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Archive for September, 2014

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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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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The state continues to face a severe budgetary crisis, the Center for Medicare & Medicaid Services has yet to approve the controversial state hospital privatization plan submitted by Gov. Bobby Jindal (R-Iowa, R-New Hampshire, R-Everywhere but Louisiana) and the proposed changes to plans offered by the Office of Group Benefits have state employees and retirees understandably concerned, afraid and boiling mad.

But you have to hand it to Commissioner of Administration Kristy Kreme Nichols: she has her priorities. She knows what’s important and she’s not about to deviate from the course she has set.

Kristy is nothing if not competitive and she is determined to be a winner—even to the point of strong arming agency directors.

The Louisiana Marathon is scheduled for Jan. 16-18, 2015, and Kristy has a bet with Department of Health and Hospitals Secretary Kathy Kliebert (who also is facing the same problem with fed approval of the infamous hospital deal) and Kristy is determined to win.

On Sept. 12, as the OGB open enrollment controversy was brewing, she sent out an email blast to “Team DOA-OTS (Division of Administration-Office of Technology Services) in which she said:

“Wondering how Team DOA compares to Team DHH? Well we’ve got a website for that! Indeed she does: http://www.thelouisianamarathon.com/doa/

(No word what the cost was of setting up the web page in terms of time and salaries to IT personnel.)

“The figures will be updated daily,” she continued. “As of now, we’re beating DHH at nearly a five to one ratio of runners!”

“Let’s keep up the momentum and reach our goal of 200! So recruit! Recruit! Recruit! And beat DHH!

“Remember! Our next big challenge is being worked up now and the reward will be well worth the wait, a BBQ with a surprise location! All participants who are registered by Oct. 15 will be eligible to attend.”

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The day before that motivational message went out to all DOA employees, another email blast went out informing anxious DOA employees that the DOA team recruited “upwards of 70 DOA employees” for the first Marathon Health and Wellness Luncheon and Competition. “We also set a goal of recruiting 200 people to represent the Division for the big race,” she said.

“Today’s winners were based on percentage and total recruits,” she continued. “First, I think it should be made known that my office (emphasis Kristy’s) won both categories with a 55 percent participation rate and a total of 18 recruits. However, we will concede our casual dress days to Human Resources and OTS. HR reached a participation rate of 23 percent and OTS wins the overall recruitment with 11 runners.”

While she complimented OTS on one hand, she also said, “It should be mentioned that while OTS wins with 11 runners, there are 780 employees in the section. Come on OTS!”

Our sources on the seventh floor of the Claiborne Building tell us that Kristy Kreme has taken steps to ensure her legacy as DOA Commissioner by ratcheting up the pressure on agency directors. That pressure, which borders on a mandate, requires directors to “encourage” employees to participate in this critical competition that is all but certain to eclipse the Saints’ 2010 Super Bowl championship or LSU’s national championships of 2003 and 2007.

That would certainly offset the lack of pay increases over the past five years and improve employee morale.

And to think, all this time we believed Kristy Kreme was devoid of compassion.

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By DAYNE SHERMAN

On Tuesday, September 23, our school-aged son was given a commonly prescribed medication by his physician. My wife attempted to get the pharmacy to fill it. We were shocked and horrified to find that it was rejected by our health insurance: Office of Group Benefits HMO Plan through BlueCross, a health insurance plan for Louisiana public employees.

For almost 16 years I have been a member of OGB, and my wife, a teacher, has been a member for 25 years. This is the second rejection we have received this year through MedImpact. Rejecting my medicine is one thing, but rejecting our son’s is another. We have never seen anything like this in our years with OGB.

You will recall that OGB was privatized under Gov. Bobby Jindal, and nearly all of the $500,000,000 trust fund has been stolen. Soon, all money dedicated to funding state workers’ insurance will be gone. The money was pilfered by Jindal in an effort to fill holes in his economically disastrous state budget. But this will mean 230,000 Louisiana citizens are about to lose all semblances of health coverage on January 1.

Earlier on Tuesday, the former Health and Hospitals head, Bruce Greenstein, was indicted, and the state attorney general declared the new state health insurance changes illegal through an opinion solicited by Rep. John Bel Edwards of Amite. I thought this might stop the train wreck.

But later in the day I had to fight tooth and nail to get our child’s medicine. I had to contact state representatives and the media. We were finally able to get the meds filled on Friday afternoon. I wasn’t looking for a freebie. We pay hundreds of dollars a month for health insurance, have co-pays for everything, and we paid $55 for the prescription. We just wanted the doctor-prescribed medication. Not the insurance-mandated meds.

Most employees and retirees will not be so lucky. Louisiana state employees and retirees need to understand one fact. If all of the proposed OGB changes go through as Gov. Jindal plans, they are effectively uninsured. Health coverage is over, and it will not be coming back.

Sure, Kristy Nichols, Jindal’s spokesperson, says the OGB trust fund was too big (Insanity!), that they are “right-sizing” the insurance plans (Destroying them!), and they’re now offering better options called Pelican HRA 1000, Pelican HSA 775, Magnolia Local, and other names worthy of George Orwell’s 1984. According to Nichols, the new plans will be pure utopia. But when an OGB member gets a letter from MedImpact of San Diego, California, a cold memo rejecting a medication prescribed by a doctor here in Louisiana, let’s call it what it is: a “death panel” letter.

As one person put it, “Bobbycare” is health care without any care at all. How true.

While our governor flits from Iowa to New Hampshire playing presidential candidate, a delusional quest to anyone but himself, Louisiana goes the way of Rome on fire, burning, burning, burning. Jindal is like a hummingbird on crystal meth. The wings are moving at a blinding pace, but the overall flight is completely doomed.

I have three questions about the OGB privatization and the missing half billion dollars: Who will go to prison for stealing state funds through a scheme worthy of a bank heist? Will the FBI investigate the theft of public money? And will the legislators stop the train wreck?

Let’s all hope and pray that the FBI, the courts, or the Louisiana Legislature will prevent Jindal from destroying one more area of Louisiana that worked before he came into office: the Office of Group Benefits.

 

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