Health Insurance Board lapse could leave 189 retirees without supplemental insurance coverage in November
Published: October 17, 2013
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ST. CROIX - Gov. John deJongh Jr. on Wednesday criticized the government health insurance board's "inability to make a decision necessary to ensure a seamless transition from CIGNA Insurance to United Healthcare for a small subset of government retirees.
In a statement he issued Wednesday afternoon, deJongh also said the board should cancel a planned trip to Las Vegas scheduled for Friday and stay in the territory and address the issue that will leave 189 government retirees who are 65 and older without supplemental health insurance coverage for November.
"To leave the territory without having resolved this issue would be a blatant disregard of their responsibility and would place the medical and prescription drug coverage for our post-65 retirees at risk," deJongh said.
According to Government House, a deadline that the Government Employees Services Commission-Health Insurance Board missed has the potential to affect retirees who have not enrolled in Medicare Part B.
They would remain covered by Medicare Part A. For government retirees 65 and older, the United Healthcare insurance is a Medicare supplement.
The Daily News was unable to reach board Chairwoman Clemmie Moses for comment on Wednesday.
While enrollment into Medicare Part B - which covers physician services, medical supplies and other outpatient services not covered by Part A - was not mandatory under CIGNA coverage, it is a requirement for government retirees 65 and older under the new United Healthcare coverage, according to Government House.
V.I. Personnel Director Kenneth Hermon Jr. and his staff discovered the lack of Medicare Part B coverage for those 189 retirees during the migration management of the post-65 retiree population from CIGNA to United Healthcare.
With the government's new health insurance plan that started Oct. 1, the insurance for retirees 65 and older is handled by United Healthcare, while CIGNA continues to handle coverage for active employees and for retirees younger than 65.
"It is completely unacceptable that they were not vigilant to ensure that these retirees are covered, especially since they made the decision to switch from one carrier to the other," deJongh said. "Admittedly, it is the responsibility of the retiree to be aware, but given all the issues that revolve around health insurance, it is an effort that is well worth the time and one that employees at the Division of Personnel started in identifying those impacted."
The governor learned on Wednesday that the board missed a 5 p.m. deadline Friday to adopt a recommendation from United Healthcare to implement a "bridge" insurance plan that would have covered the 189 retirees from Nov. 1 to June 30, 2014, according to the statement.
United Healthcare notified the board during a number of weekly conference calls and in writing before the deadline, with the most recent communication occurring on Oct. 4, deJongh said.
"I am optimistic that the GESC Board can work with CIGNA and UHC to develop an interim solution to avoid those retirees from losing medical coverage for the month of November," Hermon said in the prepared statement. "My staff and I have developed a listing of those impacted, and we are ready to work with GESC to try and lessen any negative impact."
The list has been provided to the board, Hermon told The Daily News.
Retirees cannot enroll in Medicare Part B until the period of January through March, and even then, the coverage does not become effective until July 1, he said.
"If they make a decision now, those members would have coverage effective Dec. 1 to July 1, 2014, but there is a month of health insurance and prescription drug coverage that is up in the air, and the board needs to figure out what it's going to do with this population," Hermon said.
Hermon, who is an advisory member of the board and does not have a vote, said the possibility still may exist to get the interim coverage in place by Nov. 1.
"We are optimistic that they will. In order to do so, you have to be here to make the decision and work the thing out," he said. "We're losing several days to work with consultants and United to see if there's some kind of viable solution."
At this point, officials just don't know what the new cost will be for that group of retirees, Hermon said.
Because the board let the deadline pass, "the dynamic of the conversation has shifted greatly," he said.
He asked that retirees not flood Personnel with calls.
"We don't have a solution from the board," he said. "There's no information we can provide them."
In light of the new mandatory Part B enrollment requirement, Government House said all retirees and active employees who are within three months of their 65th birthday should contact the Social Security Office at 800-772-1231 to discuss their enrollment options in both Medicare Part A and Part B to prevent any unnecessary delays when it is their turn to transition to the United Healthcare insurance plan.
- Contact Joy Blackburn at 714-9145 or email firstname.lastname@example.org.