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Archive for the ‘Privatization’ Category

Even as the Jindal administration was announcing that it was capitulating to the desires of the attorney general and state legislators to delay implementation of new proposed health coverage plans for state employees and retirees, the Office of Group Benefits (OGB) was quietly issuing a request for proposals (RFP) for actuarial services beginning Jan. 1, 2015.

https://www.groupbenefits.org/portal/pls/portal30/ogbweb.get_latest_news_file?p_doc_name=4D7A4D774E4445794D793551524559334E444531

Greg Cromer (R-Slidell) and John Bel Edwards (D-Amite) asked several times during the hearing the identity of the actuary who recommended three consecutive years of premium reductions in the face of rising health care costs and it wasn’t until the fourth time the question was asked.

“In fiscal year 2012 there was a 3 percent erosion of the fund balance,” Edwards said. “Yet, in fiscal 2013, there was a 7.11 percent reduction in premiums followed by 1.8 percent even though health care costs were going up by 6 percent. What actuary told you those reductions were sound?”

“Buck Consulting recommended a 2.25 decrease for calendar 2012,” Commissioner of Administration Kristy Nichols said.

Edwards then asked if Buck Consulting was still under contract to the state.

“That contract is being bid,” Nichols said.

“I would hope so,” Edwards responded.

State records indicate Buck had a $2.1 million contract with OGB to provide actuary and consulting services. That contract ran from Dec. 1, 2009 through Jan. 1, 2012. Additionally, Buck had another $600,000 contract from June 1, 2011, to June 1, 2013, “to assist in advising the Division of Administration with regard to public retirement systems and insurance benefits for public employees, actuarial services” at $250 per hour and per diem payments of $165.

Buck Consultants is a subsidiary of Affiliated Computer Services which in turn was purchased by Xerox in 2009. Jan Cassidy, sister-in-law of 6th District Congressman and U.S. Senate candidate Dr. Bill Cassidy, worked as Regional Vice President of Business Development for ACS and Xerox for nearly four and one-half years before going to work for DOA in December of 2012 as Assistant Commissioner in Procurement and Technology at a salary of $150,000 per year. A search of state contract records in March of 2013 by LouisianaVoice turned up four contracts with ACS totaling $45.55 million.

ACS contributed $10,000 to the campaign of Gov. Bobby Jindal (R-Iowa, R-New Hampshire and R-Anywhere but Louisiana) in 2003 ($5,000), 2008 ($4,000), and 2009 ($1,000), Jindal’s campaign records show.

LouisianaVoice, in March of 2013, noted several contracts between ACS and other states, cities, and even the federal government which drew sharp criticism over problems experienced by the company as well as questionable contracts in Texas and Alabama.

http://louisianavoice.com/2013/03/15/doa-hires-jan-cassidy-sister-in-law-of-cong-bill-cassidy-at-150000-previous-employers-records-are-less-than-stellar/

But ACS wasn’t the only entity in that organization with problems. Buck Consultants was sued by Providence, Rhode Island in 2013 because, the city claimed, Buck miscalculated $700,000 per year in savings the city anticipated through pension reform. Instead, Mayor Angel Taveras said, the cost to the city was expected to be $10.8 million over the next 28 years.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&ved=0CB4QFjAA&url=http%3A%2F%2Fwww.pionline.com%2Farticle%2F20130226%2FONLINE%2F130229899%2Fprovidence-ri-sues-buck-consultants-over-pension-savings-calculations&ei=0sIsVMTAE4OOyASQpIKIBQ&usg=AFQjCNEiIVz3kvxYoTszpqnKeonAQGq_-A&bvm=bv.76477589,d.b2U

In California, Buck Consultants was also accused of making several mistakes in its actuary for the Mendocino County retirement system, prompting the county to cancel its contract with the firm in March of 2011. Buck Consultants paid the county nearly $600,000 as a settlement of its dispute in September of that same year. http://www.ukiahdailyjournal.com/ci_17656902

http://www.ukiahdailyjournal.com/ci_18951388

In a case that should sound familiar to OGB members who have been following events since the privatization of the agency, retirees in Stanislaus County, California, in 2009 sued the county retirement board’s decision to shift $60 million in reserves to ease the county’s pension obligations for fiscal year 2009-10. http://www.modbee.com/2009/12/24/984878/retirees-challenge-stancera-over.html

And now OGB “is seeking proposals from actuarial and consulting (actuary) providers for a contract that will allow for benefit design, rate development, RFP scoring, and other analytical and financial support activities for the state health insurance plan,” the RFP says.

The actuary chosen for the contract “will provide methods for, and calculation of, health plan premiums for OGB health plans and other support services.”

So while Kristy Kreme continues to insist that the current plans for OGB do not call for increased premiums, only higher co-pays and deductibles, it’s interesting to note that the contract being sought by OGB certainly leaves the door open for premium adjustments down the road and it isn’t difficult to guess which way those adjustments will go.

The RFP says that OGB projects medical plan expenditures of almost $1.284 billion in fiscal year 2015, which begins next June 1. Of that amount $56.9 million will be in administrative costs, the RFP says, adding that OGB will require “ongoing consulting and assistance with benefit development, rate setting, risk adjustment determinations, financial analysis, analysis of claims and encounters, evaluation of expenditures, budget projections, trend calculations, causes and discovery of trend, evaluation of multiple benefit options, and financial and other reporting requirements as may be necessary to administer” the health plan.

Should Buck Consultants submit a proposal and should it be the low bidder, someone other than Kristy Nichols might wish to talk to the folks in Providence, R.I., Mendocino or Stanislaus counties in California to do a little vetting be a contract is awarded.

This consultant-happy administration has made a horrible mess of things with OGB since 2011. There’s no need to continue down that same road of bad decisions.

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Listening to Commissioner of Administration Kristy Kreme Nichols’ responses to questions during last Thursday’s House Appropriations Committee hearing over changes to the state Office of Group Benefits (OGB) health plans, one word kept coming to mine: bromides.

Bromide is defined by Merriam-Webster as “a statement that is intended to make people feel happier or calmer but (which) is not original or effective,” and by Wikipedia as “a phrase or platitude that, having been employed excessively, suggests insincerity or a lack of originality in the speaker.”

No matter which definition one might choose, that is precisely what legislators and members of the audience were treated to during the seven-hour hearing at the State Capitol.

Keep in mind as you read this that subsequent to the hearing last Thursday, the administration of Gov. Bobby Jindal (R-Iowa, R-New Hampshire, R-Anywhere but Louisiana) retreated from its plans of the gang rape of 230,000 state employees, retirees and dependents so that the administration can follow the law for a change and proceed through the legal process of obtaining approval of the proposed benefit changes for OGB members. http://louisianavoice.com/2014/09/30/in-need-of-aloe-vera-after-being-burned-by-appropriations-committee-last-week-ogb-announces-enrollment-extension/

Katrina Jackson (D-Monroe), for example, sparred with Nichols on the issue of the $1.3 million contract with Ansafone, Inc. of San Diego and Ocala, Florida to field phone calls from OGB members. “Where is the project work plan?” Jackson asked. “No one at OGB knew what it was when I called. No one on the committee has received any project work plan. We have a $1.3 million contract for phone service. Is this something that Blue Cross/Blue Shield (BCBS) should be doing?”

“We had no other choice but to ramp up our customer service for open enrollment,” Nichols said.

Jackson again asked if fielding questions from members should be something BCBS should be doing to which Nichols responded, “OGB has always retained a customer service component.”

Jackson said legislators were told three years ago that privatization of OGB “would be helpful to members, not harmful. We fixed something that was not broken and now it’s broken. We were doing pretty good but then for some reason we offered the business to BCBS, everyone shifts to that and our utilization costs go up.”

Jackson finally got Nichols to concede that utilization is a major issue. “Vendors have to 100 percent accountable for managing utilization with us. To the extent that the request for proposals (RFP) and current contract did not explicitly mandate that, we need to in the future.”

We’re glad we could clear that up for you.

Kenny Havard (R-Jackson) asked Nichols why the Administrative Procedures Act, which lays out a step by step procedure for the adoption of rule changes. For a complete list of APA requirements, click here: apa

“We are,” Nichols said.

“You’re doing that now,” Havard countered. “But you didn’t before. If you’d done it before, we wouldn’t be here now. Who decides what laws we have to follow and which ones we do not have to follow in this?”

“The legislature sets laws and we try to follow,” Nichols replied.

“Everything we do lately ends up in court and that’s exactly where this is heading,” Havard shot back. “We’ve created a problem that we’ve put on the backs of state workers. We have people making $500 a month and you’re about to raise their insurance (costs) and somebody needs to answer for it because we’ve created a problem and blaming it on somebody else. I don’t support Obamacare but I also don’t support Jindalcare.

“We lowered premiums so the state would not have to put up its share and now the fund balance is dwindling,” he said. “I just want to know who made the decision that we didn’t have to follow the APA.”

“We are following the APA,” Nichols continued to insist. In our opinion, the plan of benefits does not have to be promulgated because it’s in the OGB authority.”

State Sen. Ed Murray (D-New Orleans) attempted to question Nichols but soon grew frustrated at her evasiveness and gave way to Rep. Greg Cormer (R-Slidell) who asked but did not receive a definitive answer: Did an actuary give the opinion on the rate decrease of 7 percent? Cormer told OGB CEO Susan West, “If you were a private insurer, the Department of Insurance would have already taken you over” because of the agency’s mismanagement.

Jack Montoucet (D-Crowley) asked Nichols, “Where would OGB be today had we not made all the changes, if we’d left them alone and let them do their job? To me, it wasn’t broken. I never got a call in six years (prior to privatization) complaining about OGB. Today, I gotta tell you, Jesus Christ, I’m getting phone calls every day and this (new plan) hasn’t even been implemented. That’s scary.”

Nichols, as she did most of the day, stammered and fumbled for an answer. “All public employee health plans are experiencing the same thing,” she finally said, but then said that the cost increases “could have been prevented if we’d structured the HMO correctly in the beginning.”

Joe Harrison (R-Gray) went further than the others in calling for a special legislative session to deal with the OGB crisis and noted that there were no problems with the agency during the tenure of Tommy Teague, who was fired as CEO on April 15, 2011.

“Mr. Teague had a solvent plan and I’ve yet to hear any in the administration tell me why we moved away from that plan,” Harrison said.

“I would ask that we have a special session on this,” he said. We have more than 200,000 lives we are adversely affecting. There are other options to this. Many in the insurance and health care industry have looked at this and (have) said there are better ways to go.”

The hardest questions, however, came from Rep. John Bel Edwards (D-Amite). Following up on a question asked earlier by Rep. Greg Cromer (R-Slidell), Edwards asked if the recommendations for premium decreases three consecutive years were made by an actuary.

“I was not with OGB then,” West said. “I don’t have that information with me…”

“It’s been three hours since that question first came up,” Edwards said.

“I don’t have that information with me,” West repeated.

“It’s been three hours since that was asked,” Edwards said again. “That’s three hours in which those reports could have been brought over here. Who made the decision to reduce premiums by 9 percent total in fiscal years 2013 and 2014?”

“Ultimately, the administration,” Nichols said.

“The OGB director?”

“I wasn’t at DOA in fiscal year ’13,” Nichols said. “I don’t know where the recommendation came from.

When Edwards elicited testimony from Nichols and West that the OGB policy board had not met in more than a year even as the OGB fund balance was dwindling by $16 million per month, he asked, “Was there a lack of a quorum because there weren’t enough members appointed to the board (by the governor) or that they weren’t showing up for meetings?”

“A combination of both,” West said.

“So we have a situation where (the decision was made) to reduce premiums by 2.25 percent in 2012 which drained the fund balance by 3 percent knowing costs were going up 6 percent, and an additional reduction of over 7 percent the next year and an additional reduction of almost 2 percent the following year all the while with costs of health care going up and we were surprised that the fund balance went down?

“This is a self-manufactured crisis that you are now saying is an emergency because we had a fund balance that was healthy,” Edwards said. “We had OGB members who were relatively happy with the plan and today we have an unhealthy fund balance and OGB members who are very unhappy. In fact, I would not that not a single OGB member came to testify today who support any of those plans—not a single one of them.”

Edwards if there was to be discussion of stability for OGB, “we can’t leave it in the hands of whoever’s been running it for the last two years…”

He then asked Nichols when the decision was made to follow the rule of promulgation as mandated in the APA.

“The general counsel advice to OGB,” Nichols said, “was a plan of benefit changes should not be required to be promulgated…”

DOA general counsel Liz Murrill stopped texting long enough to interject, “We had the conversation at the beginning of September.”

“When was the decision made?” Edwards repeated.

“At the beginning of September,” Murrill said.

“The (OGB policy) board looked at what you wanted to do in July so you knew what you wanted to do by July 30. If you had started the rule promulgation process by August 30, you could get through the entire process before January 1. You didn’t do that.”

Nichols, in a weak attempt to defend the emergency rule procedure in lieu of promulgation, asked, “Why was OGB allowed to implement 41 emergency rules in the past?”

“I suspect because nobody challenged it,” Edwards shot back. “Typically, you don’t follow the law unless you get challenged and that’s the real precedence that you’re following.”

Saying a Pew Survey shows that Louisiana is the third stingiest state in the nation in providing health coverage for public employees, Edwards said there is a “tremendous disconnect between saying we had an inflated reserve fund that it needs to be right-sized and today saying we have an emergency because the fund balance is not enough and it’s on its way (from a high of $520 million) to $8 million.”

He then again asked the question that no one had answered to that point. “In fiscal year 2012 there was a 3 percent erosion of the fund balance. Yet, in fiscal 2013, there was a 7.11 percent reduction in premiums followed by 1.8 percent even though health care costs were going up by 6 percent. What actuary told you those reductions were sound?”

“Buck Consulting recommended a 2.25 decrease for calendar 2012,” Nichols said.

“If you don’t have an emergency, then what you’re going to start on January 1 is invalid and you’re causing a bigger problem than if you simply go through the ordinary rule making process,” Edwards said. “Anyone who’s adversely impacted by having to pay a higher deductible or higher co-pays by an invalid emergency rule has a right to have that money returned to them.

“The safest thing to do if you are really worried about the taxpayers of the state of Louisiana is to give very serious thought to stopping the emergency rule making process, go forward with the ordinary rule making process and have whatever plans survive that process implemented in a year that doesn’t start until they (the rules) become final.

“Public meeting notices, meeting requirements, and oversight by the legislature are all very, very important. We had people today saying this was the first opportunity that they had to come and voice their objections. That’s an important part of this whole process.”

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We don’t often do this but the House Appropriations Committee hearing last Thursday on the proposed changes by the Office of Group Benefits (OGB) are important enough that we thought it fitting to post this information.

At one point in the seven-hour hearing Frank Jobert, Executive Director of the Retired State Employees Association, said he had been told that some legislators did not want to be involved in the OGB controversy because they felt they might be blamed for the debacle. “But if you don’t get involved,” Jobert testified, “you’re going to share the blame. We need your help. It’s your job. We elected you to do this for us.”

In response to that, we decided it would be proper should be mandatory that we provide our readers with a list of those who attended.

Conspicuous in his absence was Speaker Pro Tem Walt Leger, III (D-New Orleans). Leger is one of four members of the Appropriations Committee who couldn’t be bothered with such trivial matters as health coverage for nearly a quarter-million people.

Of the 28 members of the Appropriations Committee, 24 were in attendance. Those not in attendance, besides Leger, included Reps. Bob Hensgens (R-Abbeville), Edward James (D-Baton Rouge), and Jim Morris (R-Oil City).

In addition to the 24 committee members who showed up, 45 more who are not members of the Appropriations Committee were in attendance and many of those spoke or asked questions of administration representatives, bringing to 69 of the 105 House members who cared enough about the fate of 230,000 state employees, retirees and dependents to make an appearance.

In addition to the 69 House members, several state senators also attended

The attached document provides the names of those in attendance. The first page is the list of 28 committee members and the notation that they were either present or absent. The second page is the entire House roster. Checks indicate those in attendance who are not members of the committee. Committee members’ names were left blank because they were already accounted for on the first page.

It should be noted that the second sheet may not accurately reflect all the House members who attended. If a House member did not enter the committee room and was not checked off by the Fiscal staff, or was watching the proceedings from one of the other rooms, he or she would not appear on the check-off sheet.

At the same time, it should be pointed out that if they do not make their presence known to the Fiscal staff, they would not receive their per diem payment for attending the meeting, so it’s highly unlikely that any in attendance would not be checked off on the list.

Here is the list of House members in attendance: Appro attendees OGB briefing

State Senators in attendance included Francis Thompson (D-Delhi), Ed Murray (D-New Orleans), Norbert Chabert (R-Houma), Bob Kostelka (R-Monroe), and Ronny Johns (R-Lake Charles).

Be sure to check to see if your Representative and/or Senator attended and if not, contact him or her and find out why.

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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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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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