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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 that an answer was forthcoming.

“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.

https://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 over its 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 before 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.

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. https://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.”

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.

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.

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.