Future of some University employees’ health care in jeopardy

The Illinois Department of Healthcare and Family Services, or DHFS, decision to drop the Health Alliance health maintenance organization from the state’s health care contract will affect thousands of people employed by the state, including the 7,320 University employees covered by the plan.

The future of those employees’ health care coverage remains in doubt.

DHFS dropped Health Alliance from the state contract on April 7 and awarded the contract to Blue Cross Blue Shield. Health Alliance and Humana, another health plan dropped by the state, challenged the decision almost immediately. The Urbana City Council passed a resolution questioning the decision soon afterward.

Disparities in opinion over the finality of the decision remain, as some claim that the decision rests on the state legislature. Conversely, DHFS believes the health care contracts could be awarded without such approval.

The potential health care switch could also affect the 500 Health Alliance employees in the Urbana area.

However, Jane Hayes, vice president of corporate communications for Health Alliance, said that the organization would not have to lay off staff, citing contracts with Caterpillar and State Farm as major sources of revenue. Although, the loss of the state contract would have a negative impact on business, she said.

Kathryn Ross, associate director of human resources for the University, questioned the state’s decision to award a contract to Blue Cross Blue Shield.

“As we know it right now, there is no Blue Cross Blue Shield coverage in most of the downstate and rural areas,” she said.

Ross continued to say that the Blue Cross Blue Shield network is available in only 38 of the 102 counties in Illinois, and the University has employees in 77 counties.

“We are strongly advocating for all of those employees to have fair and equal access to whatever the benefits are that are offered to the rest of the state,” she said.

As the Blue Cross Blue Shield plan stands currently, the closest primary care physician to Urbana is in Springfield.

According to a press release from DHFS, the new contract will save $102 million a year, saving $1 billion over the course of the 10-year contract. Health Alliance claimed in a press release that those figures are impossible to verify and that awarding the state’s contract to only one provider would decrease competition and raise prices.

If the new contract overcomes the legal hurdles it faces, employees currently covered by Health Alliance would have to switch to Blue Cross Blue Shield, the Open Access Plan or the Quality Care Health Plan, Ross said.

The Quality Care Health Plan is a pay-as-you-go plan in which those covered can choose their own doctors but pay more out-of-pocket costs. The Open Access Plan acts as a more traditional health maintenance organization. It has two tiers, with the lower tier acting as a regular plan and the second tier offering more access to medical resources.

University employees will not have to make a decision about their health care plan until all the facts are known, Ross said.

President Michael Hogan wrote a letter to Julie Hamos, the director of DHFS, requesting that she reconsider the decision.

“We ask for your assurance that reasonable coverage will be available from the providers upon which our downstate and rural county employees rely,” Hogan wrote.

Ross said the University is fighting to keep Health Alliance as a provider and will do so by lobbying state officials.

“We’re keeping our finger on the pulse of this issue because it’s very near and dear to all of us and the employees we represent,” Ross said.