State Health Plan problem snags cancer-stricken corrections officer
Posted August 13, 2015
Kenansville, N.C. — Earl Pike has been fighting colon cancer for the past 18 months, and he says the last thing he wants to do now is fight for state insurance benefits to pay his medical bills so he can receive treatment.
Pike is among thousands of state workers and retirees caught in a computer problem with the State Health Plan.
A shift in June to a new vendor, Aon Hewitt, to handle enrollment services and eligibility in the health plan caused the coverage to be listed as "inactive" for new enrollees, recent retirees and anyone with a change in their coverage, officials said. The mistake caused some people, including Pike, to be turned away at doctor's offices and delays in getting prescriptions filled.
Pike, who has worked as a corrections officer at state prisons for 22 years, said he scheduled an appointment six months ago for a Thursday CAT scan to determine if an aneurysm is expanding. His doctor's office called him last week and said they were having a tough time verifying his insurance with Blue Cross Blue Shield of North Carolina, which processes claims for the State Health Plan.
"According to them, it showed me as an inactive employee," he said Thursday. "I am active right on. I'm still out on sick time."
Pike checked with the human resources office at Pender Correctional Institution on Monday and was assured he had coverage, but the doctor's office said he would either have to pay for the CAT scan himself or cancel his appointment.
"They canceled my appointment to get the scan done on my aneurysm because the computers are saying I have no insurance," he said, adding that he couldn't afford to pay the bill upfront.
After days of calling around, he still hasn't been able to get his insurance verified. He said he has been diagnosed with cancer three times, and his latest cancer appears to have spread to his liver, so he doesn't have the time to miss medical appointments because of a computer glitch.
The State Treasurer's Office, which oversees the health plan for more than 680,000 teachers, state employees, retirees and their dependents, and Aon Hewitt have said they're working to resolve the issue. Blue Cross called Pike and told him someone would call him when it's resolved.
Still, Pike was miffed by Aon Hewitt's characterization of the problem as "an isolated issue impacting a small number of individuals," saying it's a crisis for any state employee or retiree who can't see a doctor or have prescriptions filled.
"It only affected an insignificant number," he said, the irritation rising in his voice. "I'm not insignificant."