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@NCCapitol

Vendor at center of State Health Plan glitch fired

Posted August 14, 2015

— 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."

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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."

12 Comments

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  • Sherrill Craig Aug 15, 2015
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    Ok, smarty-pants, pray tell how do you know they are not in China? I have not run into many excellent code-monkeys from China. They could be overpaid US coders. Unless you can cite a source, you are talking out of your tailpipe.

  • Brenda Blackman Aug 15, 2015
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    This has been a problem. More so is the problem that you are in SEVERE pain (knee) and you go for an MRI because nothing else worked and you pay 250.00 up front and they still won't read your MRI until you pay them another 350.00 because your insurance plan said your deductible is 1900.00 and hasn't been met so we aren't going to do anything for you until you met it. That is exactly what has happen to me. Thank you Raleigh Orth and Blue Cross Blue Shield and STATE EMPLOYEE HEALTH I hope you have to go through what hundreds of state employees have to go through. No one should have to live, work or play in pain, these folks are so unfair. Under paid and yet when we have to add a spouse because they got laid off they want 800.00 up front for insurance. How wacked it that. No wonder people their are so many homeless people in the USA...look how we treat them....God have Mercy on us!

  • Eric Hammond Aug 15, 2015
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    MAJOR C.Y.A. direct from the governors office on - down! AON has had a history of paying kickbacks aka. "bribery" (and profit sharing from highly profitable "computer foul-ups" like this) notice that there is NO mention of the interest obtained from stashing all that money in short - term high interest accounts?? either they pay back every single penny plus interest (at the 10 or 12% they got) or the AG still needs to subpoena EVERY single administration officials financial records and find out who exactly this corrupt company bought to get the contract!

  • Paul Donovan Aug 14, 2015
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    Ummm...you've been fired ! Call it whatever you want but you will not get paid by the state for your incompetence.

  • Barbara Sossomon Aug 14, 2015
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    Just some observations:

    1. If this vendors contract just started June 1st, WHO was the vendor that created this software to begin with? No software can be delivered in less than 3 months. I don't care how many programmers you throw at it.

    2. Now, they have fired this vendor, so WHO is going to take this over? Seems to me that this could cause even MORE problems. If you fire the vendor and then have to put it out for bid, again, who is going to administer it, until you get someone in there, to see what they have and see if they can "fix" it, or if they have to start from scratch?

    3. Where is the OLD software? Is it still viable? Can someone use it, until they figure out the problems that they have?

    All of these are legitimate questions and need to be addressed immediately.

  • Barbara Sossomon Aug 14, 2015
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    State Contracts go to the LOWEST bidder. Unfortunately, you get what you pay for.

  • Johan Summer Aug 14, 2015
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    In my experience of TESTING new Vendor software - if adequate testing (trying to break the system) is done with various scenarios, problems are identified and the vendor has the option to either fix it or the contract is immediately cancelled. If the new vendor went "live" June 1st - much testing should have been done way before June 1, so the contract should have been cancelled before now. I wonder if it was rushed so the contract vendor could be in place by fiscal year end (June 30)?

  • Roy Hinkley Aug 14, 2015
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    Well, that reply wasn't helpful.

  • Fletch Penn Aug 14, 2015
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    do some homework dude...it is easy to figure it out

  • Roy Hinkley Aug 14, 2015
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    Is that an assumption, or do you have a source for your claim regarding the programmers' nationality?

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