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The Honolulu Advertiser
Posted on: Tuesday, November 24, 2009

EUTF extends deadline


BY Greg Wiles
Advertiser Staff Writer

State and county workers will be given more time to decide on their medical insurance coverage because of confusion about choices being offered during the current open enrollment period.

The Hawai'i Employer-Union Health Benefits Trust Fund board of trustees yesterday voted to given an extra week to employees for their decisions, rejecting calls from some legislators to suspend or cancel the open enrollment process.

The open enrollment period, during which employees can change their health plans, has been extended to Dec. 7 from the previous deadline of Nov. 30, while the implementation of any changes will take place on Feb. 1, 2010, and not Jan. 1 as had been planned.

"Today's actions by the board of trustees are good for our beneficiaries," said Jim Williams, EUTF administrator. "Not only will they have more time to make their choices and submit their enrollment forms, but they can be assured that those forms will be processed by the time they need medical services."

The EUTF trustees also voted to hire temporary workers and were briefed on plans to have insurers and/or plan administrators help provide temporary workers who will process enrollment forms.

The decision affects approximately 56,000 active state and county workers who must fill out and turn in paperwork if they want to change to a different type of health plan or choose between health plan administrators. Retirees who receive coverage through the EUTF aren't affected by open enrollment.

The open enrollment period has been marred by confusion this year along with concerns that changes being filed at the EUTF offices would not be processed by Jan. 1 because of state worker furloughs and new computer software. There were worries about a potential disruption of medical insurance coverage starting next year.

The process also has resulted in a rift between the EUTF trustees and the Hawaii Medical Service Association, the state's largest insurer.

The benefits trust fund has accused HMSA of making misleading statements to retain business, while the insurer has alleged the EUTF bungled decisions on a new health plan being offered and didn't communicate clearly to members about the open enrollment period.

The confusion has spawned thousands of calls to the EUTF, which said yesterday it may be guilty of distributing open enrollment materials late, but disputed criticism that it hadn't clearly communicated about plan choices and administrators.

Moreover, it said HMSA had not abided by rules to clear advertising with it and had not taken strong enough corrective action on an inaccurate e-mail sent by an HMSA executive to state employees.

EUTF administrator Jim Williams said his office was discussing possible corrective measures it will take on its own.

The EUTF offers members a number of plans, including an HMO option through Kaiser Permanente and two preferred provider plans it designed but has its claims processed by outside contractors — HMSA and HMA Inc., a sister company to HMSA competitor Summerlin Life & Health Insurance Co.

But this year the EUTF is adding a new lower-cost preferred provider plan choice. Until now, EUTF members have had one choice for preferred provider plans — a so-called 90/10 option.

The EUTF trustees have added an 80/20 plan that features lower premiums but requires members to pay 20 percent of out-of-pocket health care costs.

HMSA was asked, and initially said it wanted to administer the 80/20 EUTF plan. HMA was assigned the 90/10 EUTF plan to administer.

But HMSA has made efforts to switch to 90/10 plan administration since learning EUTF members will automatically stay with the 90/10 plan unless they elect not to. To stay with HMSA, members must fill out EUTF forms saying they want to change to the 80/20 plan.

Those who want to stay in a 90/10 plan are being told they don't have to do anything and will be in a plan administered by HMA.

HMSA claims the EUTF didn't fully disclose the paperwork requirement when it asked for the 80/20 plan.

Yesterday HMSA asked that the open enrollment period be cancelled because the EUTF had not provided a straightforward enrollment process with clear communication, as well as other inadequacies.

"These inadequacies are why so many parties, including HMSA, are concerned for EUTF participants," HMSA said in a letter to EUTF trustees.

Williams, of EUTF, said members have to weigh premium and out of pocket costs along with which doctor provider network they like better.

He said he will be responding to legislators that had requested the EUTF take steps to clear up the confusion or cancel the process.