Health Alliance Replacement Still Unclear for State Retirees

Oct 4, 2013

The head of an Illinois group backing higher education retirees says she's never had a clear answer why the state has been trying to end contracts with insurer Health Alliance.

The Department of Central Management Services announced this week it wasn't offering Medicare Advantage plans with Health Alliance, starting in January.  In 2011, the state dropped the carrier's plans for current workers and retirees ... only to see them restored after a series of legislative and court hearings.

Linda Brookhart is the executive director of the State Universities Annuitants Association.  She says the 15-thousand retirees who rely on Health Alliance can't even find out yet what the benefits are with the four other carriers now offered to them: "CMS says please don't call the carriers because their staff isn't familiar enough with the plan yet.  Well, the reason they're not familiar enough with the plan yet because the plan isn't really available for public consumption.  Or probably, there's going to be a certain amount of training for staff."
Brookhart questions whether the move is politically motivated, noting former Governor Rod Blagojevich tried to end Health Alliance contracts in 2004.  Retirees on Health Alliance have been asked to pursue Medicare contracts with Aetna Life, Humana Health, Humana Benefit, or United Healthcare. Brookhart expects another effort by legislators to reverse the state's plans when returning to Springfield for the veto session late this month.

Meanwhile, a Health Alliance spokeswoman says criteria regarding enrollment numbers kept the insurance carrier from offering Medicare Advantage plans to retirees. The Urbana-based insurer learned this week that it was excluded for retiree plans starting in January… while the state directed those 15-thousand people to four other carriers. Spokeswoman Jane Hayes says Health Alliance was required to have one or more employers who have a minimum of 1-thousand participants enrolled in Medicare Advantage.  She says it’s hard to find an employer with that many retirees in any benefit plan, noting more employers are dropping health care coverage for retirees:  “State Farm and Caterpillar put their retirees into a benefit exchange, so they can choose a number of Medicare Advantage plans, but their employers don’t choose for them.  So it’s sort of an endorsement.  State Farm and Caterpillar endorse Health Alliance as a Medicare Advantage offering for their employees, but they don’t pay for it.”

Hayes says because the Health Alliance bid was rejected based on the enrollment requirement, its pricing was never reviewed. She says the company has submitted has a Freedom of Information Act request to see the winning bids for Medicare Advantage plans from Aetna Life, Humana Health, Humana Benefit, and United Healthcare to see if the options are in the best interest of the state and its retirees. Hayes says Health Alliance will also seek an extension of the time it has to dispute the state’s decision.  She says it’s hearing from a lot of retirees who are distraught and upset over the prospect of changing their provider.