November 2006

Monday, November 27, 2006

2:15 – 4 p.m.

Gervase Conference Room

Attendees:  Elliott Crooke, Charles DeSantis, Richard Bates, Harvey Iglarsh, William Droms, William McElroy, Robert Robinson, Gregg Bloche, Melivinia Towns, Karen Pierce, Donna Harris, Margaret Little, Mark Danielsen, Mary Anne Mahin, Rosemary Kilkenny, Eileen Fenrich, Aureller Cabiness, Virginia Flavin

Introduction of New Members

Elliott Crooke introduced new Medical Center representatives Donna Harris, Mark Danielsen and Aureller Cabiness; and Law Center representative Karen Pierce.

Approval of October Minutes

Minutes from the October 25, 2006 meeting were unanimously approved.

2007 Open Enrollment Update

Charles DeSantis provided the group with a high-level update on outreach efforts to-date.

  • 20- 25 Outreach Sessions (12 planned sessions, plus additional sessions by request)
  • 3 Benefits Fairs (100% increase in attendance over 2005)
  • Medical Plan Chooser Tool Deployed
  • Open Enrollment Call Center Up and Running

UHC Discussion

An issue arose in November when UnitedHealthcare began informing attendees at the GU Benefits Fairs, and its current participants, that they had successfully required a group of five popular providers into its Choice Plus network.  This information was misleading and incorrect.  After having numerous discussions with leadership at UHC, Charles DeSantis informed the BAC that it is his opinion that this miscommunication was a result of ineptitude rather than blatant fraudulence. 

UHC, in light of their error, will be treating those five providers as “in-network” for UHC participants regardless of whether or not those providers sign with UHC or not.  Charles is working with UHC to get a communication out to the Georgetown population in a timely manner, providing updates on the situation.

There was discussion of how employees utilizing those five providers would be informed of the claims process specific to these doctors.  A concern was expressed concerning the lag time between up front out-of-pocket cost to the participant, and reimbursement.  Georgetown is working closely with UHC to get a communication outlining claims procedures to 2007 UHC participants to minimize the out-of-pocket impact.  UHC will be asked to provide a written statement confirming that they will absorb the financial impact of treating claims from these five providers as in-network.

One member stated that UHC should issue a formal and public apology to Georgetown for this issue.

It was asked if the BAC could see a list of possible courses of legal action available to the University in this situation.  Charles informed the group that he has been in ongoing discussion with General Counsel during this process.

The Office of Faculty and Staff Benefits will allow, through a case-by-case appeals process, participants to change from UHC to another GU health plan in the event that a UHC participant feels that they have been mislead or misinformed. 

It was stated that retirees may not have been made aware of the UHC issues.  Further, it was suggested that GU find out which insurance plans accept the five providers.

Benefits Budget

Mary Beth Fargo reviewed the current status of the benefits budget. Overall, benefit budget items are on target.

Charge for 2007

The focus for the next several meetings will be on the University retirement plans.  In the January meeting, Towers Perrin will present to the committee on the current plans to provide a baseline of understanding for future discussions.

Other Business

A retiree dental plan (access only) is being considered for deployment during 2007.