Raleigh, N.C. — After weeks of difficulties for state workers and retirees whose health insurance was wrongly listed as "inactive," state officials on Friday terminated the contract of the company handling enrollment and eligibility for the State Health Plan.
The move follows a series of WRAL News reports this week about State Health Plan members being turned away from doctor's offices or having their prescriptions delayed unless they could pay upfront.
Aon Hewitt's three-year contract started June 1, but computer problems prevented the company from transmitting information on new enrollees in the health plan, recent retirees and anyone who had a change in their coverage to Blue Cross Blue Shield of North Carolina, which processes claims for the health plan, according to state officials. So, an estimated 2,000 to 4,000 people weren't showing up in the system as having coverage.
"For the individual who is a member of the State Health Plan, which is where our concern is, the background vendor partner sould not be anything that they think about. They think about, 'I go to the phatmacy, I go to the doctor and I am covered,'" said Schorr Johnson, a spokesman for the State Treasurer's Office, which oversees the health plan for more than 680,000 teachers, state employees, retirees and their dependents.
"The State Health Plan apologizes to anyone who is affected by that," Johnson said. "We are doing everything we can to resolve that and make sure that members have access to care, which is the No. 1 concern of the State Health Plan."
Benefit Focus, which used to handle health plan enrollment, now will be back on the job sometime in September, Johnson said. Until then, he urged any plan members with difficulties to call the plan's toll-free customer service hotline at 855-859-0966.
More people are now staffing the hotline, Johnson said, and they will ensure people's updated information is forwarded to Blue Cross so all medical appointments and prescriptions can be handled without further delays.
"If you think you might be affected, please call. If you're in a doctor's office and are being told that, please call the number, and our staff will work to resolve it," he said.
The State Health Plan will expedite reimbursements for anyone who had to pay out of pocket due to the problems, he said.
Benefit Focus lost the health plan contract because it had problems with customer service, but Chuck Stone, director of operations for the State Employees Association of North Carolina, said he thinks things will go more smoothly this time around.
"I think the State Health Plan and Benefit Focus both learned from the first experience two years ago, and I'm optimistic at this point that, again, this is a temporary problem," Stone said.
Johnson said problems could persist during the transition to Benefit Focus, but the health plan is working to minimize any disruption.
"Ultimately, the taxpayers need to be asking, 'Are we getting accountability when we outsource to private contractors?'" Stone said.
The state hasn't paid out any of the $50.4 million due to Aon Hewitt under the contract, Johnson said. Meanwhile, Aon Hewitt spokeswoman Maurissa Kanter insisted the company still works with the health plan.
"Aon Hewitt has not been fired. We’ve mutually agreed with the State Health Plan to transition a portion of our work to another provider," Kanter said in an email to WRAL News. "Our top priority remains the State Health Plan’s employees, and we are working closely with the State Health Plan to help facilitate a smooth transition."