PUBLIC COMMENT PERIOD ALASKA COMPREHENSIVE HEALTH INSURANCE ASSOCIATION (ACHIA)

Transcription

1 PUBLIC COMMENT PERIOD ALASKA (ACHIA) Anchorage Marriott - Skagway/Valdez Room Anchorage, Alaska Tuesday, July 19, :00 p.m. Alaska time Meeting Call to Order A. Public Comment Period The Public Comment Period of the Alaska Comprehensive Health Insurance Association (ACHIA) was called to order by Brian Angel, Chair, at 4:06 p.m. Alaska time on Tuesday, July 19, Roll was called, and a quorum was present. Board Members Present: Brian Angel, Chair Shawn Pollock Jason Gootee James Grazko Mona McAleese Sarah Bailey, Ex Officio AFLAC Mutual of Omaha Insurance Company Moda Health Premera Blue Cross & Blue Shield of Alaska Public Advocate Alaska Department of Insurance Board Members Absent: Marilyn Kasmar Public Advocate Others Present: Lori Wing-Heier Cecil Bykerk, Executive Director Debbie McCormick Peggy Onstott Alan Kellogg Wendy Schraig Cindy Carl Director, Alaska Department of Insurance C.D. Bykerk Consulting, LLC Benefit Management, Inc. M.R. Onstott Consulting, Inc. HealthLinx, LLC Fresenius Recorder Brian welcomed everyone to the Public Comment period of the 2016 ACHIA annual meeting. He said ACHIA welcomed the public to comment regarding their experiences with ACHIA, including suggestions for how the program could be improved. Brian advised that major changes were made to the law as of yesterday that would have a significant impact on the Alaska market. He said the Board had spent a lot of time during the meeting earlier today discussing those changes to ensure that they were in position to support the market through the transition period and into the future. Brian introduced Lori Wing- Heier, Director of the Department of Insurance, and then Board and public member introductions were made.

2 Tuesday, July 19, 2016 Page 2 of 5 1. Remarks by the Director of Insurance Director Wing-Heier announced that Gov. Walker had signed HB 374 yesterday, which gave ACHIA a new, different life. She recapped the history of the Affordable Care Act that was enacted in 2014 and described how ACHIA had operated and the choices it had made under the ACA that led them to where they were today. She said the bill signed by the Governor yesterday would turn ACHIA into a reinsurer, which, in essence, would allow them to be the high-risk insurance pool for the state of Alaska, which would eliminate the huge spikes in premiums that insureds had experienced in the recent past. She said the average 9.8% increase in premium for 2017 was a pleasant change as compared to the 40% spikes the market had witnessed since the inception of the ACA. Director Wing-Heier explained how the new ACHIA program would work under the recently passed HB 374 and said that ACHIA would now act as a reinsurer to the ACA as opposed to being the primary insurer for the very ill, which drove up the costs in the Alaskan insurance market. She described how the new program would work, how the current enrollees would be impacted, and the advantages the new program would have over the current one. Brian added that the Board was very excited to start work on the new program and to do its part to see it come to fruition. 2. Presentation by Administrator regarding Policyholder Service as well as Policyholder Letters. Debbie announced that Benefit Management LLC had sent a letter to the policyholders about today's meeting. She advised that BM was the third-party Administrator that handled policyholder claims. She invited the members of the public in attendance to feel free to chat and share any issues with her today, either during or after the meeting. 3. Open period for general comments and discussions - Enrolled Insureds Tofamamao Faamatuainu Tofamamao said she appreciated the opportunity to be here today, and she wanted to thank the Board for all that they have done and the assistance she has received in obtaining her meds. Regarding her health status, she said she was grateful for ACHIA's help and support. She said she wrote a letter every year and gave it to her social worker to present to the Board so they would know how much she appreciates what they have done for her. She thanked the Board again for its support and assistance. Annette Alfonsi Annette told the Board she was a passenger in a car rollover accident several years ago, and she still had several injuries and health issues as a result. She said it happened when health care was changing and she didn't know what to expect, but she discovered that ACHIA was an option for her at that time. She said it took a long time to find the right kind of health care, but she had opted for ACHIA, and her treatment was progressing. She said that through all that, ACHIA had been great to work with. She said the people she talked to on the phone regarding her health issues were patient and helpful. She said that unlike other insurance companies, when she had to call BMI for assistance she did not find it an unpleasant experience. Having said that, she said she wanted to share some of the things that didn't work out as she had expected.

3 Tuesday, July 19, 2016 Page 3 of 5 Annette said that at one point in her treatment, massages and other types of ongoing care weren't paid for. She said she thought that there was a new biller during that time, as those same services were paid for both before and after that time period. She said that she would like to appeal those claims that were denied, but she didn't know how to go about it. Debbie said she would get with her to take her information. Annette said she had been with ACHIA for almost five years, and was very grateful to ACHIA. She said that she has had back surgery and had a mild brain injury as a result of the accident, but with ACHIA, her health has continued to improve. She said if it wasn't for ACHIA, she would still be in a wheelchair today. She asked if the changes that ACHIA would undergo with the passage of HB 374 would change the coverage and/or benefits for her. Director Wing-Heier responded that the medical program would remain the same. She said that for those who were on Medicaid, there were programs that only provided supplemental drug benefits. Annette also asked if there was a way to provide hard copies of information to enrollees who either had data caps on their internet service or who did not have internet access at all. Debbie said she thought enrollees had the ability to appeal claims denials over the phone too, but she said she would present Annette's appeal for her. Cecil added that all she had to do if she wanted hard copies of anything was to request it. - General Public Lisa Davis - HIV Care Coordinator, State of Alaska, Department of Public Health Lisa said she oversaw HIV services, and she comes to the Public Comment period of the ACHIA annual meeting most years to express their support for the ACHIA program. She said that there were 13 individuals involved in the ACHIA program over the past year and 5 on ACHIA now. She explained that there had been a paradigm shift over the last couple of years to get people with HIV into treatment as soon as possible. She said the goal was to keep people healthier from the start and to decrease their viral load so that they weren't able to transmit HIV as easily. She said it was their objective to get people on insurance so they would have a choice of medical providers and they could be comfortable with their providers, and so they would have comprehensive coverage in order to maintain their health. Lisa said the ADAP program tried to shift people over to ACA plans and transition them to Medicaid, but ACHIA had been crucial for their clients who were on it, and they were satisfied with their care. Lisa said a lot of their patients had been on ACHIA for a long time, they're getting good care, and they're staying healthier for a longer period of time. She said she just wanted to provide comment today to express how important it was that the ACHIA program continue for those people who don't have any other options. Melba Cook, (three As) AIDS Assistance Association Melba advised that they had transitioned 52 clients to ACA programs during the last year. She said that many people in her program who have not been in the state long enough to apply for State benefits were utilizing ACHIA, so it had been a Godsend for those people. She said that when they started to transition people to ACA, some of the people cried because they didn't want to leave ACHIA, and said that it was the best thing that had ever happened to them. Melba stated that the three As cover the entire state of Alaska, and she's the clients' go-between with the insurance companies. She said her clients have expressed their appreciation for ACHIA, and the three As appreciated ACHIA's service because it's always easy to solve their clients' problems. Lisa and Melba responded to questions regarding their organizations and clients, and discussion was heard.

4 Tuesday, July 19, 2016 Page 4 of 5 Wendy Funk Schrag: Wendy introduced herself and said she worked for Fresenius Medical Care. She said she had worked in the dialysis industry for 26 years and as a social worker for 16 of those years helping patients with their insurance and insurance options. She said for the last 10 years, she'd worked in the Fresenius Public Policy Department. She said she was currently based in Kansas and serviced the western half of the country. She said one of her jobs that she's had during the last three or four years since the advent of the ACA was to monitor the risk pools. She said that she'd seen them dwindling and shutting down operations over the past several years. She said a few that were left were very important to Fresenius' dialysis patients, and Alaska was one of them. Wendy said she had touched base with Cecil once or twice a year for the past few years to get updates on what was trending in the industry. She explained that their under-65 Medicare clients continued to use the wraparound policy, so that was the most important ACHIA plan for Fresenius and their patients. She said that until someone had a chronic condition like kidney failure that required a lot of very costly medical services, they think Medicare is enough, but they soon find out that it's not. She pointed out that the 20% that Medicare doesn't cover can be very costly and can also keep a patient from being approved for a transplant. She said that if patients don't have comprehensive coverage, they sometimes opt out of going to doctor appointments and/or doctors don't want to serve them to get their accesses placed. She said the ACHIA program had been very important to Fresenius clients, and she thanked the Board for keeping it open. Wendy said the reason she came to the meeting in person this year was because when she did her yearly call to Cecil in May, he had talked about the bill pending in the Alaska legislature and all the changes that would result with its passage. She said Fresenius also had patients with Premera insurance, so she had decided to attend the meeting to find out how it was all going to work once implemented. She said Fresenius would keep an eye on things to see how the new market would develop. She told the Board to feel free to send dialysis patients her way if they had any questions. Wendy said she had hoped to bring their local financial coordinator with her to the meeting today because she worked with Doris in the ACHIA office on patient issues. Wendy said she was unable to attend, but she sent her thanks to the ACHIA Board as well. Marie Alfonsi Annette Alfonsi who provided comment earlier said that Marie Alfonsi was her mom and she had to leave. Marie said her mom was a retired dentist and has had plenty of experience with insurance companies. Marie said her mom wanted the Board to know that, "She thinks you guys are great!" Brian thanked everyone who attended the Public Comment portion of the annual meeting, and he thanked everyone who had provided comments. 4. Report of Nominating Committee Two Board members terms expire with this meeting. The Nominating Committee is recommending the re-election of Brian Angel and James Grazko whose terms expire with this meeting for a term expiring in With David Hill s resignation last year, we have one open company position but have not been able to identify someone to fill that position. Brian said that Brian Angel and Jim Grazko were up for re-election. He advised that David Hill's vacant seat was still vacant, and they continued to seek a viable candidate.

5 Tuesday, July 19, 2016 Page 5 of 5 5. Election of these Board members would result in the following Board composition: Brian Angel, AFLAC 2019 James D. Grazko, Blue Cross/Blue Shield of AK 2019 Jason Gootee, Moda Health Insurance 2018 Marilyn Kasmar, Consumer Advocate 2018 Shawn Pollock, Mutual of Omaha 2018 Mona McAleese, Consumer Advocate 2017 Open company position 2017 MOTION: By Sean to approve the report of the Nominating Committee SECOND: By Jason to re-elect Brian Angel and James Grazko to PASSED UNANIMOUSLY another term as recommended. Brian advised that there were two Consumer Advocate positions on the Board. He commended Mona for her many years of dedicated service and said she does a wonderful job for her constituents. He advised that the other Consumer Advocate position may soon be vacant, and the Board encouraged public participants to consider applying for the position. Annette Alfonsi expressed interest in applying for the Consumer Advocate position on the Board. She asked how they would know if/when the Consumer Advocate position became vacant and what was the process for applying. Brian said they should contact BMI or the Department of Insurance, who would put them in touch with the person they should talk to about it. Mona said that anyone could contact her as well if they wanted to know what the position required. Debbie said interested parties could call the 800 number at BMI. Brian said the Board's contact information could also be found on the website. 6. Election of officers for 2016/2017 year The Nominating Committee puts the following candidate slate forward: Chairperson Brian Angel Vice-Chairperson Shawn Pollock Secretary/Treasurer Jim Grazko MOTION: By Sean to approve the report of the Nominating Committee SECOND: By Mona to re-elect the slate of Officers to another term as PASSED UNANIMOUSLY recommended. Brian Angel was elected Chairperson, Shawn Pollock as Vice-Chairperson, and Jim Grazko as Secretary/Treasurer for 2016/ Adjournment There being no further business, the Public Comment period of the ACHIA annual meeting was adjourned at 4:46 p.m. on Tuesday, July 19, 2016.