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.
Louisiana Voice 
I, too, have received one of those lovely letters from MedImpact. Fortunately for me I received it in July, prior to the implementation date of August 1. I quickly refilled the subject medication (glaucoma drops, heaven forbid) before the August 1 effective date. That bought me a brief reprieve, but it should be interesting to see what happens when it has to be refilled again. I’m sure it’s going to be quite the fight.
I had the same thing happen and I acted as you, hurrying to get a refill before the implementation date. I’m almost out and have no idea what I’ll do. My doctor had tried numerous medications and finally found one that worked. Since there’s no generic, I’m doomed. What on earth can we do????
Remember, it was illegal for the Jindal administration to make ANY changes on previously signed contracts for prescriptions or other medical UNTIL if and when the new contracts do into effect. None of us should have been charged the higher rates for refills effective August. This cover up administration made the changes with BCBS and none of us were aware until we got August refills, myself included. Let us keeping fighting together as a group…one for all!
Jindal and his staff involved in this should all be held PERSONALLY accountable for their actions….jail and restitution!!!
Remember the Doris Day song lyric, ” a little bit of sugar helps the medicine go down” ? Unless the the legislators happen upon some spinal fortitude all state workers will have their problems solved by “ansaphone” the Tony Soprano sounding company whose motto is ” a dash of this a teaspoon of that etc. =’s great customer service.” Help!
Don’t even get me started on “Ansaphone”. I have called them more than once with questions, and I’ve gotten incorrect information each time. Fortunately, I am insurance-savvy enough to understand that I was probably getting wrong information and questioned it to higher authorities. If they are being as accurate with others as they have been with me, I smell some major lawsuits coming after January 1st when people are locked into policies they chose based on wrong information they were provided by our +$1 million contractor. Of course, by that time, Ansaphone will have collected their money and disappeared into oblivion, not to be held accountable!
That’s what happens when state employees who know the system are terminated, because “they have nothing to do”,
and a for-profit company, working from California and Florida, takes over and hires people who receive very little training to field questions to which they have no answers.
@JuneButler – Right on! I’ve already asked my rep. why they didn’t just hire some of those people back as WAE’s or emergency appointments. Of course, he does not know, but he can pass it “up the line”.
The reality is, they want to close OGB and not pay for health insurance AT ALL for employees and retirees.
I totally agree that is what the ADMIN wants to do, but can they legally!
That is definitely a lawsuit. Because whoever is receiving another type of insurance from the state shared payment with COULD NOT receive anything either. When it comes to benefits, no group can be favored over another one!
In my informal polling of support of Jindal in Louisiana I find that it is no higher than 30%. All of my friends, many to most who are Repubicans, dislike Jindal intensely. His actions bespeak of someone whose emotional makeup appears to be very, very questionable.
It is not too late to recall him. I am, for one, all in on this.
You are absolutely right about that! I registered to vote when I was 18, some 43 years ago. At that time there were very few Republicans in Louisiana, and my dad was shocked that is what I came up with. Maybe it was my idea of rebelling. Since Jindal, however, I have had a very adverse reaction to everything Republican. I even toyed with the idea of marching downtown and changing my registration, but the truth is that I can’t really say what I am now. Because of Jindal and some of the spineless legislators, I became aware of ALEC, which seems like a very shady organization, at best, that tells them what to think and how to say it. Because of ALEC and their model legislation, they tried to say to me, “oh, by the way, you may have worked for 35 years, but that deal we made with you about retirement? Yeah, we’re just not going to be able to do that.” I find that this adverse reaction has colored my perceptions of even national politics. As you pointed out by your informal poll, I just wonder if the Republican Party has any idea of the damage he is doing?
I also became a Republican at the age of 18. That was 34 years ago. I am now a declared “No Party” because of Jindal. I’m not even sure who I will vote for In November because of him and I know a lot of people just like me. The head of the Republican Party better start doing something about Jindal and his policies. People are correct when they say Jindalnocare. Our wonderful insurance BCBSLA and MedIMpact also refused my diabetes medicine but has allowed me to get massages once a week if I want. I knew 27 years ago what I was getting into as far as low pay working as a teacher for the public, but I didn’t know that 27 years later that Jindal and our elected officials that drank Jindal’s Kool-Aid would steal my insurance. Jindal didn’t do this himself and ALEC is not just filled with Republicans. All you have to do is Google ALEC Louisiana Members and you will find that your state rep. is also affiliated with this Mafia.
RECALL NOW! Pass overdue just like the one sitting in the other *white house.
*purposely not in CAPS = no respect for the resident of either!
Enough is enough. Time has come to march on the capitol and let the national media see what is happening in
our beloved state to its dedicated employees & retirees !!
Agree!!
Check out this website: http://www.dol.gov/ebsa/newsroom/fscpcp.html
It’s the US Dept. of Labor’s Employee Benefit Security Administration’s Contributory Plan Criminal Project. All together now – let’s send them a nice email. It couldn’t be more specific to our situation – theft of contributory healthcare funds.
Also, please pound the FBI Public Corruption Unit with facts about the blatant theft and corruption going on at the highest levels of state government – these thieves are so brazen now they barely try to hide their crimes.
http://www.fbi.gov/about-us/investigate/corruption/public_corruption
telephone 504-816-3000 local corruption hotline
Pathetic Piyush is no longer even pretending to be governor—just stealing his paycheck and using his office as campaign central. Time to get him off the public payroll.
Now is the time to contact your state representative and senator and demand impeachment. There IS a growing sentiment (as well as backbone and other body parts) among legislators that something decisive and swift needs to
be done. Let your voices be heard and REMEMBER, Classified State Employees, we have every right to speak out about these issues affecting us – we are only prohibited from supporting candidates and political parties.
Mr. Sherman, your hummingbird analogy is the best I’ve heard yet!! If Jindal gets any momentum (which I doubt), analogies like that will be great for his opponents. I can’t believe what state workers and retirees are being subjected to. Very early on in my mom’s working career, she worked almost 10 years with Kansas City Southern railroad. Thereafter she worked about 26 years with the State (10 with Education and 16 with Labor). We are now looking at how fortunate those years at the railroad are as they qualified her for Medicare. How ironic that Jindal rails against Federal programs, yet his own policies make State workers dependent on the very programs he routinely rails against.
I knew your dear sweet mother (Betty) at Labor! Tell her Mary Guess said hello and give her a hug for me!
They rejected my MRI last week…Thanks AIM specialty Health for the axe job.
Someone got a big atta boy that day – and they claim their specialty is Health ?
Thanks for writing this, Dayne.
I suggest state employees check out the Healthcare.gov exchanges. There are good plans out there for Louisiana residents. I signed up for one, and it’s the best insurance I’ve ever had, for less per month than the payroll deduction for our old (private employer) policy.
And Miz Kristy and Miz Kathy have the unmitigated gall to blame their mess on Obamacare. What’s worse, some members of the legislature believe them.
Is Obama teaching Jindal how to screw up Louisiana as Obama has screwed the United States? The American people are allowing Obama to do his worst. Are Louisianas doing the same? God help this once great nation.
I think we have almost the reverse situation here as we do in Washington. President Obama is forced to take executive action because of a recalcitrant legislative branch. Governor Jindal’s power seems only limited by the court system and a complacent and compliant legislative branch. The only similarity I see is, that in both cases, the legislators use the executive as a scapegoat for their own inadequacies.
Excellent piece, Dayne. Hope the book is going well.
On the money, Stephen!
Meanwhile, our suspiciously missing governor supposedly gave one his best and funniest speeches in Washington, DC, at the annual Voter Values Summit. According to the article posted online by The Advocate, in his more serious remarks (really?), Jindal stressed the importance of focusing on a “healthy culture” in the United States (really, again?): “I’m all for capitalism and a strong economy, but capitalism and free enterprise will fail in a country where people don’t respect the rule of law, don’t care for each other and don’t share a common view of dignity of all mankind as God’s creation,” he said in the speech. “Culture matters.”
I just don’t even know where to start – his respect for the child who needs his medicine? His care about the state employees and retirees? His respect for the rule of law?
It should be called BobbyDon’tCare because Bobby doesn’t care about anything or anyone except himself. While I am not a state employee I full well understand what they are going through. It seems to me that state employees have the power to initiate a recall of Jindal. I suspect there are many citizens who such as me who will be more than willing to sign the petition. Our legislature appears to be indifferent about what Jindal is doing and has done to this state, its employees and its people. There is more than ample evidence to impeach him and for the most the part indict and prosecute him and his cronies for fraud and theft among many other things. The people of Louisiana have elected Republicans and allowed them to dominate and control the state at all levels of government. Now they are sitting around watching them dig Louisiana deeper into the bottom of the pit of all states in the Union. Republicans need to ask themselves what Bobby Jindal, David Vitter and in my case John Fleming have done for them. There is only one true answer — NOTHING except make things worse.
I don’t believe in blaming an entire party – Republicans nor Democrats for that matter, concerning the actions of numerous egotistical sociopaths. The only party we should have is the People’s Party…do away with all other parties. Condemn the actions of the individuals, make them accountable!
Are there are remedies available?
Piyush’s behavior is getting more and more bizarre. And the State Legislature continues to blindly follow his scheme du jour.
Sure. A recall could begin, but you know how Jindal’s folk would handle that? Scott Walker, Scene2. Sean Hannity would hype it up as State workers not being able to handle life like the private sector, etc. I’m not so sure Jindal isn’t hoping for that scenario to unfold as a rocket booster for his national ambitions. Sadly, it just might work!
A recall takes a lot of time and must be properly organized to succeed.
State employees may sign a recall petition but cannot promote or work on it.
Organizers have 180 days (half a year) to have about 900,000 registered voters (a third of all registered voters in the state) sign a recall petition, which must then be certified by the Secretary of State. Then a statewide election must be held to decide whether to remove the official. By that time Jindal’s term will be up anyway and he will have done further, untold damage to the state.
Ask your legislator to impeach the little weasel NOW. NO – DEMAND IT.
Robert – Exactly, and as a consequence, the legislature would be off the hook for its complicity (active or tacit) in much of what the administration’s done over the last six and a half years. As Earthmother suggests, impeachment would be the optimal solution, beyond a criminal trial and imprisonment. But the legislature would have to grow a spine and be courageous enough to have its own hand in things brought to light.
I received a lovely MedImpact letter in the middle of July. I had just refilled my prescription so I could not refill before the new rules took effect. I have since filled a different prescription. It cost triple what I had been paying. My doctor scheduled me for an MRI last week. It was denied. My doctor had to talk very firmly to them before it was finally approved.
The very idea that a paper pusher in California is going to look at a spreadsheet to determine if my condition warrants me having a test done books my blood. I have paid in premiums for 30 years. The only people who should be making that decision is my doctor and me.
I am ready to retire, but am too scared to do so. What is that devil going to pull next??
Keeping audiences in stitches is the closest Jindal comes to healthcare. The little fool took his pander tour to the hate group over the weekend. He got the audience stirred up and laughing, yet he still only tied for fifth place in the straw poll that concluded the event. Yeah, Jindal’s “considering” a run for the White House, but not even his fellow Republicans on the whacko wing of the party are “considering” voting for him. But Jindal’s comedic talent may come in handy on talent night in the Big House, preceded by the vocal stylings of one Bruce Greenstein.
Maybe he can follow in the footsteps of that prototypical comeback kid, Jim Bakker: Become a televangelist, spend a stretch in the big house, and wind up selling Apocalypse supplies on the Internet:
http://jimbakkershow.com/
P. S. Anybody else on here remember Jim and Tammy? Their empire at its height made Jimmy Swaggart at his peak look like a piker.
Yes, I well remember the Jim and Tammy team! What a sham! I’m considering lobbying the legislature to adopt the old rock group AC/DC’s “Highway to Hell” as our official State song. http://www.youtube.com/watch?v=l482T0yNkeo
Not only is the train off the track, but it’s blasting down the “Highway to Hell”.
Where were all the irate citizens a couple of years ago when we tried to recall Third World Jindal? By the time he term-limits out he will have destroyed many other state programs. As Dayne writes, they won’t come back. And the feckless Legislature won’t stop him. They have been in lockstep with him throughout his reign, rubber-stamping ALL of Jindal’s ALEC legislation. Even some DINOS (like Sen. Ben Nevers, an ALEC member) are in Jindal’s radical right pockets.
BUT WAIT!!! “Sinner” Dave is waiting in the wings to out-jindal the current disgrace.
PTL!!!
JINDAL = Jamming Indiscriminate Nonsense Down All Louisianans.
Great acronym! So sad, but true! I will have to borrow giving you credit of course!
Glad you liked it and we can work to spread it far and wide! Who knows, maybe one day a member of the MSM may even put him on the spot and ask him what he thinks of it!
Impeachment is the remedy, but the legislature won’t do it. Jindal follows the Tea Party/Family Research Council rule books to a T, with weak pushback from only a very few members of the legislature.
Both parties, Democrats and Republicans, have sold out to banks and corporations, but spare me the equivalence between the two in governance. What you see in Louisiana is what you will see writ large on the national scene if Republicans take control of the presidency and Congress. Get ready for a wild ride, because the Tea Party and religious fundamentalists now own the Republican party.
This is another abuse of power the LEGISLATURE is allowing to happen.
Those is office now that do not step forward and stop this MUST NOT BE RETURNED TO OFFICE.
Call and contact your senator ans state representative. Go see them!
Do it over and over.
Get your family and friends to do it.
Ask them, your senator and representative, to specifically tell you what they are going to do about this.
If you do not get an answer, or a satisfactory answer, tell them you will NEVER vot for them again and will ask everyone you know not to vote for them.
They are all up for re-election next year.
And, they are reading this. Get after them!!
I have never worked for this state. I do have some very very close relatives that do. I sent a copy of this article to my Representive. He and I have been going at it for some time now. I asked him to be sure to read the comments that every one has written. I encourage every one to email there Representive and every one else they possible can. By the time Jindal is gone, things will only get worse. Vitter is Jindal x 4. This state cannot take 4 more years of this.
Some of the legislators did give them hell this week at the committee and they do get it. Whether they do anything. . .
With the new deductible, copays, and out of pocket maxes, even under what they are selling as the “Cadillac” plan (the Magnolia Local Plus) a middle income family is a car accident away from financial ruin. There is no actuarial basis for the necessity of any of the changes. If there were any justified numbers no one was given an option to pay increased premiums to account for additional risk. If they had numbers and they were offering us umpteen options, why couldn’t they have offered us that 1 more?
Some very highly qualified state servants — maybe overqualified — accept a lower salary for public service rather than working for a higher salary in the private sector partially because of the benefits and hours. The insurance premium contribution has historically been part of that deal. If the insurance doesn’t cover anything, they are working on kissing that goodbye.
On 9/26, OGB put out an RFP for an actuary — maybe the legislature’s questions have prompted a little bit of something. What was prompted we can never be sure. . .
I always want to have faith that something good can happen but it keeps getting harder . . .
I want to thank everyone. Your response over my column has been great (despite the reason for the column causing my family a horrible few days). My message is simple: If you get a “death panel” rejection from MedImpact, send the copy to A. Your state senator and representative, B. To Bobby Jingles, and C. Post it on Facebook, email the rejection story to your friends, and your local media. People must know what is happening now and will happen. State employees are in the dark for now. Keep me posted. –Dayne, author of Zion: A Novel (coming Oct. 30).
So what exactly can we expect as an outcome of the Appropriations Committee meeting about the OGB changes? Are the legislators going to follow up with any action or is the show over? Is it up to us now to file lawsuits? To think, this is all because Ronnie-Bobby wants to drive the clown car.
Received Annual Enrollment brochure today which indicated $0.00 for generic and $20.00 brand name medications for disease management program. I called Medimpact who advised that information was incorrect, that it is $0.00 for tier 1, $20.00 for tier 2 and $40.00 for tier 3. Also, no information coverage for a number of services including laboratory and imaging.
Warning to Retirees without Medicare: You may very will find yourself with VERY limited options, depending on where you live. The information available online is helpful and you should use it to explore your options. Depending on where you live, and who your doctors are, you could easily find that you are stuck with Pelican HRA 1000 if you want to keep seeing your present doctor(s) because the Vantage provider list is limited.
Fortunately, I am on Medicare so I have more choices, but my wife isn’t old enough for Medicare so her options are very limited.
A lawsuit needs to be filed pronto to stop what is happening to Group Benefits. The question is how do we organize this and get it going.
Is the State Employees Union looking at doing anything?
AFSCME is pretty low-key nowadays and has very few state employee members. Victor Bussie was the last union leader who had a real interest in the state and its employees and his power was limited to that derived from his considerable charisma and negotiating skills. Although retirees without Medicare would seem to be the most at risk, the Retired State Employees Association has been silent on this so far unless I missed something.
Unless it changes its whole approach to policy implementation [summarized as “just do it”], and in the absence of a court order, these changes are going forward. Even if the court puts a hold on things, for all we know this administration would be happy to run the whole program into the ground, leaving us with nothing. This has the potential to be the biggest threat to the well-being of employees and retirees of this administration.
RSEA Executive Director Frank Jobert and a number of his staff were present at the House Appropriations meeting last week. Mr. Jobert and one of his staff members did testify before the committee. RSEA has been very good about keeping its members informed of any pending changes that will affect them via e-mail and Facebook.
In addition, Committee Chairman Fannin mentioned more than once in the meeting that there was not one single “green card” in support of the program changes, and nobody testified in favor of the program changes other than Kristy Kreme and OGB Admin. He said that is highly unusual.
The legislators were against the changes and strongly recommended that DOA find another solution, and they did advise them that they would probably end up being sued and lose. They also advised them that if it were found that the changes effective July and August 2014 were found to be illegally implemented, then they would be required to refund all increases collected to date.
The videos of the meeting are available for viewing in the archives on the legislature’s website.
Now, whether or not anybody “gets the ball rolling” to file suit is another matter. Personally, I think that there are a number of issues at hand that could possibly constitute a class-action lawsuit (i.e., no meetings in areas that have extremely high concentrations of State employees/retirees; arbitrarily restricting the Magnolia Local plan in the Baton Rouge area to 3 parishes, preventing other neighboring parishes from being able to benefit from the reduced premiums, etc.). However, I personally cannot foot the bill to “get the ball rolling”, and I’m sure not many others can, either.
the ball is rolling. Stay tuned.
Reblogged this on The Daily Kingfish and commented:
Ouch
dalford1@peoplepc.com
I have looked extensively at the OGB website and their calculator. As a single retiree, I feel like one of the lucky ones, if we could even call it that. After having cared for ailing parents for 13 years, I know how devastating medical issues can be. My dad died in 2003, and was on dialysis for 5 years. I haven’t seen anything in their calculations about how that would be handled. While my dad was fortunate to have Medicare, I know his expenses even over 10 years ago were over $50,000 a year. The benefit plans used to provide a realistic basis that was staggered. The single person had one plan, married or with one dependant, and finally the family plan. The jump from single covererage to a single parent with one child is devastating. With the deductibles AND the jump in out of pocket expense from $3,000 to $9,000, most people with coverage for more than one person will be devastated. I am having lunch tomorrow with an 85 year old married retiree. He retired in 1986, and I know that his benefit is around $22,000 a year. This is unfortunately not an unusual situation, whether it is a young single parent or a married retiree. Insurance is supposed to protect you from catastrophic loss, and this fails to do so. While we would like society to care about the retirees, I think the strongest argument is the impact on the existing workforce, particularly the single parents. They will be at the lower end of the pay scales, and completely prevented from feeling that they can publicly voice concerns. And the child or children are the most vulnerable.
Thank you.
Excellent points.
Another warning to retirees with Medicare: The calculator state53 refers to will not work for you. Also, be very careful when using the formularies. Your best bet to find medications on People’s Health, for example, is to search at the highest possible level. For example, if you are looking for a statin, just enter statin. If you enter a name brand or make a mistake typing the generic of a name brand, you may be told your drug is not covered. So be careful.
Anonymous Retiree: My apologies to you and to Frank Jobert. I was unable to be at or watch the hearings and had read nothing of Frank’s testimony before your comment and Tom’s newest post.
Since my husband and I are both covered by Medicare, my concern is whether we should look for another supplementary plan. OGB pays part of the premium, so I presume it will not be to our advantage to change. Or will OGB pay part of the premium for another plan?
I also wonder whether co-pays for medication through Blue Cross may skyrocket. I will attend the meeting for retirees later this month, and I hope to get honest answers, but I don’t feel at all confident that I will.
No apologies needed! I just wanted to get that clarified quickly. Mr. Jobert does a great job defending us. I just think the press was so overwhelmed by the legislators venom towards Kristy Kreme and her sidekicks that they overlooked a LOT of other stuff.
Perhaps the best thing would be for everyone to pressure the Attorney General’s office to go to court in efforts to put the OGB Changes on hold.
I sent an email to oreilly@foxnews.com to investigate our just complaints regarding OGB. May other state & retired employees did also. We are tired and want to take a stand. Please do the same. Maybe if we get national attention to this matter our legislature will take notice and do something to help us. If Jindal succeeds in his plan to destroy our health insurance benefits, at least the rest of the country will find out what kind of president, etc. he will be for our nation. God help us!
Outstanding. “Out-fox” him. Good move, Carmen. Thanks.
earthmother, any update on the possibility of the class action suit you mentioned a few days ago?
k777us – stand by. Will share news asap. Things are falling into place.
Again, thanks very much, earthmother.