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Archive for the ‘Health Care’ Category

If anyone—ANYONE—in charge at the Division of Administration (DOA) or the Office of Group Benefits (OGB) knows what they’re doing, please contact us immediately because we have given up all hope that the Jindal administration in its entirety has the first clue.

The following is the latest news release from OGB (through DOA, we’re certain; no one would dare take this responsibility on without the prior blessings of Commissioner of Administration Kristy Kreme Nichols.

But it is ample evidence that these are the people Jimmy Breslin had in mind when he wrote The Gang that Couldn’t Shoot Straight.

After all the planning, all the news releases, all the email blasts, all the expenditure of time and money (we would add talent to the list, but that would generate instant doubt in the minds of our readers), OGB and DOA now suddenly shift gears with this.

Here is the news release (with our comments in boldface type):

The Office of Group Benefits announced Tuesday it would extend the annual enrollment period for its 2015 health plan options through the end of November 2014. The enrollment period will now begin October 1 and last through November 30. The health plan changes are scheduled to begin March 1, 2015 instead of January 1 when the plan year begins.

The enrollment period for supplemental insurance products, including dental, vision and life insurance will be extended through November as well. Those plans will take effect January 1 along with flexible spending plans. Flexible spending accounts allow employees to set aside a portion of their paycheck to pay for qualified expenses before taxes are deducted.

“We take the concerns of our members very seriously (We got our butts handed to us by legislators last week) and want to do everything we can to ensure they have the time and resources necessary to make their plan choice,” said Commissioner of Administration Kristy Nichols. “Shifting our timeline will give people the chance to get accurate information and better understand their options.”

(What she means, of course, is now members will have an extra month to select a method of cutting their own throats.)

In addition to the extended time frame, OGB will allow retirees who are enrolled in an OGB health plan option, either as primary or secondary coverage, to remain in a comparable option without having to re-enroll. Retirees interested in Medicare Advantage plans are still required to enroll by December 7 for the plan year that begins January 1. If no action is taken by the end of the enrollment period, retirees will remain in the option most comparable to their current selection. Active employees who take no action will be enrolled in the Pelican HRA 1000 option, a new choice that offers up to $2,000 in employer funding that offsets out-of-pocket costs. (We hope that will discourage the pitchforks and torches at least until Gov. Jindal can finish his absentee term.)

Several new options with lower premiums and increased employer contributions are available beginning March 1. Members are encouraged to use the additional enrollment time to make the selection that best fits their needs. Most members will remain in their current plan through February 28, unless they choose to make a change. However, members who wish to remain in or select a Vantage plan must make their selection effective January 1.

As health care costs across the country continue to rise (We’re still blaming Obamacare for everything—even the Saints’ poor start), OGB and other employers have had to make changes to benefit offerings in order to continue to pay claims. While OGB maintains a reserve fund that contained more than $370 million in cash at the end of fiscal year 2014, the cost of claims currently outpaces the revenue received through premiums each month (We won’t bring up those premium reductions again; we’ve heard enough about those).

Last week, OGB announced it would begin the process of promulgating the schedule of benefits (but only after Reps. John Bel Edwards and Kenny Havard scalded us in that committee hearing). Sending fiscal and economic impact statements to the Legislative Fiscal Office (LFO) begins the promulgation process that will make OGB’s benefits a part of state law. Once the LFO approves, the rules will be sent to the Office of the State Register, the President of the Senate, the Speaker of the House, and oversight committees. The committees will then send a recommendation to the governor for approval. OGB expects the regular rules to be promulgated by March 1 (We hope legislators don’t remember that we said we couldn’t extend this past the first of the year).

OGB is also issuing emergency rules (Will that be emergency rule number 42 for OGB? We’ve lost count) to publish the formulary and prior authorization changes that took effect in August for active employees and retirees without Medicare. Those changes will take effect in January for retirees with Medicare, in line with the Medicare plan year. Emergency rules have the same effect as promulgation of regular rules, for up to 120 days. They will take effect immediately and continue through the administrative process.

Information on the 2015 plan options is available on OGB’s annual enrollment website at www.annualenrollment.groupbenefits.org<http://www.annualenrollment.groupbenefits.org>. (Or you can totally waste your time by calling Ansafone.) Members are receiving decision guides in the mail that outline each plan in detail. 43 meetings are being held across the state in addition to live webinars for employees and retirees. OGB has also developed a cost calculator tool that allows members to compare plans and out-of-pocket cost side-by-side as well as a one-sheet that compares last year’s plans to the upcoming year’s options. Additionally, customer service hours have been extended to 7 a.m. through 7 p.m. Monday through Saturday.

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LouisianaVoice has not posted a story on last Thursday’s House Appropriations Committee hearings on the Office of Group Benefits because we did not want to do what the mainstream media under the pressure of a deadline must necessarily do: get the story out quickly and without going into a lot of detail—in short, an overview.

This is not a criticism but simply an observation of the nature of the job. Reporters must report the highlights of such lengthy hearings without going into too much detail. Both time and newspaper space (air time for TV news) dictate this.

We are not bound by such constrictions. Nor are we always tied down to deadlines. While the story is important, we would rather review the entire seven hours of testimony and give you the mood of the hearings, both the adversarial sparks and the heart-wrenching emotion of some of those who gave their testimony.

Accordingly, we will offer two installments on the hearing. The first will concentrate on the testimony of state employees and retirees who will be adversely affected if the proposed plans are implemented, with retirees taking the hardest hits. The second installment will relate the exchanges between the administration representatives and members of the legislature, most of whom ignored the warnings of three years ago when the administration first proposed firing about 150 OGB employees and hiring a third party administrator (Blue Cross Blue Shield of Louisiana) and now must deal with the consequences of an angry constituency.

The hearing was one of repeated confrontation between legislators and the administration, and while both sides attempted to adhere to legislative protocol and professionalism, there were times when each side’s contempt for the other surfaced, albeit briefly. But it was sufficient for observers to see that members of the legislature, after six and one-half long years, have finally reached a point that they no longer trusts or have any real patience with the administration of Gov. Bobby Jindal (R-Iowa, R-New Hampshire, R-Anywhere but Louisiana).

In 2011 then-Commissioner of Administration Paul Rainwater said the state did not need to be in the insurance business but now, a short three years later, the administration has embedded itself in the day to day operations of the Office of Group Benefits, even to the point of bringing in two former BCBS executives to assist CEO Susan West in finding her bearings.

The following year, in 2012, Jindal attempted to “reform” state employee pensions. Our best example of what those reforms would have done, a story we’ve told several times now, is the one of the state employee who planned to retire after 30 years. If she never received another raise before her retirement, her pension, under the current retirement plan, would be $39,000 per year. Under Jindal’s plan, her retirement would have been slashed to $6,000 per year—a $33,000 per year hit—with no social security.

The courts ruled his retirement plan unconstitutional, so now he’s coming after health care benefits.

Rainwater’s successor, Kristy Kreme Nichols and West (the third or fourth CEO since the administration fired Tommy Teague—to tell you the truth, we’ve lost track) alternated in dodging questions, fumbling explanations and being generally unsuccessful in providing simple yes or no answers in their sparring with legislators. Division of Administration (DOA) Executive Counsel Liz Murrill, meanwhile, spent much her time sitting behind the witness table texting, seemingly oblivious to heartbreaking testimony of those who are seeing their coverage costs skyrocketing.

She texted, for example, while Janice Font, an art teacher from West Baton Rouge Parish, told the committee that she must take eight medications daily and can barely make the co-payments on her prescription drugs now. “And now you tell me I’ve got to pay double?”

Murrill continued texting as Font said she had to take five months disability “making $200 a month less than my house note” and how she “can’t even call the company to fix my air conditioning.”

The texting continued as Font implored legislators to explain to her what she had done to deserve such treatment. “I am a good teacher. I do a good job. And I’m barely making it. I don’t deserve this. I would like for somebody to come down here and tell me why this is being done to me.”

Henry Reed, a retired State Fire Marshal’s office employee, said he fought FEMA for hurricane recovery money on behalf of the state but has seen little in the way of gratitude on the part of that same state since his retirement. A victim of both epilepsy and narcolepsy, Reed said he has to take one medication that costs $2,000 per one-month supply.

His doctor prescribed two pills per day of that medication. “OGB changed to Medimpact (a San Diego company OGB contracted with in January to pay prescription drug claims) and Medimpact informed me they would pay for only one pill per day. Apparently someone sitting at a desk in California knows more about my condition than my doctor.

“I thought I had a good health plan,” Reed said. “I called OGB and they referred me to Medimpact.”

Roy Clement is retired from the Department of Environmental Quality (DEQ). “I’m being asked to choose between plans that will decrease my benefits while increasing my costs,” he said. “In 2011 Paul Rainwater came before the committee and said OGB funds would not be directed to other programs after privatization. But if you cut premiums, the funds that were not earned (the state’s 75 percent contribution to premiums) go someplace else.

“Tommy Teague was forced out after he had more than $500 million (in the OGB trust fund). Now the fund is going broke.

“Our mandate at DEQ was to help the people of Louisiana,” he said. “Yet we’ve seen an administration plunder every agency for their use.”

Kay Prince, a retired school teacher from Ruston, said she and her husband “chose to work for the state because of good retirement and excellent benefits. Now that we’re older and not in as good health as when we were younger, we need these benefits and we feel we are not being treated as fairly by the state as we treated the state by giving of ourselves everything we had. This is not a good situation. OGB was a wonderful thing and that was what largely influenced us in our decision to remain in Louisiana.”

Vicky Picou said simply, “If you need one of these (proposed) plans, you can’t afford it. Most increases are loaded heavily on those least able to pay.

“It’s not open access if the costs are more than your monthly income. This administration has found deep pockets to subsidize corporations (but) has found nothing but contempt for OGB members who are ill. Under this administration, OGB has seen its CEOs come and go, its workers get terminated and now this administration wants to see its ill and elderly shoved off the OGB plans.”

Neil Carpenter said OGB is not living up to its own philosophy and goals. “Never in my career have I seen half a billion dollars played with so capriciously and arbitrarily,” he said. “I would at least think you would have an actuarial report whereby you could set premiums. From what I’ve seen, they’re based on nothing. There’s no methodology to the madness.” (We will have much more on this in tomorrow’s story.)

“I know the money was not transferred from the reserve fund to the general fund,” he said. “I know that. But if you reduce the amount coming out of the general fund by underfunding premiums that are supposed to be going to the insurance program, you have effectively done the same thing.

“Somehow, we were paying too little to fund the plans and our reserve fund got too big and now we’re broke because we had too much money.”

Ann Curry, a retiree from the Office of Juvenile Justice pointed out that because members from East and West Feliciana parishes are on the Vantage Health plan, they have been going to doctors in Baton Rouge but because of the structure of the new proposals, those members will not be eligible for the less expensive plan because the Baton Rouge doctors will not be in that network. Consequently, they would have to opt for the more expensive plan.

Mary-Patricia Wray, legislative director for the Louisiana Federation of Teachers, said the administration’s idea of “right-sizing” the OGB plan really meant right-sizing for the administration. “The right-sizing, according to this plan, means it will be suffered by state workers and teachers only. The costs to the state stay the same. Deductibles, co-pays, out-of-network costs will be going up—way, way up. Whenever the state’s position in right-sized, it comes out on top. The last time it right-sized, it saved $95 million by decreasing premiums. That decision led to financial problems and now the state is being ‘same-sized,’ not right-sized. Members of OGB will bear the burden of that poor decision.”

Frank Jobert, executive director of the Louisiana Retired Employees Association said the administration created the crisis. “This entire conversation today would not be necessary had we not reduced premiums and created the problem that exists today that you’re trying to solve on the backs of employees and retirees.”

Jobert said he had been told some legislators do not want to get involved in the OGB discussion “because they’ll be blamed. But if you don’t get involved, you’re going to share the blame. You’re going to leave some people out in the cold.

“This program was fine,” he said. “It was functioning; we were happy with the premiums and nobody was complaining. Now we’re doing everything in a completely different manner, adding confusion, giving programs new names and no one is happy. We need your help,” he told the legislators. “It’s your job. We elected you to do this for us.”

Tommy Teague, who was fired as executive director of OGB on April 15, 2011, when he failed to embrace Jindal’s privatization plan, was one of the last non-legislator to testify. His firing followed that of his wife Melody six months earlier for testifying before Jindal’s streamlining committee. And though she appealed and got her job back, the firing of the two gave birth to the often used term “teagued” as synonymous with being fired or demoted by Jindal.

Teague now serves as general counsel and Vice President of Provider Relations for the newly formed Louisiana Health Cooperative.

“There was never a rule change undertaken at OGB without going through the Administrative Procedures Act (APA),” he said. “We followed the APA every time there was a change in a benefit plan. We allowed for complete oversight of all changes as the APA called for.”

Legislators, as we will see in tomorrow’s installment, were highly critical of the administration’s reluctance to comply with the APA.

“I do have a business motive for being here,” Teague admitted. “Louisiana Health Cooperative is a new start-up health maintenance organization (HMO).

“OGB is required to seek out any Louisiana HMOs that would like to participate in the state employee health coverage during open enrollment. We asked OGB for an opportunity and they refused to let us participate even though we believe the law requires the solicitation process to include us. We offer a plan very similar to the current HMO plan and could save the state millions of dollars.

“We would encourage the oversight process and that you push back the open enrollment (now scheduled for Oct. 1—Oct. 31) and that we be allowed to participate and offer our plan through the open enrollment process.”

Then, deliberately and emphatically, Teague said, “When I was fired (from OGB) in 2011, the fund balance was $506 million and the Office of Group Benefits was running like a top.”

And Liz Murrill texted.

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A directive to craft a request for proposals (RFP) in such a way as to favor a specific vendor during a meeting of top administrative officials in 2010 may have violated the state’s bid laws and opened the door to charges of bid-rigging, according to a former State Senator who spoke with LouisianaVoice on Wednesday.

That meeting may also have been instrumental in the decision by then-Commissioner of Administration Angéle Davis to resign her position in early August of 2010.

Former State Sen. Butch Gautreaux (D-Morgan City), who was the State Senate’s representative on the Office of Group Benefits (OGB) Board of Directors, told LouisianaVoice that the meeting was held to discuss an RFP from vendors to provide health care coverage to state workers in northeast Louisiana.

Gautreaux said he was told by then-OGB Executive Director Tommy Teague that he (Teague) was directed by Timmy Teepell to “write a tightly-written RFP” so that only one company could meet the bidding criteria.

Teepell was Gov. Bobby Jindal’s Chief of Staff at the time of that meeting. Besides Teague and Teepell, also in attendance at that meeting were Jindal’s Executive Counsel Steve Waguespack who would succeed Teepell as Chief of Staff, and Davis.

Teague, contacted Wednesday by LouisianaVoice, confirmed the substance of Gautreaux’s story, though he said he was by now somewhat vague as to who was in attendance. “That happened so long ago,” he said, “but the gist of what he says is correct.”

Davis announced her resignation on June 24, 2010, though she stayed on until Aug. 8 when she was succeeded by Paul Rainwater. Teepell resigned in October of 2011.

The vendor that Teepell was most likely referring to was Vantage Health Plan of Monroe which currently holds two separate contracts with OGM worth a combined $53 million.

One of those contracts, for $45 million, is a one-year contract to provide a health maintenance organization (HMO) and hospitalization provider network plan and runs from Jan. 1, 2013 through Dec. 31 of this year. The second, for the same time period, is for $8 million to provide a Medicare Advantage plan for eligible OGB retirees. That plan, similar to ones offered by Peoples Health and Humana in South Louisiana, would be available only to those retirees eligible for Medicare. Retirees hired prior to 1986 and who have never worked in the private sector long enough to qualify for Social Security would not be eligible for the latter plan.

Vantage Health Plan has held 11 state contracts in all, totaling nearly $325 million at least as far back as former Gov. Mike Foster’s second term. The first, for $6.7 million, was for three years, from July 1, 2000, to June 30, 2003, to provide medical services for active and retired plan members.

Under Foster and into former Gov. Kathleen Blanco’s term, Vantage held two contracts: one for $46 million that ran three years, from July 1, 2003, to June 30, 2006 to provide an HMO program, physician and hospital provider network, and a one-year contract, from July 1, 2006 to June 30, 2007, was for $30 million to provide HMO services for state employees.

In Jindal’s first year in office, 2008, OGB issued a $9.925 million contract that ran for 30 months, from July 1, 2008, through Dec. 31, 2010, for Vantage to provide a Medicare Advantage plan for eligible retirees.

The following year, a $20 million contract for only 10 months—from Sept. 1, 2009, to June 30, 2010—was awarded to Vantage to provide an HMO plan to OGB members.

In 2010, Vantage received its biggest contract for $70 million for only 22 months, to run from July 1, 2010 to Aug. 31, 2012 for an HMO plan. That contract was one of four contracts with Vantage totaling $161 million that overlapped between July 1, 2010 and June 30, 2013.

Other contracts included:

  • One running from Jan. 1, 2011 to Dec. 31, 2012 for $14 million for Medicare Advantage plan for eligible retirees;
  • One for $10 million for only three months, from Sept. 1, 2012 to Dec. 31, 2012 for a medical home HMO plan for members;
  • One for $65 million for two years, from July 1, 2011 to June 30, 2013 for an HMO plan.

The obvious question is: Why Vantage?

For openers, Vantage and its officers have been active in writing checks for state politicians.

Gary Jones, president of Vantage, has personally contributed at least $20,000 to state politicians since 2003, including $10,000 to Jindal and $5,000 to former Gov. Blanco.

Michael Ferguson, a director of Vantage Holdings, Vantage Health Plan’s predecessor, gave $4,000 to state office holders, including $1,500 to Rep. Frank Hoffman (R-West Monroe) who serves as vice chairman of the House Health and Welfare Committee; Matthew Debnam, also a director of Vantage Holdings, $1,000 to Hoffman, and Terri Odom, also a Vantage Holdings director, $500 to Hoffman.

But it is Vantage Health Plan itself that is the biggest player in lining the pockets of state politicians.

Vantage, since Jan. 1, 2003, has kicked in no less than $61,900 to candidates. These include $1,000 to Jindal, $2,000 to former legislator Troy Hebert who now serves as director of the Office of Alcohol and Tobacco Control (AGC), $1,500 to House Speaker Chuck Kleckley (R-Lake Charles), $16,000 to Insurance Commissioner Jim Donelon and $5,000 to Sen. Mike Walsworth (R-West Monroe), among others.

While these contributions are all legal, they do raise the recurring issue of influence buying at all levels of government. And it is the $70 million contract in 2010 that raises the issue of possible bid-rigging. And while there may well have been no such attempt, if Teepell did indeed issue instructions to Teague to craft the RFP in such a way that only Vantage would meet the bid criteria, then the administration crossed a serious legal line for which it must be held accountable.

It was subsequent to that 2010 meeting and only weeks before the contract was awarded that Davis submitted her resignation and Teague was gone the following year on April 15, 2011.

This claim should spark investigations by the Inspector General’s office, the Attorney General, the East Baton Rouge District Attorney’s office and the U.S. Attorney’s office—the latter because federal Medicare funds were involved in several other Vantage contracts.

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Regardless of how you might feel about Common Core, Gov. Bobby Jindal has shown in no uncertain terms that he is either a liar willing to twist facts to his own political advantage or that he is just too dense to comprehend the English language.

As our friend Stephen Sabludowsky over at Bayou Buzz noted in his blog post today (Monday, Sept. 22), Jindal, having crashed and burned in state court (for what seems like the umpteenth time) has now filed a “frivolous” lawsuit in federal court challenging Common Core and by some extension as yet undefined, President Barak Obama. http://www.bayoubuzz.com/buzz/item/748889-jindal-misleads-in-his-legislative-auditor-common-core-spin

Jindal, Sabludowsky noted, said in a press release following the release of an issue brief by Legislative Auditor Daryl Purpera’s office that the report “declared that Common Core Standards are driving curriculum in the classroom.” http://gov.louisiana.gov/index.cfm?md=newsroom&tmp=detail&articleID=4678

Jindal added that while the report says that standards are not synonymous with curricula, “the report clearly declares that standards drive curriculum.”

The report, however, says nothing of the sort.

That sent Sabludowsky into orbit. “The word ‘drive’ does not even appear in the report, nor does the word ‘drives’ or even ‘driving.’”

Jindal filed his lawsuit against the Obama administration, saying the federal government (read: Obama) “has hijacked and destroyed the Common Core initiative.”

That, of course is the only tact he could have taken, given the fact that he once was an ardent proponent of Common Core

Yet, blaming Obama for the Common Core standards is more than a little misleading. Our friend Gregory DuCote correctly pointed out that the standards were adopted by the National Governors Association and the Council of Chief State School Officers. “I do not see Barak Obama’s name” in the report. “I do not see him credited with the standards.”

All of which got us to wondering what would happen should Jindal somehow, against all odds, be elected POTUS and attempt (either by misinterpreting or by manipulating) to skew the meeting of an international communique or a clause in a peace treaty or trade agreement?

With that in mind, we take you to the White House Oval Office sometime in say, 2018 or 2019:

President Jindal: I’ve just read the report on the Chinese economy and I don’t like what I see.

Press Secretary Mike Reed: Why is that, Mr. President?

Jindal: Well, it says here in black and white they want to initiate an “aggressive tirade mission aimed at exploding western markets. It’s obvious they’re planning to bomb Wall Street.”

Reed: No sir, it says “aggressive trade mission aimed at exploiting western markets.”

Jindal: Don’t correct me. I’m POTUS. Get me the Joint Chiefs of Staff, the NSC, Homeland Security and CIA Director Edmonson. Where’s my Budget Office director?

Kristy Kreme Nichols: I’m right here, Mr. President. I’ve been practicing my half-truths, distortions and denials.

Jindal: Kristy Kreme, where do we stand on Social Security and Medicare?

Kristy Kreme: It’s just Kristy, Sir. Some jerk in Louisiana hung that stupid name on me. Our program to cut Social Security and to offer less coverage under Medicare at higher premiums has resulted in 93 percent of senior citizens having to go back to work to supplement their retirement income. And eliminating the funding for unemployment certainly was effective. We have handicapped military veterans and homeless people cutting lawns and doing landscaping now. By the way, Susan West is doing a great job running Medicare under DHH Secretary Greenstein.

Jindal: Excellent. More people working. That’s what we wanted. Mike, put out a press release about our full employment program. How does Attorney General Faircloth feel about the legal issues involved?

Executive Counsel Thomas Enright: I spoke with him on this and he thinks it’s a slam dunk.

Jindal: Good. I knew I could rely on Jimmy. Always there when I need him. Oh, I need to talk to Secretary of State Teepell about that Russian threat to deploy its nuclear missiles.

Teepell: I’m here, Mr. President. That communique from Putin said he was offering to destroy his nuclear weapons, not deploy them.

Jindal: Destroy, deploy. Whatever happens, we know it’ll be Obama’s fault. Is the Secretary of the Interior here to give his report?”

Scott Angelle: Yes sir, Mr. President, I’m here. I’m happy to report that we have finalized contracts with Exxon/Mobil to open up oil and gas drilling in all the National Forests. Of course, we may have to cut down a few redwood and sequoia trees. Fracking in Yellowstone, however, could pose a problem with the geysers. Especially Old Faithful.

Jindal: Frack it. Those tree huggers probably believe in global warming, too. Do we have a report from Treasury?

Secretary of Treasury Tim Barfield: Everyone on Wall Street sends their best, Mr. President. The Dow set an all time record yesterday, thanks to our sweeping deregulation programs.

Jindal: You’re doing a heckuva job, Barfee. How’re we doing on our legislation to create a new cabinet position?

Chief of Staff Kyle Plotkin: It looks good, Mr. President. I believe we have the votes for the Secretary of Morality position.

Jindal: How does Gene Mills feel about his nomination to the post?

Plotkin: He’s warming up to it, sir. He’s taking a page from the Koran and informing senators and congressmen that if they adhere to a strict monogamous marriage, they will go to heaven where they will be rewarded with 70 virgins.

Jindal: How’s that working out?

Plotkin: We have complete bipartisanship in the House and Senate on this. And ALEC is seriously considering it for their model legislative package for state legislatures next year. We’ve never seen such enthusiasm. It’s a breakthrough of historic proportions.

Jindal: Well, I fail to see the hysterics in that but I’m glad they’re receptive.

Reed: Sir, it seems to me that you spent eight years as governor beating up on the federal government for trying to run our lives and now you’re trying to get it to monitor America’s bedrooms.

Jindal: But don’t you see, now I am the federal government. And you’re fired. This is great! I really do have the job I want.

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If further evidence is needed that Kristy Kreme Nichols and Susan West are trying to shovel water with a pitchfork in their efforts to put a good face on the looming changes in the Office of Group Benefits (OGB), LouisianaVoice has learned of more developments that aren’t very pretty and which are sure to only intensify the confusion and indecision accompanying the pending open enrollment period that begins on Oct. 1 and runs through Oct. 31.

And now you can add another name to the mix—that of newly hired (at $106,512 per year) Group Benefits Administrator Elise Cazes, formerly an executive with Blue Cross/Blue Shield of Louisiana, which serves at the OGB third party administrator for OGB’s preferred provider organization (PPO).

Nichols, meanwhile, keeps churning out all those happy face news releases—some even written by Gov. Bobby Jindal’s communications officer Mike Reed but published in the Baton Rouge Advocate under her byline—in an attempt to assuage the concerns of some 230,000 state employees, retirees and dependents now covered by OGB.

But now, in addition to the administration’s losing credibility with its rosy assurances in Louisiana, OGB customer service efforts appear to be coming unraveled in California—and perhaps even Florida—at a cost of $1 million to Louisiana taxpayers.

A week ago, we told you about the state’s $1 million contract with Ansafone of Santa Ana, California, and Ocala, Florida (okay, we first said it was Answerphone of Albany, New York and that the contract was for $2 million, but our IT (I’m Telling) source in Nichols’ office was incorrect on those points).

At any rate, the state hired Ansafone to hire 100 persons in California and another 100 in Florida to man phone banks to field questions from OGB members. Not only was it absurd (not to mention heartless) to fire two dozen OGB employees recently because there was “not enough work” for them, but to then pay an out-of-state firm to hire phone bank employees in California and Florida—employees completely unfamiliar with OGB’s proposed coverage plans—was nothing less than insulting, not to mention shortsighted and yes, stupid.

To illustrate our point, we received word today (Thursday) out of California of what can best be described as a monumental disaster in the making. The preparations being made in Santa Ana have all the clearheaded thinking of a sack of rats in a burning meth lab, to paraphrase a line from Two and a-Half Men.

It seems that the job fair for prospective employees to man the phones more closely resembled a cattle call, a term normally used to describe open auditions for movie and television parts. That’s where actors and actresses (in this case prospective telephone service representatives) show up en masse for auditions (job interviews).

Except in this case there were no interviews of any of the 80 or so applicants who showed up. Instead, they were shown a video presentation that passed for orientation at the end of which they were all congratulated on their new jobs. No interviews, no screening, no background checks. Hired.

There followed six days of “training,” that consisted of the reading of handouts distributed to the new employees. “They read to us verbatim from a two-inch-thick document,” said one of the hires who asked that his name not be revealed. “Half of those there kept falling asleep.”

He said the OGB representative, Elise Cazes, asked for feedback from the new employees, some of whom failed to return for the second day of “training.”

“It was not until our first day on the phones that they told us the information they had tried drilling into us was wrong,” he said, adding that they were told to instead use “the knowledge base on the computer.”

He said the problem with that was the knowledge base, which contains a dozen or so links “only comes up when there is a call coming through,” making it impossible to access the data in advance.

“If I take a call, I like to be able to answer questions without having to put him on hold while I search for the proper link to access so the caller does not think I don’t know what the hell I’m doing,” he said.

“I expressed my concerns about this and I asked for printouts of the correct information. I thought they were serious when they said they wanted feedback. I was wrong. Wednesday was my day off and I was called at home and told the client no longer wanted me on the project.”

The “client,” he said, was OGB and the directive came from Cazes.

At least you have to give her credit: she certainly learned quickly that dissention is not tolerated by Jindal and his hand puppets.

Our source said the people Ansafone and OGB have answering insurance plan questions “are grossly unprepared for the questions that plan members have or are going to have with open enrollment begins. The slapped everything together,” he said.

“My last day there (Tuesday) they were still purchasing computers and setting them up. They ran out of room and had to set up in a warehouse with no air conditioning,” he said. “They were running fiber optic cable and wires everywhere.

“I feel bad for these people who are going to be calling. They’re (OGB and Ansafone) are doing everything on the fly. The system is middle school at best. There are going to be dropped calls, incorrect answers and a multitude of other problems,” he said.

He said members who do not select a plan or who do so incorrectly will be automatically defaulted to the Pelican HRA 1000 plan which is the least desirable of the four plans OGB will offer next year.

As you read this, keep in mind that Ansafone’s web page somewhat prophetically contains its “five Star Recipe for Customer Service Failure.” http://www.ansafone.com/five-star-recipe-for-customer-service-failure/

Oops. Looks like that page has been taken down since we called attention to it last Friday. Perhaps Ansafone took one look at the OGB open enrollment plan and saw customer service failure in the cards. And a million bucks can cause you to compromise on otherwise strongly held principles.

Nevertheless, the recipe is was so rich in irony that we can’t resist giving you the three main ingredients again:

  • A “tablespoon of no communication.”
  • A “dash of not caring.”
  • “4 ounces of empty promises.”

OGB members may wish to start a check list to keep score on the accuracy of that recipe just for the fun of it.

The legislature is scheduled to review the OGB Health benefits in the Joint Legislative Committee on the Budget on Friday (Sept. 19) and in the House Appropriations Committee next Thursday (Sept. 25).

Additionally, OGB has scheduled a series of meetings throughout the state during October to answer questions about the open enrollment.

https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A497A4F4445794D793551524559334D6A4531

The information OGB has supplied for annual enrollment leaves many questions unanswered.

One reader has compiled a list of questions that need to be answered before making an informed choice. The questions that should be posed to OGB during these hearings are as follows..

  • The flexible benefits guide for 2015 is not on the website.  Are the IRS maximums of $2500 still applicable?
  • The benefit comparisons do not include any mention of laboratory and radiology services. Are these subject to the deductible? Also, what are the co-pay and/or co-insurance amounts for each plan?
  • Annual mammograms are currently covered with no charge for OGB members. Will this continue? What about pathology for well women pap-smears?
  • Are the co-insurance amounts computed on the contract rate for in-network providers? What about the co-insurance computation for out of network providers—is this on the contract rate or provider charges?
  • Are the listed deductibles for in-network providers a separate amount from the listed deductible for out of network providers? Example, is the total deductible for in-network and out-of-network providers for Pelican HRA 1000 $2000 + $4000 for $6000 deductible? Is this the same answer for all plans?
  • For Out-of-Pocket Maximums (OOPM), once the OOPM is reached, are all services/benefits covered at 100%? Are the OOPMs for in-network providers a separate amount form the listed OOPM for out-of-network providers? Example, is the total OOPMs for in-network and out-of-network providers for Pelican HRA 1000 $5,000 + $10,000 for $15,000 OOPMs? Is this the same answer for all plans?

The problem is the only ones who might have an interest in the OGB open enrollment and the options offered are state employees.

And state employees who ask questions are subject to being teagued.

Ah, but there is a silver lining.

All the meetings, including the legislative committee meetings, are scheduled during the work day which makes it difficult, if not impossible, for many state employees and teachers to attend.

So it appears your jobs are safe for now even if your medical coverage is not.

Whew! That was close!

 

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(Editor’s note: We’re re-posting yesterday’s story after our source informed us we had been given the incorrect name of the telephone answering service hired (on a no-bid contract) by DOA to attempt to provide answers to the growing concerns of members of the Office of Group Benefits)

The news out of Division of Administration (DOA) and the Office of Group Benefits (OGB) just keeps getting more and more bizarre and emerging revelations only serve to solidify the fact that Commissioner of Administration Kristy Kreme Nichols and OGB Executive Director Susan are woefully in over their respective heads.

It’s not just that the Jindal administration just hired two new six-figure salary employees from Blue Cross/Blue Shield (BCBS) to unfix what Kristy Kreme and Susan West fixed—although that’s part of it. Paying Thomas Groves $220,000 a year must smart, given that it is $50,000 more than West pulls down as head of the agency. Elise Cazes will make $106,512 as group benefits administrator.

And it’s not that the OGB trust fund has dwindled from a $540 million pre-Piyush Privatization balance to less than half that amount today—although that’s part of it.

And it’s not that costs to some 230,000 state employees, dependents and retirees who are members of OGB will be going up by some 47 percent and benefits will decrease, Kristy Kreme’s soothing assurances to the contrary notwithstanding—although that’s part of it.

And it’s not that legislators and legislative staff members are eligible to participate in a better plan, LSU First (an option not even available to Louisiana’s other public university employees)—although that’s part of it.

And it’s not that the administration lied to state employees back in 2012, telling us that there would be no premium increases or benefit cuts—although that’s certainly part of it and it doesn’t help that the administration continues to churn out many of those same lies.

And it’s not that most of the staff at an agency that was operating at smooth efficiency and was widely approved of by member employees was fired in order to allow BCBS to take over as the OGB third party administrator (TPA) to handle claims—although that was a big part of it.

No, it isn’t any one of those things. It’s all of them, the cumulative effect of an administration rolling over its loyal employees, forcing many of them into early retirement (if they’re eligible for retirement) or worse, unemployment.

But as if that weren’t bad enough, seemingly with each passing day, the plot at DOA and OGB continues more and more to take on the appearance of a theater of the absurd than it does an administration of mature individuals responsible for running a $25 billion a year state government.

The most recent blunder involved the layoff of about two dozen OGB employees “because there wasn’t enough work for them,’ leaving a skeleton staff unable to man the telephones to take questions from thousands of OGB members, particularly retirees, wondering if they were going to continue to have health coverage.

To fill that vacuum, BCBS employees were brought in to answer the phones but were unable to answer specific questions because of their unfamiliarity with OGB policies.

So then to solve that problem, 20 DOA employees were brought into OGB’s IT section but have done no better.

The obvious answer? Ansafone Communications.

Who?

Well, it’s not Answerphone, a company out of Albany, N.Y., as we were originally informed. Our IT (“I’ll Tell”) source informs us the spelling was given to us incorrectly and that it should have been Ansafone out of Santa Ana, California, and Ocala, Florida. And the contract is for about a million bucks, not the $2 million we were originally told.

Still, it’s another of those emergency contracts that DOA is issuing with reckless abandon with no requests for proposals, no bids and apparently, if the Alvarez & Marcel (A&M) contract, which went from about $4.2 million to more than $7 million at warp speed, is any indication, no ceiling.

Of course, all contracts must be approved by the Office of Contractual Review. But the Office of Contractual Review works for…(ahem), Kristy Kreme.

Not much more is known about Ansafone than we were able to learn about Answerphone except Ansafone does include a little more hype on its web page: http://www.ansafone.com/

Kristy Kreme assures us in a Baton Rouge Advocate news story  that Ansafone “in health care enrollment” and that “Ansafone representatives have experience with managing benefit plans and have been trained extensively on OGB and its offerings.” Apparently, their “extensive training” of a few days better qualifies them than the OGB employees who did that for years before they were shown the door.

http://theadvocate.com/news/10253537-123/ogb-hotline-hours-extended

It does have on its web page a cute “Five Star Recipe for Customer Service Failure,” however. http://www.ansafone.com/five-star-recipe-for-customer-service-failure/ Kristy Kreme and Susan West might want to peruse that a bit. Some of the ingredients included:

  • A “tablespoon of no communication,”
  • A “dash of not caring,” and
  • “4 ounces of empty promises.”

Sounds like something this administration cooks up virtually every day.

Frankly, we don’t see the need to pay these folks. In fact, Kristy Kreme may want to consider collecting royalties from Ansafone for stealing the Jindal recipe for failure.

So while our source provided us with the name of the wrong company, we will gladly take our one error, embarrassing though it certainly is, over the endless examples exhibited by Jindal, Kristy Kreme, and whoever happens to in charge today at OGB. We would print the name, but given the new salary structure there, we’re not exactly sure who that is and we don’t want another glaring error—not this soon, anyway.

Perhaps we can get some answers next Friday (Sept. 19) when the Joint Legislative Committee on the Budget meets in House Committee Room 5 at the state Capitol at 9 a.m. or the following Thursday (Sept. 25) when the House Appropriations Committee meets at 10 a.m. in the same committee room. Both meetings are being held to address OGB’s rising costs, falling revenue and dwindling benefits.

Maybe Kristy Kreme and Susan West can both appear and enlighten the legislators tag team-style with their combined wizardry.

But basically, what we know is this:

  • Two dozen OGB employees were fired because they didn’t have enough work to do;
  • BCBS employees had to help on the phone lines but were incapable of answering the multitude of questions from members;
  • About 20 DOA employees were brought in to help on the phone lines but that still wasn’t enough;
  • A firm with a sketchy web page about which little is known was hired at a cost of $1 million to provide 100 operators in California and 100 in Florida to help out on the phones with problems in Louisiana.

All things considered, we can only borrow a phrase from the Ol’ Perfesser, Casey Stengel who said of his 1962 New York Mets baseball team (that lost 120 of 162 games):

“Can’t anyone here play this game?”

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(CLICK ON IMAGE TO ENLARGE)

My grandfather had a favorite expression he was fond of saying: “The stuck pig squeals the loudest.”

That may well explain the sudden onslaught of reassurances emanating from the Jindal administration in the form of press releases and op-eds, all telling us that our benevolent governor, expert that he is on health care, is taking care of and we shouldn’t worry about all those looming increased costs and reduced benefits.

But as it turns out, we may be about to see a new development to the controversy swirling around the proposed premium increases and benefit cuts for members of the Office of Group Benefits.

And just in case you might be wondering why your friendly legislator hasn’t been up in arms over the radical changes in health coverage being proposed for some 230,000 state employees, retirees and their dependents through the Office of Group Benefits (OGB) before now, there’s a reason.

If some similar action were taken to adversely affect their per diem, travel, and other perks, it would be quite another story. They’d have been squealing long before now.

But you see, 261 House members and staff and 151 senators and staff are not members of OGB and therefore, don’t have any skin in the game (my grandfather would have said they don’t have a dog in the hunt) being played by the administration and Blue Cross/Blue Shield of Louisiana.

So where do those 412 people get their health coverage?

LSU First.

And now two of those legislators who earlier fell out of favor with Gov. Bobby Jindal when they questioned the wisdom of privatizing OGB at the outset, Reps. Joe Harrison (R-Gray) and Cameron Henry (R-Metairie) are back and the governor can’t be happy about it.

And Henry is even putting out feelers about moving all 230,000 members of OGB to LSU First, saying it is something “we should explore for employees to get into since the Office of Group Benefits is fiscally unsound.”

Meanwhile, House Speaker Chuck Kleckley (R-Lake Charles), normally a wad of putty in Jindal’s hands, has suddenly grown something akin to a spine and called for a special hearing on Sept. 24 to take up the OGB changes. Other legislators also beginning make demands of the administration to have someone present to answer questions about the radical changes.

State Rep. John Bel Edwards (D-Amite), a candidate for governor, said he wanted administration representatives questioned under oath.

It was Edwards who originally requested that Kleckley call a meeting of legislators to discuss OGB. “The OGB fiasco is proof positive that privatization for the sake of privatization is foolish,” he said. “A reserve balance that recently exceeded $500 million is half that now and bleeding $16M per month due to mismanagement and budget chicanery, and the ultimate price will be paid by state retirees and employees through higher premiums, higher co-pays, higher deductibles, and higher co-insurance in exchange for fewer benefits, more forced generic drugs, and more preclearance of needed treatments and other changes that make crystal clear that the OGB beneficiaries will pay more for less.”

“I feel vindicated,” Harrison was quoted as saying by the New Orleans Times Picayune in reference to the depletion of the OGB trust fund which has shrunk from $540 million to less than half that since Jindal’s privatization plan went into effect. http://www.nola.com/politics/index.ssf/2014/09/louisiana_legislators_have_a_h.html#incart_river “Exactly what I said was going to happen is now happening,” Harrison said.

And Henry is even putting out feelers about moving all 230,000 members of OGB to LSU First, saying it is something “we should explore for employees to get into since the Office of Group Benefits is fiscally unsound.”

Jindal had Henry and Harrison removed from their respective committee assignments when the two refused to go along with Jindal’s legislative agenda during the 2013 legislative session.

Administration officials, in an attempt to discourage a mass exodus from OGB said state employees now in OGB may not find the LSU First plans to be a better option, invoking such terms as “better service,” “strike a balance,” “right sizing of benefits,” “wider range of options,” and “it’s all the fault of Obamacare.”

So, just what is LSU first, anyway?

LSU First is the health coverage offered employees throughout the LSU system and back near the end of the Mike Foster administration, a memorandum of understanding (MOU) was approved that allowed legislators and legislative staff members to opt out of OGB in favor of LSU First.

Senate 2003

House of Representatives 2003

The plan presently is not available to employees of Louisiana’s other institutions of higher learning or civil service employees other than those working for the Legislature.

So, why would anyone make the switch?

The answer to that is simple: Even before the pending revamp of OGB which will prove far more costly to members, LSU First was vastly superior in the benefits it offers. And now, with the increased premiums, higher deductibles and co-pays for OGB members (an overall cost increase of 47 percent), the contrast between the two plans is even more stark. http://www.lsufirst.org/wp-content/uploads/2012/01/2014_LSU_First_SPD.pdf

http://www.lsufirst.org/wp-content/uploads/2013/12/2014-SBC-Opt1.pdf

LSU established the plan for the fiscal year July 1, 2002 through June 30, 2003, adopting the “Definity Health Model Health Coverage Plan,” and the House and Senate climbed on board a year later, on July 1, 2003. The original MOU was signed in May of 2003 by then-LSU President William Jenkins, House Speaker Charles DeWitt, Jr. (D-Alexandria), and Senate President John Hainkel, Jr. (R-New Orleans).

No sooner said than done. The ink wasn’t even dry on the signatures on the MOU when legislators and staff members started a mass migration to the LSU plan. Additionally, civil service workers scattered throughout state government who were fortunate enough to have spouses working for LSU also switched.

The language in the MOU was such that any legislator who left the House or Senate and moved on to another state office or appointment was allowed to retain his or her coverage under LSU First. That would include, for example, people like former Gov. Mike Foster, Commissioner of Alcohol and Tobacco Control Troy Hebert, Lt. Gov. Jay Dardenne, and former House Speaker Jim Tucker.

LouisianaVoice made an inquiry of the LSU administrative types as to who pays the employer portion of the premiums and whether or not the governor, the commissioner of administration, and cabinet members were eligible for member in LSU First.

What we got back was less than satisfactory but entirely typical of the mindset of this administration. “We have fulfilled your public record request and any further questions can be directed to our University Relations office,” wrote Stephanie Tomlinson, coordinator, LSU Finance and Administration.

In other words, if one asks a simple question and does not specifically request documents or records, he is out of luck. This administration has no intention of helping someone seeking information and would prefer to toss obstacles in the path of transparency.

But we can play this game, too. We replied with the following email:

Okay, we’ll try it this way:

Please provide any and all documents and/or public records that identify all eligible members of LSU First medical coverage, including the governor’s office, Division of Administration and the various cabinet positions.

Please provide documentation and/or any and all public records that provides a breakdown of premium payments for LSU First, including employer/employee contributions and including which employer, i.e. the state, the House or Senate or LSU, pays the employer contributions.

Now that we have requested actual documents/records, we’ll see how they respond.

We did glean from the MOU, however, that the Legislature most likely is responsible for paying 70 percent of the premiums for legislators, legislative retirees, and staff members.

Meanwhile, Jindal communications officer Mike Reed, a native of Boston (Jindal apparently cannot find qualified Louisiana residents for these jobs), churned out a fact sheet that Commissioner of Administration Kristy Kreme Nichols proudly published verbatim as her own work as via an op-ed piece in today’s (Thursday’s) Baton Rouge Advocate under the heading Changes Good for Insurance Users, Taxpayers. (A hint, Kristy: U.S. Democratic Sen. John Walsh of Montana recently dropped out of his race for re-election after allegations of plagiarism.)

As for Reed, we can only hope that if he returns to Boston he doesn’t offer his services to the Red Sox. Mired in last place in the American League East, the Sox have enough problems without taking on another pitch man who can’t seem to find the strike zone.

Reed’s press release was directed at a recent well-researched column by political writer Jeremy Alford: For Health Care Woes, Jindal Prescribes Confusion. http://lapolitics.com/2014/09/for-health-care-woes-jindal-prescribes-confusion/

Reed sent the “fact sheet,” entitled Setting the Record Straight: LaPolitics Column on Healthcare reform in Louisiana, to state legislators on Wednesday. The four page letter was peppered with what Reed smugly, if inaccurately, described as “myth” followed by “Facts.”

Of course, being from Boston, it goes without saying that Reed is intimately familiar with all the nuances of Louisiana politics, including the sordid history of the administration’s recent health care issues. These include Jindal’s sticking his nose into the OGB operations and firing Director Tommy Teague who had taken the agency from a $60 million deficit to a $500 million fund balance, closing down or giving away state hospitals, the governor’s refusal of Medicaid expansion which led directly to problems at Baton Rouge General which last week announced it was closing its emergency room, forcing the administration to pump $18 million into the private hospital to keep its ER open to indigent patients forced to travel to the mid-city facility after closure of state-run Earl K. Long Hospital.

Undaunted, Reed waded into the fray, dutifully blaming everything on Obamacare just as his absentee boss would have him do. And Kristy Kreme eagerly published the tome under her byline.

https://webmail.east.cox.net/do/mail/message/view?msgId=INBOXDELIM16848

The whole thing evokes images to go with one of our favorite Sinatra songs: http://www.youtube.com/watch?v=K1fVQGESUTo

Bobby Jindal (Gov. R-L)

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