IBM Extend Health Transition Complaints --- All Roads Lead to Extend Health

I wrote to Dr. Rhee to, once again, complain about what is happening.
    
What follows is my email to and answer from Dr. Rhee about the incorrect enrollment information I got from Extend Health.  IBM is now pushing most complaints to Extend Health to answer.  I spent about 30 minutes on the phone yesterday with an EH "specialist" after we played phone tag a few times.  In one of his voice messages he told me the agent involved in screwing up my enrollment would be counseled as this was a teachable moment.  I left a testy voice message back and saying "don't you dare blame this on any individual … there are many agents who are giving us wrong answers so it is EH management who is at fault for not properly training their agents".  When we did talk he dropped the BS bingo language and we had a honest conversation. I told him the way EH is communicating with us really stinks whether it is related to program rule changes, website design, agents saying things wrong, having to spend hours on the phone just to enroll and not being able to read the legal rantings in addition to hearing a recording that sounds like it is being played at the wrong audio speed.  

  

Extend Health can't take the rap for IBM doing this crappy transition. They can only take the rap for crappy service.  It is IBM executives that decided to create this mess and threw a bunch of old people under the bus.  The only positive thought I can conger about what is happening is that one day the people who thought it was so clever to do this will also be old.  Even though they might have a lot more money than me, most of them won't be Warren Buffet rich so they will still have to deal with the same health insurance crap we are dealing with now and NO subsidy because that benefit is long gone.  By then Medicare will be means tested to the max so their Medicare insurance will cost them a whole lot more and hopefully suck all their money away!  

From: Retiree Comms <retiree@us.ibm.com>
To:
Sent: Wed, Nov 6, 2013 12:12 pm
Subject: Extend Health Transition Major Enrollment Problem

Dear

I have asked an Extend Health executive to contact you to review your experience.  We take customer service very seriously and your experience is not acceptable.  We are working very closely with Extend Health on the quality of support their benefit advisors deliver. 

We are not able to meet your request to continue in your Aetna Medicare Integration plan.  That plan is very similar to Medigap plans, which are available to every retiree on the exchange.  I know this is not the answer you were looking for, but we believe the Medicare Exchange delivers increased choice and flexibility in plan options for the vast majority of our retirees.  

Thank you for writing to express your concerns.


Kyu Rhee, MD, MPP
Vice President Integrated Health Services



From:      
To:        Kyu Rhee/Somers/IBM@IBMUS
Cc:        Diane J Gherson/Armonk/IBM@IBMUS
Date:        11/01/2013 07:21 AM
Subject:        Extend Health Transistion Major Enrollment Problem

---

Dear Dr, Rhee,

I did all my homework and checked THREE times with Extend Health agents to be sure my enrollment selections would be acceptable to EH such that I could get my HRA subsidy. I checked both before and after my enrollment call. Everyone I spoke with at EH confirmed my selection would meet the criteria for enrollment such that I could get my HRA subsidy. And, my profile indicates I am enrolled and my application is being processed. My EH plan choice was to enroll in the same part D insurance plan I am already using in 2013.

   
When does an EH enrollment mean "maybe not"? I am learning that I am not really enrolled in an insurance plan until the insurance company processes and accepts my application. Better still - EH says it is not their problem if the insurance company rejects my enrollment EVEN WHEN THEY KNOW IT WILL BE REJECTED.

 
I know my application will be rejected because a colleague tried, this week, to do a similar enrollment to mine and the EH agent he worked with knew enough to stop him from doing it. My colleague specifically referenced my enrollment and gave the EH agent my name to say ... that person did it ... why can't I? According to the EH agents he worked with - my enrollment through EH will be rejected by my part D insurance plan because I already am enrolled in that plan. Ergo, I will not have enrolled in a plan via Extend Health and since EH will not show as the insurance agent of record I will not have access to my HRA subsidy. 

 
Now, I would have thought the EH agent would immediately flag my profile and tell someone to call me asap because the agent knew my name and that I will have this problem. Instead - he told my colleague this wasn't an EH problem - they are only the insurance agent. He said the insurance company will send me a letter and tell me about the duplicate enrollment rejection. My guess is the letter will say since I am already enrolled in the plan I don't need to enroll again. My further guess is they will say nothing about the fact that EH is therefore not the agent of record for my plan. And, therefore, had my colleague not tried to do the same thing, I would likely think I still had full access to my HRA subsidy. 

 
Wait - it gets better. If the insurance company sends me a letter after December 7th, I will still be in a stew even if I realize the impact on my HRA subsidy access. I will not be able to switch to another part D plan because Medicare Fall Enrollment will be close and I have no SEP for my part D plan. Ergo - no subsidy for me! Wow, this really demonstrates how EH is totally invested in helping me make the right insurance choices. 
  
THE ONLY REASON I KNOW ABOUT THIS PROBLEM IS PURE LUCK that a friend tried to do the same thing. 

 
I decided I will call EH and just tell them I changed my mind and want to enroll in another part D plan rather than try to fight this battle with them. I'm the one that has the most to lose re my HRA subsidy. Ugh, another hour  plus on the phone with EH enrollment listening to boilerplate and repeating my name and SS# a thousand times. It's a good thing I am retired. 

   
Is this really a better choice for IBM retirees?  Certainly it is not for me.  I am begging you - please give me back the choice of Aetna Retiree Health Access health exchange so I can get my Aetna Integration plan. RHA was a true insurance health exchange that offered excellent choices at stellar premium prices.  You did it for Aetna PPO and HMO enrollees.  Why can't you do it for Aetna Integration enrollees too? 

IBM Medicare Extend Health Enrollment Deja Vu to change part D plans - Lucky Us!!!

We just went through the enrollment process a second time to switch to new part D plans since we were not supposed to reenroll in the same plans we are using in 2013 as it would NOT allow us to access our HRA accounts. 
 
I continue to be astonished and furious that NO ONE from Extend Health called back to tell us about this problem after we enrolled on October 22nd.  The agents this morning verified that we would have had a problem if we did not change to new part D plans.  I actually feel sorry for the agents because they are taking the heat for the incompetence of their organization. 
    
It took about one hour to make this change.  I just shake my head over that too.  I should have been able to do it online in 5 minutes.  Once again, we had to talk with 3 different agents - each time verifying our information.  The best part is being able to hear the boilerplate recording yet again. 
 
This is onerous.  Just onerous.

IBM Medicare Extend Health DO NOT try to enroll in the same Part D plan you use in 2013

I wish IBM would hold a public hearing with their stockholders on the transition to Extend Health.  Whomever vetted Extend Health aka Towers Watson should be fired. 
  
As I have written earlier, I did all my homework and checked THREE times with EH to be sure what I was doing would be acceptable to EH such that I could get my subsidy both before and after my enrollment call.  Everyone I spoke to at EH confirmed my selection would meet the criteria for enrollment such that I could get my subsidy.  And, my profile says I have enrolled and my application is being processed.  My choice, which was confirmed, was to enroll in a part D insurance plan I already am using in 2013.
   
When does an EH enrollment mean "maybe not"?  You aren't really enrolled in an insurance plan until the insurance company processes and accepts your application.  Better still - EH will say it is not their problem if the insurance company rejects your enrollment EVEN WHEN THEY KNOW IT WILL BE REJECTED.
      
When a colleague tried, this week, to do a similar enrollment to mine the EH agent he worked with knew enough to stop him from doing it.  My colleague referenced my enrollment and gave the EH agent my name to say ... that person did it ... why can't I?  According to the EH agents he worked with -  my enrollment through EH will be rejected by my part D insurance plan because I already am enrolled in that plan.  Ergo, I will not have enrolled via Extend Health so EH will not show as the agent of record.  Ergo, I will not have access to my subsidy because I did not pick a plan where EH would be the insurance agent of record on my part D plan.
  
Now, one would think the EH agent would immediately flag my profile and tell someone to call me because he knew my name and that I will have this problem.  Instead - he told my colleague this wasn't an EH problem - they are only the insurance agent. The insurance company will send me a letter and tell me about the duplicate enrollment rejection.  My guess is the letter will say since you are already enrolled you don't need to enroll again.  My further guess is they will say nothing about the fact that EH is therefore not the agent of record for you plan.  And, therefore, had my colleague not tried to do the same thing, I would go on believing I had full access to my subsidy.
     
Nice - right?  Wait - it gets better.  If the insurance company tells me this after December 7th, I will still be in a stew even if I then realize it impacts my subsidy access. I will not be able to switch to another part D plan because Medicare Fall Enrollment will be close and I have no SEP for my part D plan. Ergo - no subsidy for me!  Wow, this really demonstrates how EH is totally invested in helping us make the right insurance choices.
  
I decided I will just call EH and just tell them I changed my mind and want to enroll in another part D plan rather than try to fight this battle with them.  I'm the one that has the most to lose. Ugh, another hour on the phone with EH enrollment listening to boilerplate and repeating my name and SS# a thousand times.  It's a good thing I am retired.
 
Time to write another letter to Dr. Rhee.

IBM Extend Health Transition MetLife Dental Plan for Veterans is a WOW!

Update 1/7/14:  We thought we could enroll in the VADIP plan because my spouse is a veteran but had never registered in the VA health system.  Unfortunately, now, you cannot even register if your income is above a threshold of about $55,000.  My spouse never bothered to register years ago -- because WE HAD IBM MEDICAL.  The government income limit rules went into effect after 2003. If you registered before 2003 you are grandfathered. You must be registered in the VA health system to be eligible to buy the VADIP plans even though the VADIP is not means tested. Too bad.

The Veterans Administration is working with Delta Dental and MetLife to provide dental plans to eligible veterans next year.  It is an experimental program that begins enrollment 11/15/13 for dental insurance effective 1/1/14. 
    
You must enroll in the VA health system to be able to use this dental program. You can enroll in the VA health system online - it is quite easy and they respond really quickly.  They will want to know your financial status but they do not ask for verification of your income statement if your annual income is more than about $50K/year.  They only want verification for low income statements to determine subsidy benefits.  The dental plans are not low income premium adjusted --- everyone pays the same premium.  My guess is low income veterans will continue to go to VA locations for dental services.  Here is two links to help you get started:
    
http://www.va.gov/healthbenefits/vadip/

https://www.metlife.com/VADIP/index.html
    
For VFWs there is already a program in place but to use this program you must prove you were in active combat in a foreign war.  It looks to me like the benefits are not as good as the VADIP program described above.  To find out more about the VFW program go to:

http://www.vfwinsurance.com/veterans-dental-insurance.html

IBM Extend Health Transition IBM PR - Retirees "Like" This Change. Really?

The IBM public relations team keeps saying there are many retirees that like the change IBM is making for Medicare eligible retiree insurance plans.  I wonder how many is "many".  After all 1% of 110,000 people is a lot of people.  But it certainly isn't a majority.
  
I do believe there are some people who like this deal better.  Who are they and why?

• Retirees with spouses under 65: 
  
  They were required to pick from the IBM medical/prescription drug plan choices to be able to cover both themselves and their spouses. IT WAS IBM THAT FORCED THIS RESTRICTION.  IBM's supplemental insurance plan didn't really start paying until out of pocket expenses were $4000.  There were a few things immediately covered like preventive and diagnostic health checkups but the medical coverage didn't start until you had about $15-20,000 in medical bills. That's a lot of doctor bills (most of a hospital short stay bill is covered by Medicare A).   The prescription drug plan also might not have been a good plan for covering drugs used by the couple. An easy fix would have been to allow the couple to each enroll in different plans.
      
• People living in rural areas:
     
  Sometimes people have difficulty finding local doctors - particularly for specialties.  Joining a localized HMOs may be the best way to remedy the problem.  Perhaps IBM HMO offerings might not  provide the best doctor networks available in the area.  There is no easy remedy for this kind of problem.
      
• Better Medicare Advantage plans:
      
  There are a lot of MA plans in the open market that provide different doctor networks or different benefits than the Medicare Advantage plans offered by IBM.  Maybe the doctors a retiree wanted to see were in a network plan not offered by IBM.

HOWEVER - the Aetna PPO and HMO offerings from Retiree Health Access were some of the BEST Medicare Advantage plans I have seen and I have seen a lot because of the volunteer work I do. It's hard to believe there are better ones available.  The Aetna Integration offerings are also spectacular offerings. Integration A is almost equal to a medigap F no deductible plan.  It doesn't get better than that. The Met Life Dental group plan is one of the best plans available.  All these plans were excellent price performers.  I believe IBM had an easy fix for the retirees with spouses under 65.  If they subtract out those retirees - I wonder how many people are happy with this change versus how many people are unhappy about it.  When I think back on the sea of confused and distressed faces of the retirees in the Poughkeepsie meeting in September - I think I know the answer.

IBM Extend Health Transition - Yet Another Rule Change for HRA access?

I was looking at the www.ibmemployee.com website yesterday and there were postings saying that the requirement to get the HRA subsidy has changed (again).  They say now only the retiree needs to buy either a medical plan or a prescription drug plan from Extend Health to gain access to the HRA subsidy for both the retiree and the spouse's reimbursement of insurance premiums and out of pocket medical expenses.  The retiree's spouse does not have to purchase an EH plan. The posting included an email from Dr. Rhee with that information.
  
I have not verified this with an Extend Health agent but, if it is true, it is important to know.  I also don't understand why we are not being officially notified of these substantive rule changes and have to find out by word of mouth.  This change means you can buy most of the plans that are a best fit for your medical needs irrespective of whether or not EH sells the insurance.
   
I also should mention that it may be risky to buy a medigap plan through Extend Health as the way to gain access to your HRA.  The rules on this are not clear and maybe IBM will fix the following delimma.
  
Right now, if you are able to buy a medigap plan with guarantee issue because the IBM group insurance you have is ending in 2013 then you cannot be denied by the medigap insurance company.  However, once you've bought the EH medigap plan your guarantee issue right ends unless you live in a state that requires continuous enrollment.  Very few states require it.  New York and Connecticut do. 
  
So, what's the big deal about that?  Well, suppose in 2015 Extend Health is no longer selling that medigap insurance plan you bought through them in 2014.  That can happen because the insurance company decides they no longer want EH as an insurance agent.  Does that mean you've lost your access to your HRA subsidy unless you buy another plan through EH?  You might be able to keep your subsidy access by buying, during Medicare Fall Enrollment, a part D insurance plan EH sells - if a plan they offer cover your drugs. If not, then you might have a problem.  You can only switch to a new medigap plan EH does sell if your state has continuous enrollment.    You have no guarantee issue right to do so in other states and therefore can be denied or charged a higher premium.  The medigap plan you bought in 2014 is not ending - EH just isn't selling it anymore.  That's the delimma.
  
I don't have a solution for the situation beyond making IBM aware of the problem.  They set the rules.  They can eliminate the requirement to buy any insurance from EH the same way they are changing the other rules.
  

  

IBM Extend Health Buying a Medigap Policy - Easier Said Than Done

Update - 11/21/13 - the insurance agent said she must come back to the house to have us sign our policies for them to take effect.  I asked if she could just mail the policies  but she insisted she needed to bring them to the house.  Here goes another round of let me sell you .....this is just onerous.

I know, I know ... I keep saying that but I shake my head over what IBM has done to all of us.  It's not right.  We made IBM a great company by providing our expertise and labor. Although I am not a Marxist, I do believe our labor had great value and we made IBM prosper by  providing it. In return IBM made a  promise to value our labor via retiree health insurance.  We earned these benefits and now IBM is stealing from us.

Original entry on 10/26/13

My spouse and I bought our medigap policies a few days ago but it wasn't easy to do.  I started the selection process by looking at Extend Health offerings.  As I have said in previous posts, they offered very few choices and the ones they did offer were not from the lowest price products available in my zip code for medigap F high deductible.  So, Extend Health was not a good place for me to buy a medigap.
       
Medigap insurance is what is called indemnity insurance.  To quote Wikipedia -  "an indemnity is a generalized promise of protection against a specific type of event by way of making the injured party whole again."  In the case of a medigap the indemnity is defined very precisely by the particular letter associated with your insurance policy.  Each type of policy (A,B, F, K, L, N ...) specifies when the insurance policy will pay and when it will not pay.  The payment is always secondary to original Medicare and since it only pays as a secondary there is no specification for what medical procedures will be covered - only the degree to which it will cover your original Medicare deductibles and coinsurance (e.g., copays).
    
I wrote that paragraph because people are still anguishing over which medigap insurance company is better or worse or whether the doctor will accept the plan.  There isn't a better or worse and there is no doctor network involved in the payment process .  Every insurance company is issuing EXACTLY the same policy that works in EXACTLY the same way as second payer to original Medicare. CMS automatically sends the claim to the medigap for processing.  The doctor is not involved at all. Therefore, the only way to pick an insurance company is based on PRICE.
      
OK - so I wanted to buy the lowest price medigap F high deductible plan in my zip code.  I looked on www.medicare.gov to find out who offers policies and called the company that sells the lowest premium F high deductible policy several times plus I sent emails. They never returned my calls or responded to my emails. I wasn't surprised as I had heard this same result from several people over the past four years that I have been helping people with Medicare questions.  I don't know why they list as selling the policy and have actually filed a complaint with the department of insurance a year ago but never heard from them either!
  
I was able to reach an agent for the next lowest premium insurance company on my list. The policy was $10/month more expensive.  However, this monthly premium is still $28/month cheaper than the policy Extend Health offered. I had to buy through an insurance agent as it is the only way they sell the insurance.  The agent came to our house to sell us the medigap policy which also did not please me.  I deliberately told her when I made the appointment that I was only interested in buying a medigap F high deductible policy but I suspected she would try to sell us every product offered by the company.  And that is exactly what happened.  We said no to burial insurance, long term care insurance, annuity insurance ..... Try as we might to short circuit the sales pitch she pressed on.  After about an hour of sales pitch we were getting really cranky so she finally filled out the paperwork for us to buy the medigap F high deductible plans.  This insurance company also requires automatic payment out of our checking account which I do not like but kept reminding myself the premium difference for us was $56/month for these 2 policies versus the EH offered polices. Wow, that was so much easier then just going online and enrolling in IBM group insurance!  I wish Dr. Rhee would get a boil for every lie he is telling.  His body would be covered.
   
I also wanted to revisit the math surrounding medigap plans. People are still confused about which plan to pick.  Here is another way of looking at which medigap plan to buy.  I'll use myself as an example.  I am pretty healthy but I have a couple of medical conditions that require monitoring and it seems I end up in ER about once a year for something stupid like a sprained ankle, an infected cat bite or a gall bladder attack.  Even so, my medical bills are typically around $4000/year total. Medicare covers 80% of that so if I did not have secondary insurance I'd pay about $1000/year between copays and deductibles. If I pay a medigap annual  premium of $3000/year to immediately get 100% secondary coverage and only get $1000 worth of payments from the policy it seems to me to be a waste of money.    I'd rather pay $1048/year premium and the $1000 out of pocket.  Especially since the $2048 will be totally covered by my HRA subsidy and I will still have almost $1000 left to use for my part D coverage. 
  
If I really get sick then I know my insurance and out of pocket cost will cap at $3158.  At that point the F high deductible plan will take over.  So, I am betting $158/year that I will stay well.  Not a bad bet.
    

   

IBM Extend Health transition HRA Beneficiary Letter - MAKE SURE YOU GET & READ IT

Update 11/24/13:

Just so you know - you should receive a letter back from IBM confirming your selection. I sent in my notorized form several weeks ago and just received a letter back from IBM confirming my choice of "no survivor coverage". 

On October 14, 2013 IBM sent out a two page flier/letter about the HRA survivor benefit. This letter is a legal document. Make sure you get this very important letter as it affects how much money your will get in your HRA account.
    
Read the letter, then read it again and make sure you understand it.  You need to take overt action on how you want your survivor benefit to be processed.  Here is the crazy part. It doesn't matter if  you are single or married or have eligible dependents --- you MUST take action or, by default, your subsidy will automatically be reduced. I'll say it again because it is rather unbelieveable -----
  

IF YOU TAKE NO ACTION YOUR HRA SUBSIDY WILL BE PERMANENTLY REDUCED EVEN IF YOU DO NOT HAVE AN ELIGIBLE SPOUSE OR DEPENDENTS 

  
In order to keep your entire subsidy - you must elect "NO IBM SURVIVOR COVERAGE",  notarize the form (it is on the back of the two page flier) and mail the form to the Budco processing company by December 16, 2013.   There is a second deadline of January 16, 2014 during which you can submit a form to change your first selection so that gives you the chance to change the default. 
  
 

    

IBM Extend Health Enrollment Experience ---- Update and Confusion

Written on 10/30/13 -- Correction and Update
  
I just got off the phone with a friend who tried to "enroll" in the same drug plan he already has. He was told that he cannot do that because then Extend Health will not be the insurance agent on record and he will not be entitled to his HRA subsidy. He talked to three different EH people and they all said the same thing. He now has to pick a new drug plan because it is still better to do that then to buy an EH medigap plan which is substantially more expensive than what he can get on the open market.

Even though I asked an agent before I enrolled if we could use the same part D plans as we already had and then I asked the enrollment agent again when we enrolled if we could just reenroll in the same plan - they both are wrong. I am told that our enrollment will be rejected. Now, when will they tell us this? Beats me. I was going to just let it go until they caught it but am not sure that is a good idea. I just spent a couple of hours trying to sort through our alternative choices. None of which are great.
 
So, I called Extend Health once I decided on the changes and explained the situation.  The Benefits Agent said there was no need to change a thing as my spouse and I are properly enrolled.  This is insane ---- just insane.  I will just wait it out and see what happens.
  
Written on 10/22/13
       
Today my spouse and I enrolled in Extend Health plans so we can get our subsidies.  The call took approximately one hour and most of that time was spent listening to boiler plate scripts and/or repeating our names and addresses so that we could be recorded for each plan we enrolled into.  We each enrolled in a part D prescription drug plan that we already are using so that we can get our subsidies and we each enrolled in the VSP vision plan. We did not enroll in a dental plan as the one that was offered was worthless.  I told them we did not want to setup any automatic premium payments to be paid out of our checking account for any of the insurance plans but at step 2 of the enrollment process the step 2 agent insisted that it was required by VSP to do so.  I relented and let a one time payment be taken from our checking account for the VSP plan.  Yes, there are two different agents for the enrollment process.  The first agent "helps" select a plan and then you are transferred to a second agent that actually does the enrollment.
  
I asked the first EH agent if they could sell me a medigap F high deductible plan from Banker Conseco as that is one of the least expensive F-HD plans available in my zip code.  They said they could not.  I didn't think they could  but it was worth asking.  I have an appointment with a Banker Conseco agent later this week to buy the medigap plans directly from the insurance company. 
  
I also told the first EH agent that I knew exactly what I wanted and to please skip any discussion of the plans available in my zip code.  They quickly did so and did not try to pursue it at all. I believe that is why our enrollment process only took a hour.  Although the enrollment process went smoothly, it is still a ridiculous process.  There is so much script reading and prerecorded listening to make sure EH cannot be accused of misleading an enrollee that it is truly obnoxious.  At one point as we listened to one of the prerecordings we could hear the agent yawning.  That was a highlight of the whole process!
  
I have been writing much about being sure you know exactly what you want before your enrollment appointment.  My experience confirmed how really important it is to do so. 

IBM Medicare No Grandfathering of HRA reduction for current surviving spouses

I helped someone this morning who is a surviving spouse.  IBM is not grandfathering her subsidy allotment.  They are reducing her subsidy in 2014.  Isn't there something about stealing from widows and orphans that is villian material?  Wow - how low can IBM truly go?  I guess really low.