-higher-education-funding?utm_source=PI+Extra+4.11.16&utm_campaign=PI+email+4.11.16+&utm_medium=email
GOVERNOR RAUNER shuttering Illinois Universities: Daily Kos, April 11, 2016: http://www.dailykos.com/stories/2016/4/11/1513575/-Illinois-GOP-Governor-Rauner-Shuttering-Illinois-Universities-Voting-Blue-No-Matter-Who-Matters?detail=facebook
HOW TO destroy a State: An und fur sich, March 25, 2016: https://itself.wordpress.com/2016/03/25/how-to-destroy-a-state/
Vol. 9, No. 2 June 2016
APAC News is published by the Academic Professional Advisory Committee of the University of Illinois at Chicago.
ISSN 1946-1860
Editor: William S. Bike
Staff: Gail Mansfield, Susan S. Stevens, Mary Voelker, Monica M. Walk
Chair: Colleen Piersen
Vice Chair: Ahlam Al-Kodmany
Secretary: Mary Berta
Treasurer: Kimberly Mayfield
Web Chair: Jeff Alcantar
Web Chair: Jeff Alcantar
April 7, 2016
Budget Impasse Raises Health Insurance Questions
 |
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:
Cigna: 800-962-0051
HealthLink OAP 800-624-2356
Coventry OAP 800-431-1211
Delta Dental 800-323-1743
Cigna: 800-962-0051
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.
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