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The Honolulu Advertiser
Posted on: Saturday, November 14, 2009

Unions urge delay in health care switch for Hawaii public workers

By Derrick DePledge
Advertiser Government Writer

Three public-sector union leaders yesterday asked the state Employer-Union Health Benefits Trust Fund to cancel open enrollment in health care plans for government workers, claiming potential delays in processing applications could disrupt coverage for workers in January.

The leaders of the Hawai'i Government Employees Association, the University of Hawai'i Professional Assembly and the United Public Workers said such disruptions would be "unacceptable" and urged that existing health care plans be continued for six months while problems are resolved.

The EUTF is offering government workers a new health care option through the Hawai'i Medical Service Association with lower premiums but a higher co-payment. Under the new option, the state covers 80 percent of the cost and workers pick up 20 percent.

The EUTF is also offering a version of the current health care plan — with payments split 90 percent to 10 percent — but administered by HMA Inc. instead of by HMA and HMSA.

HMA is a sister company of Summerlin Life & Health Insurance Co., which entered the Hawai'i market five years ago.

Workers who have HMSA and want to remain in the current health care plan would automatically be moved to HMA, while those who want to change to the new option from HMSA have to apply.

EUTF has warned that staff shortages and a paperwork backlog could delay the processing of applications for workers who want to switch health care plans.

"While there is no blame to assess, since we trust that your staff has done all it can to keep up with the burgeoning work load, we feel it would be irresponsible for the trustees and staff to continue this open enrollment fiasco given the likely outcomes and the impact on employees," the union leaders wrote in a letter.

Open enrollment ends Nov. 30, and the EUTF board of trustees does not meet again until Dec. 9, so the board would have to either call a special meeting to cancel open enrollment or rescind it in December. "That's a decision for the board to make," said Jim Williams, the EUTF's administrator.

George Kaho'ohanohano, the board's chairman, said the potential challenges were discussed before the open enrollment period began.

"I would not vote to hold up open enrollment," he said.

Randy Perreira, the HGEA's executive director, said union leaders want to ensure that government workers have the time and ability to make thoughtful decisions about their health care coverage.

The EUTF, in addition to the warning about potential delays in processing applications, also cited a computer programming error as the reason for not distributing open enrollment notices describing workers' enrollment and dependent status.

"Conceivably, people would not be able to access their benefits," Perreira said. "And that, for us, is just unacceptable."

State Senate President Colleen Hanabusa, D-21st (Nänäkuli, Mäkaha), and several other lawmakers have urged the EUTF to suspend open enrollment because of potential confusion about the instructions.

Although the EUTF's open enrollment guidelines clearly explain the new health care option, the instructions also say that workers who want to continue with their current plan do not have to take any action. Some lawmakers believe that may confuse workers now under HMSA who will be automatically switched to HMA.

"For many years, EUTF enrollees have never been automatically defaulted to another carrier," wrote state Rep. Ryan Yamane, D-37th (Waipahu, Mililani), the chairman of the House Health Committee. "There are government workers who have gone their entire careers with the state and city and never had to take any action to retain the same coverage from one year to the next."

HMSA, citing widespread confusion among government workers and the potential for processing delays, also has asked the EUTF to cancel open enrollment. Antonio Saguibo Jr., HMSA's vice president for account management and sales, wrote that the "current process is fatally flawed with little real hope that it can be corrected mid-stream."

But EUTF, and HMSA's competitors at HMA, claim the state's largest health insurer has created the confusion by alarming government workers.

Harris Nakamoto, HMA vice president and general manager, said HMSA made a blunder by choosing to administer the new health care option with the 80 percent to 20 percent co-payment and is now trying to undo its mistake.

HMA stands to gain new customers by default through the open enrollment process.

Nakamoto said HMSA made a similar tactical mistake earlier this year and ended up being temporarily dropped by the Hawai'i State Teachers Association in favor of HMA.

"It's typical of a big gorilla going ahead and trying to unravel something," he said. "They're trying to blame people for their own mistake."