ALC-Employee Benefits Division Oversight Subcommittee

Let's call the meeting to order I don't have any comments from the chair do you have incumbent senator Hammer. Okay I need a motion to suspend the rules to take at this agenda item I have a motion I have a motion for representative Lowery second all in favor. I approved okay of Jake you want to come forward and tell us about the contract amendment. Good morning Jake Gleed employee benefits division so we came before you are earlier this year with a request to go forward to defend our of peas one for actuaries services and the other for an employee assistance program. since that time we've gone through the procurement process with those two programs and there for several reasons have reached the conclusion that it is a in the best interest of the program in the state that we not continue to pursue those specific our of peas and that instead we extend our existing contract with the existing firms that provide those services. I can provide reasons for that on the actuary side we felt like we were not clear enough on what we were asking for in our proposal these are three year deals if you win a contract with the state you're locked in for three years. Vendors play a hugely important role in the office and the responses we got were really kind of all over the map we got some responses that were very expensive we got some responses that warrant and it made me think we weren't clear enough as a state in telling the vendors what we expected them to deliver we don't want to get into a bad situation where we are frustrated that a vendor is not delivering what we think they need to deliver and the vendors frustrated because they think they're delivering what we ask for so with that in mind we have requested an extension of our existing contract and will go out to our of P. again on that act for a contract with a new R. F. P. here coming up shortly. Would you maybe elaborate a little bit it was there more a problem with employee assistance or more with the actuarial and you've already answered to that age the the employee assistance program was primarily a lack of time on our and we ran out of year to administer a new procurement procurements are. Hands on it they're very difficult they're very cumbersome and bureaucratic we've had a number of staffing challenges that our office we're in the middle of a number of other procurements and so we just ran out of time we felt like we couldn't give at the time and attention it really deserves I think when we talk about it with the A. P. here we had pretty high hopes that that could be a program that could really help our members out we still want to do that but we just need to be able to devote the time and resources that that kind of a a procurement or solicitation deserves. Okay and we're a representative Lowery he had questions. Recognized. Thank you madam chair of Jake I've got two questions one how long is will the extension B. just one year just a one year extension and then secondly is the the current company that is providing the actuarial service did they submit a a proposal in the the last round of R. F. P. they did okay so they have an intention of wanting to continue yes so it also when we had done that original arc in the act for one of the key pieces of it was that we would utilize them as part of the cost assessment for EVD specific bills there's a fiscal impact statement requirement. that jobs now being done by the Siegel group so at the time we wrote the R. P. I think there was an expectation that we would be involved in it since we're not we didn't want to end up paying for something that we don't use. One more follow up if I may you can you can you be a little bit especially. Really just focused on their actuarial actuarial service Duties can you be a little bit more specific of what were some of the issues where you ended up having really dramatically varied submittals what is it that's needing to be tightened up so right now I'm not large employers like ours are increasingly complicated regulatory environment so that the there's been a series of federal law starting I think with the affordable Care Act but before that that place new limitations and rules on employers like ours so we have to show that our insurance is affordable we have to show that If we have a high deductible plan and we have to that it meets the requirements for a high deductible plans in addition to that there's all sorts of new stuff coming down the pipeline there's the price transparency which is going to require that insurance companies like ours post on our website how much we reimbursed to providers. If you think about that that's going to be a huge shift in American healthcare and. The opportunities for plans like ours to improve our efficiencies and effectiveness are huge. I had really wanted to get somebody who an actuary who can help guide us through all of those processes. The responses we got I don't know that we really got that I don't know that we were really placing ourselves in the best position to both avoid regulatory problems that are sometimes very difficult if you remember earlier this year president Biden just came out of the blue and said everybody all the insurance companies have to pay for that scenes or something we had forty eight hours to to roll with that we only found it because one of our attorneys Sullivan is so there's there's a real pitfalls for us and not having that sort of expertise which trust me we do not have right now DVD. In addition from a business standpoint there's opportunities out there that I really want to make sure that we have someone in place to to help us maximize. Okay all right thank you thank you madam chair. Senator Hammer you're recognized thank you measure first of all want to tag and what you just said you don't have the expertise in the office right now do you ever had that kind of expertise in the officer we always had to rely on outside actuary to bring it we've always had an actual review our books and that there's a good reason for that right we we want enact side firm with the accreditation and reputation to protect to confirm that our numbers are correct. Over the years though that role has of all from just crunching the numbers into a healthcare consultant and to my knowledge we. I've never we say in my time anybody we've never had that background or knowledge and honestly it is becoming so precise and and the expertise of significant that I don't know if we ever have. It in your is better to go the outside actuary route than it is to. Bring somebody on that to your point men to go you don't have the expertise to identify things that pop up all this and like you mentioned president Biden did yes so the idea would be if we can contract with a large entity a large firm that has resources in Washington DC that has a large stake clients elsewhere. I there's lots of us state health plan administered to get together and compare notes because we're all facing in a lot of ways the same challenges but everybody has a different approach to it and so having the perspective of somebody who can come along and say okay you've got this problem we traditionally see it resolved in this way can be really helpful for us I actually thought about having some in house actuaries I think that it could potentially help us and save some money but I want to save money on our claims costs want to save money on our pharmacy benefits. Saving money on our actuaries maybe going to save us a couple hundred thousand dollars and I'd rather spend money on that so that we can make smarter decisions down the road okay and then one last thing on the handout we have. exercising renewal option for services for one year with increased contract amount the original contract date was August of eighteen with the end date of December twenty one and so what brings you be forced today is that the December well see this is for three years renewable for four additional one year terms what happens if within the next year that you're asking for an extension on this one would you still have time with that current provider group to extend it further out if need be I think we do but our intent is to go back out within or if P. and get a new contract okay hi and I have questions are related to the subject matter when you're done manager please. Okay does anyone else have questions related to this contract amendment. Okay if not we will a rule that says reviewed by the committee of. Okay without objection was will say its review of okay it stayed there I think in other Business senator Hammer had some questions just in general thank you measure sorry to catch you right here without having a chance to pre talking about this but I need to bring stuff up ask about it can you tell us where you are right now as far as the number of requests to opt out on the teachers insurance side please to the last numbers I look at I think we're at Levin thousand closing to twelve a closing in on twelve thousand I think it's when the month of November and it of course November was the period when of folks are supposed to opt out we were looking at about sixty four percent of the twenty nine thousand retirees we have enrolling in the Medicare advantage plan that said we continue to process opt outs we're trying to be as accommodating as we can to people we're still getting the word out we're still hearing from people that they didn't know they needed to opt outs were really trying to be as accommodating as possible my guess is we won't really have hard numbers until mid January. but I would think we would be looking at about sixty forty. state employees state retirees are more likely to enroll them in a public school employees but I think sixty forty is a good projection okay I want to read you of a text I got like ten minutes for walk in this meeting and I just want to transfer publicly because they came from this person it may be from somebody else it's just a matter giving response says in two weeks I want to be without insurance I opted out of the United health Medicare advantage for teachers are applications were to be processed by November eleventh they have not even started mine an employee benefits and they received that first week in November of the statement is that there are piles and it is taking a long time to work through it says in two weeks I have medical appointments by Medicare has already been changed to United health and health advantage is being dropped without my permission can you speak to that is that just misunderstanding on that person's park or is that actually occurring that is actually occurring we have had some mistakes of people who have said they opted out and have enrolled been enrolled in the United healthcare we're working diligently through these processes one of the reasons that we have capped the opt out period open for as long as we can is because we recognize there there will be mistakes they'll be issues we've tried you know at the beginning of this we tried to have a specific opt out period in November we tried to put some some guard rails on that so that administratively we could be as accurate as possible in our processes however that's collided a little bit with the need to be accommodating with a population of people who dental use email necessarily they don't the they want to use mail they want to send it certified mail they might wanna walk in they might want to opt out five or six different times. and so we've we've had some challenges there I will say this the individual's was certainly go to the doctor and they should certainly get the healthcare that they need we're working right now with our partners United to make sure that any issues that we come across our fixed as quickly as possible and to be as responsive as we can to our members the latitude to keep going manager. Thank you and that listen I'm not I'm not targeting you or anything like that I just want to if there's a problem what we need to do to know that it's getting fix what we need to do to tell our constituents that are calling us what's going to happen in order to get it fixed so a couple questions and one is to have enough help over there to process are you are you running up your overtime of what do you need in order to help because quite honestly. You you've inherited this so what do you need a way of help in order to be able to get through the pile. Well so one of the request that we made this body if you recall was to implement the Medicare advantage plan and twenty four so that we could have time to staff up since I took off we've reorganized we've had to add significant resources to accounting to management to some other places we are in the midst of implementation of not just the Medicare advantage plan but also we're looking at a PPM implementation we've implemented scary aspect program there's a lot that's going on right now as far as staffing goes we have five or six positions open I think at any point in time a lot of our people are brand new because they come and go we're rolling with it my system administrator. Resigned about three months ago we've had a very hard time replacing her so I'll tell you it is a challenge finding people who can come in and do this job on a day in the database. Hello hello you too should take your through the pa you got now knowing that there potentially could be others added to it how long how far loan how long would it take you we met last night to review what we had the decision was made to go ahead which should be resolved today as far as processing goes now how we can confirm and and get communication out to those members that is the next step in the process but my focus right now is making sure that if there are problems if they are problems that we get them fixed very quickly. And what about the issue of people the statement was set up by Medicare has already been changed United health and health advantages being dropped without my permission because as I understand this and also got a quick call in to the person they had submitted it by November eleventh but what I'm interpreting is because of the delay in order to get that recognized or as you mention well go some back and forth. Have these people already been switched over to United health and you know how many of those have that are going to be switch back once you get the backlog cleaned up I and don't have a handle on the numbers the process we use was an opt out process so right we recorded them as opt out they should not be transferred over the concern I've got is those who either did opt out or believe they've opted out but somehow or another their opt out front there form the request got lost in the shuffle that's what we started going back and reviewing to make sure that we we have an accurate count and we don't move anybody over who doesn't want moved over okay then the last thing would be this if in the event. They incur medical expenses you know some unfortunate happens are you going to determine who's responsible for the cost in the event it's a person that is in this situation well so the benefits are identical between either plan okay so I can tell you who's responsible and that would be the plan okay a man sure what I'd like to request you know put a for motion if I need to I'd like to ask Jake to bring a report to fully L. C. Friday morning as far as the number of those that have opted out and just give a summary report to the full ale C. as he is given to us this morning so that all members can be aware of it in the event they are getting the same message as I'm getting we could have consistent communication to where there's no miscommunication so I'd like to make a request check that you just come before fully able street Friday morning and be prepared to give report we talk off line looks. Thank you. Can we wait until we have all the questions to address questions it and with that be a difficult for you to get that information okay and Representive Crawford thank thank you madam chair I check my question are gases would you say this statement is correct it's two part. In a normal world people do not have to offer changes if they want their plan to stay the same is that correct. I'm not talking Medicaid advantage I'm just talking in a normal insurance world when people change in the private sector and in many many public sector plans the option is not provided okay to opt out mine my understanding is I did not change my insurance so it stayed the same I did have a window of time where I could act so what's happening. With my constituents is because I've never had to change before if they want to keep it the same. This has flip flopped to where if you don't. If you don't want your plan to change now you have to opt out. Would you agree that's where the problems coming in. I think that the members were talking about have never had to make a decision on their insurance and so one of the issues were running into is yes now they have to make a decision so we've changed it to where they really are doing what they've always done but since they're doing what they've always done their planned it's changing. Sure enough from a benefit standpoint that's not good for the state of Arkansas well as it is understood we're following the recommendations of this body in doing the opt out process part of the body not the full body thank you. Representative Wardlaw you're recognized thank you US senator Hammer your request we can make sure that's on the agenda for Friday that's easy and doesn't need a motion the other thing Jake I think need to be clear that these folks that are in the United healthcare right now I'm not assume that coverage until January one correct so there's very on the likelihood that they would incur medical costs between now and January one that would have to be we'll well thanks if they do it would still be covered through their existing by that's that's my point so do you think that you guys will have most opt outs that you have in hand process before January first so there's no interruption we are leaving the window open until late January if not in a month I knew you were given at thirty days after the first year but the ones you have in hand now do you think you will have those process before general idea okay the vast majority are processed and we're looking forward to that program getting off the ground of being successful when you come Friday with that report can you give us the percentage of the members that are staying and United healthcare versus the ones that are been opt out yes thank you thank you manager. represented by the SEC you turned off your marker you okay with. Okay of a representative Hammer you had another response I'm sorry the question or. Thank you. One of the one of the previous committee she made the comment that people opted out and then the other one back in are you still seeing that trend and how much of that is adding to the confusion because we've got jumped out now they want to jump back in yep we're going to work all that out that's not our priority right now to be honest our priority is fixing. The if we made a mistake we need to fix and that's what we're focused yeah and I'm I'm not implying that that was a mistake on your part it's maybe just realization that people got out under this thought process of maybe after time they've had a chance to listen all the discussion now the reliable yeah what back in and we've talked to United to make sure that they're they're working great with us to being very flexible okay well and thank you I know you didn't have we didn't talk before this but I appreciate you answering questions publicly maybe a clear up some of the misconceptions Commission information that's out there appreciated thank you. Say no further questions we're turned.