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Backlog at state agency could disrupt health coverage for public workers


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POSTED: Tuesday, November 10, 2009

The state board that governs the public workers health fund is so backlogged that it doubts it will be able to process all applications for state and county workers who want to change medical plans during the current open-enrollment period.

In a letter sent to state and county personnel officers and legislators, Jim Williams, administrator of the Hawaii Employer-Union Health Benefits Trust Fund, said there was a “;serious workload and resource issue.”;

The problem is so severe, Williams said it “;may prevent the EUTF from completing open enrollment and other processing on a timely basis and by important deadlines.”;

The problems caused the Hawaii Medical Service Association to say the enrollment process is “;fatally flawed and should be canceled rather than risk members not being able to access their health care plan.”;

Jennifer Diesman, assistant vice president for HMSA government relations, said the association is concerned that state and county workers must actively change their plans if they want to remain with HMSA.

Yesterday the Capitol was flooded with state and county workers who tried to attend open-enrollment sessions. Diesman said nearly 3,000 information packets were distributed at the Capitol.

Meanwhile, HMA Inc., another medical plan provider, is in place to take care of government workers who do not actively switch plans.

Harris Nakamoto, HMA vice president and general manager, said they do not object to the new plan, and said HMSA is trying to blame the trust fund.

The issue is complicated because the fund decided to offer two basic plans along with coverage by Kaiser Permanente.

The plan administered by HMSA calls for public workers to pay 20 percent of their medical fees, while the HMA plan would call for workers to pay 10 percent.

The dispute between the two medical service providers is going on while the fund is struggling with increased calls for information and with a staff shortage that cannot be remedied because of the state hiring freeze.

Williams called staffing levels “;inadequate,”; noting that state worker furloughs are expected to make matters worse.

“;In order to address ongoing workload issues, overtime has been scheduled on a continuing basis and will continue for the foreseeable future,”; Williams said in his letter. He said the office had 3,251 forms waiting for processing, 529 forms waiting for scanning and another 766 forms to be indexed.

“;The call center has been stretched beyond its limits,”; he said.

The staff usually handles 4,000 calls a month but received more than 3,000 calls in the first three days of November.

“;The confluence of events will likely result in a situation where we will be extremely challenged to provide even a minimally acceptable level of services to active employee, retirees and their dependents,”; Williams said.

Williams was out of the office and not expect to return until Friday, according to a recording on his office phone.